NHS sets new goals as trusts battle to meet carbon reduction targets

Published: 1-Feb-2013

New five-year strategy to include social care bodies and look at whole systems, not just energy reduction

NHS trusts and patients are being consulted over plans to drive improvements in sustainability across the health and social care sector as it becomes increasingly unlikely Government targets for a reduction in carbon emissions will be met.

The NHS Sustainable Development Unit (SDU) is planning to bring out a new five-year plan next January to replace the NHS Carbon Reduction Strategy, which was launched in 2009.

Assuring a sustainable health, public health and social care system is one of the greatest and most important challenges of our time and our vision and ambition should match the scale of this

That document set NHS trusts a target of reducing carbon emissions by 10% by 2015 based on a 2008 benchmark.

However, recent figures show that, even though there has been a 1.9% reduction in building energy use, an 18% reduction in waste, and a 1.4% drop in water use, the NHS will need to cut their carbon footprint by a further 4.6% by 2015 to meet the strict targets imposed by the strategy and the Government’s wider Climate Change Act .

To drive these improvements, the SDU has this week begun a five-month consultation on the replacement strategy, with the recommendation that it increases its scope to include, not just the NHS, but public health and social care systems as well.

In a joint statement, Sir David Nicholson, chief executive of the NHS Commissioning Board, and Duncan Selbie, chief executive of Public Health England, said: “Assuring a sustainable health, public health and social care system is one of the greatest and most important challenges of our time and our vision and ambition should match the scale of this.

This is an ideal moment to look at the way we deliver services across the entire system to make them more sustainable and to ensure we support people through their life journey

“We have a clear responsibility to take a leading role in tackling climate change and have a genuine opportunity to influence change for our patients, service users and the public.

“We must align, integrate and co-ordinate a whole system approach to health and care that ensures the future is more environmentally, financially and socially sustainable.

“This is an ideal moment to look at the way we deliver services across the entire system to make them more sustainable and to ensure we support people through their life journey.

A sustainable healthcare system must do more than focus on carbon. It must also consider how to minimise other negative impacts, for instance by reducing waste and harmful environmental or social impacts

“Together this is our opportunity to set challenging, yet achievable, sustainable development goals that we wish to be accountable for making happen.”

Covering a five-year period to 2020, the revamped strategy will help in understanding how and where to focus efforts to deliver more financially, socially and environmentally sustainable care. The current consultation is asking for feedback from patients, service users and wider communities, health trusts and their partners, local authorities, and representatives from the third sector.

It asks seven key questions.

  • Is a new strategy needed to co-ordinate and guide action to 2020?
  • Which elements of the health and care system should be included in the scope of the next strategy?
  • Should the health and care system set itself challenging ambitions with regard to sustainability, such as legal, regulatory and policy mandated milestones?
  • Should sustainable development be measured more broadly than through carbon reduction only?
  • What areas of sustainable development need to be prioritised in the next strategy?
  • What areas of research need to be prioritised to enable a more sustainable health and care system?
  • Are there any questions, issues and opportunities missing from this consultation document?

Technology has the power to transform the care experience by changing how the health and care system interacts with patients, service users and communities; how we monitor health; and how we deliver interventions

The consultation document states: “Reducing carbon emissions must be a core component of any future strategy. However, a sustainable healthcare system must do more than focus on carbon. It must also consider how to minimise other negative impacts, for instance by reducing waste and harmful environmental or social impacts. At the same time, it must take the opportunity to maximise the positive impacts of delivering care by adding value at every point and by making every effort to enhance health and reduce the need for services in the first place.”

It is expected NHS trusts will embrace the proposals, with a recent RAND survey, commissioned by the NHS, revealing that 90% of NHS leaders actively engage with sustainability and are keen to identify how to make progress. An Ipsos MORI poll also showed that 90% of the public wants the NHS to work more sustainably. In addition, 31% of NHS trusts currently include sustainability in staff job descriptions, 37% run energy awareness events, 80% have published a board-approved Sustainable Development Management Plan, and 53% have signed up to the Good Corporate Citizenship tool.

Highlighting the interventions most likely to have the biggest impact on sustainability moving forwards, the consultation report says better use of medical technologies will be key.

While trusts have been quick to take advantage of ‘big hit’ investments such as combined heat and power and solar power technologies, telehealth and telecare devices could have a major effect on whole system efficiency over the coming years, it states.

It adds: “Technology has the power to transform the care experience by changing how the health and care system interacts with patients, service users and communities; how we monitor health; and how we deliver interventions. For example, telehealth can often give people much more understanding and control over their own care.

The proposal is to encourage organisations to incorporate environmental and social impacts and benefits into their evaluations of designing better services for patients, service users and the public

“Even though telehealth is increasingly being used across care services, the link between technology use and how to enable more sustainable models of care is not as well described in terms of aligning the financial, environmental and social benefits.

“The proposal is to encourage organisations to incorporate environmental and social impacts and benefits into their evaluations of designing better services for patients, service users and the public.”

It also calls for a more structured response to climate change and the effect this will have on public health and wellbeing; and better evaluation of specialist healthcare service models, such as current chemotherapy pathways.

To access the consultation report, click here.

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