The condition and design of assets shape how this risk translates into impact. Over half the estate dates from 1946 to 1990, and these buildings were not designed for current climate conditions. They show significant impacts at hazard intensities that newer buildings absorb without consequence. In this context, ageing systems and limited passive cooling are not maintenance issues. They pose financial risks and increase the likelihood of service disruption in a system already operating under pressure.

Dependence on the wider infrastructure system also shapes risk. We modelled cascading electricity failures across the estate and found that buildings can remain physically undamaged yet lose their clinical function entirely if the upstream power supply is disrupted. This shifts the focus from individual asset exposure to system performance.

The challenge is translating this level of understanding into action.

We have addressed this by building an Adaptation Playbook into Resilience Explorer®. This links each building’s risk profile to a structured set of interventions, filtered by hazard, asset type, lead time, and complexity, enabling decisions to be made within the same workflow as the analysis.

This assessment is helping the NHS Property Services Ltd prioritise investment, strengthen resilience and support long‑term clinical service continuity across the estate, as climate risks continue to evolve. The window for cost-effective intervention sits within current planning cycles. Decisions made now will determine how this risk unfolds.