| ABSTRACT 
         The environmental 
        performance of National Health Service Scotland's (NHSScotland) smaller 
        healthcare buildings were investigated with a view to identifying ways 
        of reducing the environmental impacts of energy, waste, water and transport. Energy emerged as 
        one of the prominent issues. This was based on data taken from an energy 
        audit of 180 buildings randomly selected from all NHSScotland health boards. 
        A wide variance in energy consumption throughout the sample was discovered, 
        which could not be explained by variations in fabric, structure, elevation 
        and orientation of the buildings. It was believed a benchmark or similar 
        suitable energy target could be an appropriate tool to help lower energy 
        use in buildings of this class. Therefore, based on Building Research 
        Establishment (BRE) baseline and good practice data for similar buildings, 
        and including an allowance for patients' needs, an energy target was developed. Research into waste 
        and water issues showed that the disposal of prescription, and over the 
        counter, medicines is highlighted as a problem area in Scotland. The research 
        showed there could be over 300 tonnes of medicines being disposed of in 
        Scotland every year with over 40% of these flushed into 
        sewerage systems where sewage treatment plants have no means of removing 
        them before emitting them into surface water systems. |  |  
          The 
          impacts of these pharmaceuticals alone can have serious adverse affects 
          on non-target species but there is little known about the effects cocktail 
          mixtures of these chemicals may have on the environment. Further 
          research was carried out on the awareness of management and staff of 
          environmental issues and their behaviour towards such issues while at 
          their place of work. Results 
          from a randomly selected group of 71 health centres and clinics showed 
          that many healthcare workers who responded believe that climate change 
          is happening with the majority of those blaming human society as the 
          main cause; many also believe the trend can be reversed. A high proportion 
          of respondents believe that power generation contributes to impacts 
          on human health.  Given 
          that NHSScotland's negative impacts on the environment are substantial, 
          due mainly to poor environmental performance, investigation was carried 
          out into how best to approach changing the culture within the organisation 
          to help reach environmental targets and become sustainable in the long 
          term. |