The PSC news-insights: entry

18/11/2020

What does a Net Zero National Health Service mean for NHS organisations?

In partnership with AECOM, we brought together a roundtable of guests from across the healthcare system to discuss how the new targets are affecting them and how they can best prepare their Trusts for Net Zero.

The NHS’ Net Zero announcement in the ‘Achieving a Net Zero National Health Service’ report was bold, ambitious and… left a lot of questions unanswered.

We knew from conversations with our clients, colleagues, and leaders in this space, that people working at NHS Trusts across the UK still wanted to know: how these targets affect them and how they can best prepare their Trusts to reach them.

We partnered with the global infrastructure consulting firm, AECOM, to host a roundtable to bring together experts who could shed some light on these questions. Our roundtable was Chaired by Lord Bob Kerslake, former head of the Civil Service. On our panel were:

• Dr Marina Romanello: Data Scientist at the Lancet Countdown for Health and Climate Change

• David Cheshire: Regional Director within AECOM’s Sustainable Development Group

• Samuel Rose: Capital investment and sustainability lead at The PSC

What does a Net Zero National Health Service mean for NHS organisations?

Our audience were representatives from across the healthcare system, including Commissioners and Providers who will sit at the heart of implementing these Net Zero targets.

For a full analysis of what is in the Achieving a Net Zero National Health Service Report, read our previous ‘Digest’ blog that breaks down everything you need to know about the NHS’ announcement last month.

The result was a fascinating discussion that offers some practical guidance for how health systems can approach the targets. We’ve pulled out some of the key questions from the audience that we think address some universal concerns - read on to see how our experts answered them.

  1. Is there a correct order of interventions to deliver Net Zero targets?
  • Many interventions need to happen in tandem to achieve the order of carbon reduction required under the ambitious NHS targets. Interventions should occur simultaneously to improve NHS estates; energy supplies; supply chains and clinical pathways.
  • The key is to reduce your carbon emissions before doing anything else – a lower threshold makes it easier to achieve targets
  • It’s important to ensure real time data collection and carbon management is in place to measure impact.

 

  1. How can health systems play a key role in the transition to a Net Zero NHS?
  • They will play a key role in leading the transition to a Net Zero health service.
  • Health systems and providers are anchor institutions within local areas – geographically spread across the whole country, they are key drivers of the local economy with large influence on local travel and health.
  • Systems are key in delivering innovative clinical models through integrated care. There is strong alignment between the Long Term Plan objectives (integrated models of care, close to help, with a greater emphasis on preventative care) and sustainability initiatives to reduce carbon emissions.
  • Reducing the need for acute healthcare is the best approach to reducing emissions. Health systems will continue to play a key role in driving this at a population level as they mature as Intergrated Care Systems (ICS) and there is a shift towards preventive care closer to patients’ homes.

 

  1. What data should NHS Trusts be looking to get in order to properly track progress?
  • Following the ‘Achieving a Net Zero National Health Service’ report, the next phase of work for the For a Greener NHS team is to engage Trusts and ICSs in developing plans for how they can realistically achieve the Net Zero targets.
  • Key to this will be for Providers, and whole systems, to have a good understanding of their carbon-footprint data. They should track progress using:
    • Meter readings for energy consumption
    • Waste and water management data
    • Composition of fleet vehicles
    • Understand patient/ visitor/ staff travel
    • Data on ambulance use
  1. How much of the Net Zero target can be achieved through behaviour change?
  • The transition to a Net Zero NHS requires changes across the NHS’s estate and operations.
  • Behaviour change, including travel and delivery models, could lead to up to 20% reduction in carbon emissions.
  • One of the limitations is that these behavioural changes are one of the hardest things to implement. Changing the ways and modes of travel could lead to up to 10% reduction in emissions, but on average it is 4%.
  • Innovative clinical models at a system level are key - they provide integrated care close to home, with a focus on preventative care to minimise the demand for acute services.
  • Large investment over an extended period is required to get all the way to zero.

 

  1. How much of a priority is Net Zero seen at board level across NHS Providers? And how can we address the economic concerns over Net Zero?
  • There is a sense of mixed progress across Trusts, and a central theme of the discussion was concern over delivering Net Zero.
  • There was useful insight from attendees – one rep said that the sustainability agenda is seen as an essential part of hospital redevelopment.
  • There remains the old paradigm at board level of needing to justify sustainability economically (although moral paradigm is clear). If the economic paradigm does not change, it will keep hindering the argument for Net Zero.
  • It's always an uphill battle whereby the business case doesn't necessarily stack up in terms of the carbon reduction measure, and if it's not the cheapest option in a cash-strapped NHS it may not get through. Is a new carbon tax inevitable? Could this be applied internally to NHS operations?
  • A potential approach, posed by Dr Romanello, to solving the economic argument is quantifying the health benefit of decarbonisation. This is something she is looking into.  

 

As always, we’d love to hear your thoughts on delivering Net Zero – the challenges you’re facing, recommendations, or experiences in this area. If you’d like to chat with us, drop Louis a note at louis.jamart@thepsc.co.uk.

Authors: Samuel Rose, Louis Jamart 

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