The PSC news-insights: entry

10/12/2020
Strategy

Digest: What does the new climate plan mean for the NHS and healthcare provision?

In November 2020, the government released its Ten Point Plan for a Green Industrial Revolution - we dissect what this means for the top three causes of carbon emissions across the NHS

The Ten Point Plan sets out ten key priorities for government investment to help the UK re-build in a greener way after the disruption caused by coronavirus.

As one of the largest employers in the world, with roughly 1.5 million employees, The NHS is the UK’s biggest public greenhouse gas emitter, accounting for around 5% of the UK’s carbon footprint.

In this blog, we’ll take each of the top causes of carbon emissions in the NHS – supply chain (62%), its buildings (15%), and staff and patient transport (14%) – and ask what the plan outlines and our take on its likely impact on the NHS net zero carbon targets.


Figure 1 Sources of carbon emissions by proportion of NHS Carbon Footprint Plus (Source: “Delivering a ‘Net Zero’ National Health Service”, October 2020)

 

  1. Supply Chain (62% indirect carbon emission share)

Key takeaways from the plan

The NHS supply chain delivers over 300,000 products to 1,000 different endpoints and underpins the care that can be provided. A large proportion of the NHS’ direct carbon footprint originates from delivery vehicles, including HGVs and ships. These forms of transport, unlike smaller vehicles which can easily run off electric batteries, are better served by hydrogen power due to hydrogen’s higher energy density. Therefore, government investment in hydrogen power and its supporting infrastructure is crucial to enable the shift away from fossil fuel powered goods transport. The plan announces the investment of £20 million in trials of hydrogen and other zero emission lorries and £20 million in the development of clean maritime technology.

The PSC take

Research and development in hydrogen technology responds to a clear need, and the investments announced will likely contribute to the sustainability of the NHS’s supply chain in the medium to long term. Looking at the international scale, the global healthcare supply chain is highly complex and will require a coordinated international response. The next UN Climate Change Conference, COP26, which will be held in Glasgow in 2021, will play a key role in setting international ambition. Many NHS supplies are manufactured outside the UK, which makes securing the buy-in of large manufacturing economies vital. China recently set the ambition to be net zero before 2060, which is an exciting development in this space and will undoubtedly influence global supply chains.

 

  1. Public buildings (15% indirect carbon emission share, including building energy, water & waste)

Key takeaways from the plan

Whilst building energy makes up a relatively minor share of the NHS’ indirect carbon footprint (15%), it is the largest contributor to the NHS’ direct carbon footprint (62.5%). This positions it as a priority issue between now and 2040. Some CO2 is embedded in the fabric of the NHS’ buildings and more is released as a result of energy usage (heat and electricity), water and waste.

The plan sets out the importance of increasing the energy efficiency of new builds and increasing the use of low carbon heating, for example through the installation of heat pumps. Heat pumps allow the transfer of heat from natural sources to thermal reservoirs, making them a sustainable alternative to boilers and traditional central heating systems. The plan also promises to support the growth of offshore wind, low-carbon hydrogen and nuclear power. These three initiatives will contribute to the further decarbonisation of electricity and heat.

The PSC take

The plan addresses a number of challenges facing the NHS when it comes to sustainable estate planning. Ensuring that its buildings are efficient and using renewable energy sources are priorities. It is also important that the estate itself is used efficiently: preventative medicine can reduce the acute need in the population, delivering better health outcomes for patients and reducing demand in acute care settings.

For existing NHS infrastructure, pursuing net zero is also an opportunity to get the balance right between refurbishment, retrofitting and demolishing for new builds. Refurbishment and retrofitting are important options for improving sustainability, as maximising the use of existing assets in building programmes would significantly reduce the carbon impact of these projects. To support this, the UK will need to build up the right skills base for retrofitting and refurbishing, which, if done correctly, can then be exported to other countries facing similar challenges. The Health Infrastructure Programme 2 (HIP2) is an opportunity to make progress and coordinate a national approach that will be sustainable in the long term.

 

  1. Transport (14% indirect carbon emissions share)

Key takeaways from the plan

Patient and staff transport are important contributors to NHS carbon emissions. This is recognised by existing schemes, including car-sharing programmes. However, the emissions associated caused by staff and patient transport would be reduced if all vehicles were electrified.

Point 4 of the plan states that the sale of new petrol and diesel cars will end in 2030 (10 years earlier than planned) and outlines how the UK government will accelerate the shift to zero emission vehicles, for example by supporting the development of the electric battery supply chain in the UK. This could lead to a significant step-down in carbon emissions associated with transport.

Bolstering this, the plan aims to increase the share of journeys taken by green public transport, partly by funding 4,000 zero-emission buses and by electrifying and expanding more railway lines. This could support thousands of NHS staff and patients to reach their place of work or care quickly and with a very small carbon footprint. The aim to deliver more care locally in the future should also enhance this effect.

The PSC take

We believe that new clinical models promoting care at home, locally and virtually will play a key role in reducing healthcare’s travel carbon footprint. More care delivered closer to or at home will reduce the number of journeys made, shortening average journey times. In turn, strong local public transport provision is vital in continuing to support access to local services.

 

What this all means 

The new climate plan is a positive step towards a greener UK economy, and issues associated with NHS direct carbon emissions, such as building energy and transport, are covered quite well. For its indirect emissions, particularly those relating to the supply chain, global solutions at an international level will be required. Global momentum on the need for greener economies is gathering and the UK is pushing this agenda forward. Its latest commitment, reducing emissions by at least 68% by 2030 compared with 1990 levels, equates to reducing carbon emissions at the fastest rate of any major economy.

There is a huge and exciting opportunity for a green recovery post-COVID. We are optimistic that this opportunity to achieve net zero will be fast tracked over the next 12 months and beyond, to catapult the NHS into a more sustainable future, both in terms of emissions, and population health outcomes.

Authors: Eleanor Gibbon and Donato Melchiorre 

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