With the NHS generating around 18 million tonnes of carbon and CO2 annually, estates personnel face a considerable challenge in meeting tough Government and EU energy reduction targets while maintaining patient safety/comfort amid predictions of, for instance, hotter summers. A three-year research project, which builds on the conclusions of two recent academic papers examining low energy design and refurbishment strategies for NHS buildings, and the opportunities for low energy ventilation and cooling, is investigating practical ways to adapt the NHS Retained Estate to increase its climate change resilience while simultaneously reducing its carbon footprint.