Healthcare: BREEAM requirement

From 1 July 2008, all health authorities in the UK (Department of Health, NHS Wales, NHS Scotland and the Department of Health Social Services and Public Safety of Northern Ireland) require new healthcare buildings seeking Outline of Business Case (OBC) approval to commit to an EXCELLENT rating (assessed against BREEAM New Construction) and all refurbishments (assessed against BREEAM Non-Domestic refurbishment and fit-out) to commit to a VERY GOOD rating.
In Scotland, project specific requirements in relation to the BREEAM assessment will be dealt with by Health Facilities Scotland as part of the NHS Scotland Design Assessment Process.

UK health authorities capital cost thresholds below which a BREEAM assessment is not required:
England: where capital cost1 is <£2M.
Scotland: where capital cost1 is <ÂŁ2M.
Note: For NHS Scotland Boards, reference should be made to the Scottish Capital Investment Manual (available on, especially the business case guide, which sets out the BREEAM requirements for Healthcare buildings.
Northern Ireland: where capital cost1 is <ÂŁ2M.
Note: In Northern Ireland, listed buildings do not require assessment.
Wales: No minimum capital cost1 thresholds, however the Welsh Governments Planning Policy for all non-residential development applies.

All Countries: Where the capital cost falls below the relevant threshold, a Pre-Assessment should still be undertaken (at the OBC stage) to determine whether BREEAM certification is appropriate to that project.

1. Total Capital Cost for Publicly Funded Build Schemes includes all the items contained in the Capital Investment Manual Cost Forms OB1/FB1 (i.e. Construction Works, Fees, Non-Works Costs, including Land Purchase, Statutory and Local Authority Charges, Decanting, Enabling and Temporary Works etc., Equipment, Contingencies, including Optimism Bias, and VAT, as applicable). The Total Capital Cost for Privately Funded Schemes includes all the same items as for Publicly Funded Schemes plus the cost of Financing the Capital (i.e. rolled up Interest, Banking Fees – Arrangement, Due Diligence, Lawyers etc.
– Third party Equity Costs).