Hospitals are controlled yet complex ecosystems which provide a therapeutic
environment that promotes healing, wellbeing and work efficiency for patients and staff. As these
buildings accommodate the sick and vulnerable, occupant wellbeing and good indoor
environmental quality (IEQ) that deals with indoor air quality (IAQ), thermal comfort, lighting and
acoustics are important objectives. As the specialist nature of hospital function demands highly
controlled indoor environments, this makes them energy intensive buildings due to the complex
and varying specifications for their functions and operations. This paper reports on a holistic
building performance evaluation covering aspects of indoor air quality, thermal comfort, lighting,
acoustics, and energy use. It assesses the performance issues and inter-relationships between IEQ
and energy in a new building on a hospital campus in the city of Bristol, United Kingdom. The
empirical evidence collated from this case study and the feedback received from the hospital staff
help identify the endemic issues and constraints related to hospital buildings, such as the need for
robust ventilation strategies in hospitals in urban areas that mitigate the effect of indoor and
outdoor air pollution and ensuring the use of planned new low-carbon technologies. Whilst the
existing guidelines for building design provide useful instructions for the protection of hospital
buildings against ingress of particulate matter from outdoors, more advanced filtration strategies
may be required to enact chemical reactions required to control the concentration levels of
pollutants such as nitrogen dioxide and benzene. Further lessons for improved performance in
operation and maintenance of hospitals are highlighted. These include ensuring that the
increasingly available metering and monitoring data in new buildings, through building
management systems, is used for efficient and optimal building operations for better IEQ and
energy management. Overall, the study highlights the need for an integrated and holistic approach
to building performance to ensure that healthy environments are provided while energy efficiency
targets are me