Putting the green into green wing

New NHS strategy aims to lead the way on sustainability

From low-carbon buildings to swapping bottled water for tap, the NHS has published a carbon reduction strategy designed to slash its footprint and meet tough 2020 targets.

At 18 million tonnes CO2 per year, the NHS carbon footprint has increased 40% since 1990. Now the NHS Carbon Reduction Strategy For England sets out plans to cut emissions in stages as follows:

• 10% by 2015
• 26% by 2020
• 80% by 2050.

It promises tight energy efficiency standards and rigorous carbon management, with “regular board-level reviews” to keep it all on track.

“If you focus on energy usage, you’ll only be hitting about 20% of the carbon footprint,” explains Dr Dave Pencheon, Director of the NHS Sustainable Development Unit (SDU).

“So if we’re really going to fulfil our aspiration of being an exemplar sustainable and low-carbon organisation, we need to work across travel, transport, food, procurement and energy.”

Procurement is key: buying goods and services is responsible for nearly 60% of the NHS carbon footprint. Every organisation, says the strategy, “needs to consider their approach to commissioning, sourcing and buying”. This includes considering whether new items are even needed, and looking for reused or recycled options where appropriate.

When it comes to food, says Pencheon, “we know the provision of high-meat diets is carbon intensive and environmentally destructive – and it’s not particularly good for human health to overindulge in high saturated fat”. So this could lead to fewer meat and dairy dishes on the menu, and more sustainably sourced fish.

All new NHS buildings should aim to be ‘low-carbon’ by 2015. While giving no set definition of the term, Pencheon says this would mean “significant measurable reductions” to help meet the Government’s aspiration of zero-carbon status for all public sector buildings by 2018. There will be greater emphasis on designing buildings to encourage sustainable behaviour. “If you work in a hospital and it’s too hot, and there are no building controls around, you simply open a window and waste the energy,” says Pencheon. “So giving people access to thermostats is one example.”

Water, too, “should be managed as a precious resource”, says the paper. The first step, adds Pencheon, is to measure and cost use. Water-saving moves could include tap water (rather than bottled) for onsite meetings, speedy identification of leaks, water efficiency technology and recycling. ‘Scrubbing up’ could get smarter, too: research at two Glasgow hospitals revealed that of two types of tap used for surgical scrubbing – ‘knee on’ and ‘elbow on’ – the former helped save 5.7 litres of hot water, and approximately 80g CO2, per scrub.

There’s a powerful economic incentive for action, says Pencheon: “Even if you’re only saving a few thousand pounds [through reduced energy bills], that’s money that could be going into direct patient care.”

“It’s really good to see the NHS are waking up to this,” says Helen Clarkson, Deputy Director of Forum for the Future. “Making it happen is the real challenge, so we’re working with them to look at delivering on it.” The key, she says, is not to stop at ‘tweaking’ existing practices.

She’s currently working with the NHS SDU, looking at how the healthcare system needs to be adapted to prepare for climate change. And work is under way with the Sustainable Development Commission on a vision for a sustainable healthcare system, as part of the evidence base for the Marmot review of health inequalities commissioned by the Government.

The sheer size of the NHS means that if it does get sustainability sussed, the impact could be huge. “It’s the biggest employer in Europe,” says Clarkson. “If you could persuade everyone who works there to start thinking about sustainability, the impact on awareness levels would be massive.” – Claire Baylis

29 May 2009

Claire Baylis