Around the globe and within every industry, the pressure to tackle the climate emergency continues to mount.
The healthcare industry, however, has a greater incentive than most, with rising global temperatures predicted to result in water scarcity, food insecurity, extreme weather, and even an increase in infectious diseases.
So global health systems will need to adapt to deliver high-quality services and respond to these evolving circumstances.
The commitment made
Two years ago, the NHS set two key targets: net zero by 2040 for direct emissions; and net zero by 2045 for emissions along the value chain, including goods and services bought from partners or suppliers.
This was an ambitious commitment and five years ahead of the UK’s wider net zero target, which currently stands at the year 2050.
To understand whether the NHS is on track to meet these objectives, we need to better understand its key stakeholders and the appropriate stakeholder management strategy
To understand whether the NHS is on track to meet these objectives, we need to better understand its key stakeholders and the appropriate stakeholder management strategy.
Internal NHS functions, such as HR, procurement, estates and facilities, IT, and the community of medical personnel, clearly have a part to play in lowering its carbon footprint, but the impact of external players like suppliers and patients cannot be understated.
A variety of factors that are outside of the NHS’s immediate control also significantly affect the size of the challenge.
On a macro scale, global events like the COVID-19 pandemic and the war in the Ukraine may temporarily derail net zero efforts, although conversely, they can both also be used to frame the importance of sustainability.
In the private-sector supplier base, attitudes towards the value of net zero investments are already varied and, as recession bites in the UK and globally, there may well be shelving of these investments and net zero initiatives.
Lastly, the current and increasing healthcare demand, with a depleted and fatigued workforce in the NHS and limited cash resources, threaten to further squeeze the time that can be committed to net zero initiatives.
Ultimately, regardless of the pressures, the key will be to ensure the value of net zero investments is well articulated among all NHS stakeholders, and for the NHS to take more of a long-term holistic view at both an organisational and individual level.
Is the NHS on target?
The NHS clearly cannot rely on national net zero policies in hitting their own target, as the national 2050 net zero target is not only five years too late, it also doesn’t consider the full international supply chain.
In October 2021, the NHS reported that it expected to cut total emissions in 2021-22 by 1260 kilotonnes of carbon dioxide equivalent (ktCO2e), which would put it well on track to meeting the original 2045 goal just one year after setting the objective.
In the private-sector supplier base, attitudes towards the value of net zero investments are already varied and, as recession bites in the UK and globally, there may well be shelving of these investments and net zero initiatives
These reductions were expected as a result of changes to its own operations and practices, including energy efficiency, lower carbon heating system upgrades, reductions in and the electrification of travel, and a switch away from high-carbon anaesthetics.
By 2022, all NHS trusts had Green Plans in place, and the Health and Care Act 2022, introduced in July, made the NHS the first health system to embed net zero into legislation.
This Act brings the guidance within the ‘Delivering a Net Zero National Health Service’ into statute, affecting all integrated care systems, NHS providers, and suppliers.
The NHS will also go one step further by launching a sustainable supplier assessment to its 80,000 suppliers in early 2023. This will evaluate and rate where suppliers are in their sustainability and net zero journey.
NHS supply chain partners are at various stages in their journey to net zero
Mitigating the risks and grasping the opportunities
When it comes to actioning net zero along the supply chain, the NHS is challenged by a lack of data and, therefore, confidence in forecasting and decision-making.
Moreover, it is already evident that there are large disparities in expertise and approach to applying net zero in procurement across the hundreds of NHS providers, a reflection of the challenge in changing overall mindsets to focus on the value of net zero initiatives.
Disparity in net zero ‘maturity’ and context is also evident and magnified across the 80,000-strong supply chain, with suppliers spanning many different product and service categories and at various stages of the net zero journey.
To mitigate these operations, procurement, and supply chain risks, the NHS needs to introduce advanced training and common standards, methodologies, and tools.
There should also be a continued commitment to the net zero roadmap and more focus on circular economy practices.
The goal must be for net zero to be considered alongside effectiveness, efficiency, and economic factors in service planning and delivery
Additionally, the NHS needs to consider the upskilling of all its staff communities, reflecting the external policy and standards landscape, to embed net zero thinking universally.
The goal must be for net zero to be considered alongside effectiveness, efficiency, and economic factors in service planning and delivery.
Actioning the change
To deliver on these long-term net zero goals, there is a holistic approach required by all healthcare stakeholders.
Initiatives need to span all service planning and delivery aspects, focusing on reducing direction emissions from energy and travel, as well as wider environmental and sustainable development goals through the supply chain.
In order to avoid unexpected roadblocks, more sustainability training is necessary, and both the NHS and its supplier base must balance cash-positive carbon reduction initiatives with cash-negative initiatives.
The importance of government action cannot be understated.
The Government should take note of the value of investing in net zero and the long-term health benefits that will result.
With budgets permanently low, government funding should focus on quick wins such as mindset and process changes – particularly centred around how net zero initiatives will prevent long-term ill health – in addition to existing infrastructure investment such as the recent funding announced to boost low-carbon heating in the public sector.
If all staff and supplier stakeholders can be aligned, collaborating to improve efficiency and elevate environmental performance, the NHS will be a lot closer to reaching its net zero goals and futureproofing its infrastructure.
