This paper aims to review the state of the art technologies for the energy efficiency within the hospitals sector. Hospitals are liable for an unstable amount of energy demand and joint emissions, because of their 24/7 nature of operation and hence resulting larger energy consumption than a typical commercial building. Additionally, they need high quality and warranted supplies of electricity. Due to increased energy demand and therefore the depletion of existing fossil fuel based sources, it is required to use the energy more efficient.

Cooperation between public and private sector has achieved a remarkable widespread, in the Italian context, over the last two decades. Nevertheless, the increasing difficulty in accessing the capital market and the rising cost of funding sources, both noticeable over the past few years, led to a slowdown of Public–Private Partnership (PPP) initiatives. Meanwhile, the community is expressing new needs to be satisfied, such as the conversion of brownfields, the recovery of housing stock dating back to former times, as well as the refurbishment of public offices or schools.

To address challenges associated with climate resilience, health and well-being in urban areas, current policy platforms are shifting their focus from ecosystem-based to nature-based solutions (NBS), broadly defined as solutions to societal challenges that are inspired and supported by nature. NBS result in the provision of co-benefits, such as the improvement of place attractiveness, of health and quality of life, and creation of green jobs.