Lorna Rothery spoke to Olivia Murphy-Fawcett, Head of Sustainability and Social Impact at NHS Shared Business Services, about how the UK’s health system is working to reduce its carbon emissions and reach a net zero NHS
The health service contributes around 4-5% of total UK carbon emissions; can you describe some of the most significant sources of emissions across NHS England?
The NHS is a system with a highly complex emissions profile. In 2021, NHS England (NHSE) mapped its carbon emissions, which accounted for roughly 4% of the UK’s total carbon emissions. It divides these emissions into two core parts – the NHS Carbon Footprint, covering emissions from areas under its direct control, and NHS Carbon Footprint Plus, emissions it can influence through its buying activities (i.e. Scope 3 emissions derived from the value chain).
What’s particularly striking about the latter, which includes medicines, equipment, and supply chains, is that it accounts for about 62% of the NHS’s entire emissions footprint. (1) This presents procurement professionals with a significant and exciting opportunity to make a difference in the reduction of carbon in the NHS.
At NHS SBS, Scope 3 emissions, primarily from the goods and services we use, also constitute the largest proportion of our carbon emissions. As a leading supplier of corporate services to the NHS, it is incumbent on us to collaborate with our suppliers to address them. We have, therefore, adopted a procurement perspective, which is now an integral part of our own Green Plan, to emphasise the crucial role of our suppliers in our emissions reduction efforts. That, in turn, can positively impact not just ours but also the NHS’s net zero goals, and we have been diligently working with our suppliers to accurately assess their emissions.
For the NHS, which will undergo a similar process to us here at NHS SBS, this engagement process can be time-consuming. But there have been some excellent and exciting quick wins for the NHS in reducing emissions, particularly in specific areas of medicine and equipment, such as medical gases, greener transportation, or the overall waste management life cycle – all excellent ways to quickly make changes to reduce emissions.
Waste management has also been a focus area for us at NHS SBS, and we have been exploring various digital solutions and technologies to reduce the environmental footprint of waste in the NHS. To do this, we have worked extensively to identify and onboard innovative suppliers onto our Framework Agreements like our Sustainable Healthcare Recycling & Waste Management procurement framework, providing NHS Trusts with easy access to these solutions.
Net zero NHS: How can emerging technologies and digital solutions support NHS England’s net zero ambitions?
It is crucial for emerging technologies to support the transition to net zero. If we don’t embrace new approaches, the situation will only worsen.
The NHS has made significant progress in improving efficiency, such as implementing LED lighting, leak detection, and energy efficiency systems. While these technologies were once emerging, we’ve seen them become widespread solutions in public and private sectors across the UK, and they will become increasingly important through refurbishment programmes.
Additionally, technologies can support emissions and sustainability from the outset in major programmes. For instance, the adoption of tech-enabled care, which reduces the need for building new wards and allows for better care by supporting patients at home, where they prefer to be. You also reduce the resources that would potentially come into contact with someone in the patient journey. This is why we have created a Virtual Wards combined procurement solution. It enables hospitals to source the tools and technology required to set them up from suppliers we have fully vetted. Patients can then efficiently be discharged, where deemed clinically appropriate, to a virtual ward setting and monitored remotely within the environment.
For healthcare providers, we know it can be overwhelming to understand how new technologies can help when there are so many. So, we have a responsibility to ensure we are bringing the best technology to the market, which has been tried and tested. For example, in our sustainable waste framework, pyrolysis tech was an area we explored, which involves heating material to high temperatures and releasing the energy inside it. The advancement can be utilised to heat the hospital estate rather than disposing of the waste, reducing the costs of waste management and managing logistics. These are important capabilities that NHS organisations can now utilise.
How can NHS hospitals, Trusts and ICSs as a whole measure the progress they are making on their net zero NHS ambition?
Amongst all of this new technology, there is a crucial need to track changes over time and, when new solutions are implemented, see their impact on carbon emissions. This is where data becomes critical. The NHS has done a great job by looking at its baseline, but now, focus is needed on tracking change over time to see the real difference in its carbon footprint.
It’s often Business as Usual to track various data streams, such as bed availability, patient journeys, and so on, but it will be important for the NHS to also track carbon emissions reductions as part of a cultural shift. To help with this problem, earlier this year, our carbon specialists collaborated with Worcestershire Acute NHS Trust to address its Scope 3 emissions, assisting it in managing and analysing its data, identifying the top emitters in its supply chain and taking appropriate action. This involved automating a very labour-intensive process to simplify ongoing tracking so the team could focus on doing the work to reduce on the ground.
Additionally, our carbon mapping tool can support efficiencies and reduce effort in this space. We know that across the NHS, suppliers often work with multiple organisations. Therefore, it’s more efficient to collect data centrally instead of repeatedly asking the same questions. We’ve investigated this for Worcester, comparing the consistency across their Trust to find ways to improve carbon efficiency so calculating emissions can also support wider efficiencies across an area.
Can you tell me about the NHS SBS Green Plan and any key issues that need to be addressed?
At NHS SBS, sustainability has always been core to what we do, but three years ago, we knew we wanted a robust, clear, and strategic plan around our emissions to help us get there. We launched our Net-Zero by 2040 target, which is SBTi verified, and our company-wide sustainability programme, ‘Healthy,’ alongside building our first Green Plan, which outlines our strategic approach to hitting Net-Zero, our roadmap.
For NHS SBS, it’s about integrating sustainability and social value into our strategy rather than just adding it on. This requires strong governance and strong engagement from everyone involved through all layers of the organisation. It’s my job to explain to our teams, our customers, and our suppliers why this is important for them and to bring them on this journey with us. It’s everyone’s responsibility, both in the NHS and at NHS SBS, to reduce our emissions. Reaching Net-Zero by 2040 is a complex goal and requires our teams to be fully on board with us.
In terms of challenges, our key areas of focus over the coming three years will be continuing to use 100% renewable energy, reducing absolute emissions, further supporting our suppliers to reduce supply chain emissions, and exploring greener IT equipment, such as opportunities to refurbish and resell IT equipment to support skills development and reduce waste. These initiatives are part of our commitment to embracing a culture that integrates sustainable practices as part of our everyday operations rather than a separate concept.
As we navigate towards 2040 and look to the future, we will be working to ensure we stay informed about the risks of climate change. We want our focus to be on prevention rather than mitigation. However, we need to be realistic. The world is constantly changing, and climate change is imminent. We want to be aware of the risks to infrastructure, the health system, people’s wellbeing, and the patient journey. Identifying opportunities to prevent these risks from materialising in the NHS and identifying where we can provide support.
What key policy measures are needed to support the health system’s carbon neutrality targets? How important is international collaboration in achieving these targets?
There have been some noteworthy examples of exciting initiatives in this space. One of these is the procurement policy notice concerning carbon reduction plans (PPN 06/21). I cannot emphasise enough how significant this is in creating a level playing field for suppliers who are now required to measure and monitor carbon emissions consistently. This is a major step, as it allows for establishing a baseline and tracking the supply chain’s emissions over time. Equally, it supports suppliers on one journey.
The PPN has been truly game-changing, and we have implemented it across all our framework agreements, aligning with NHS guidance to ensure broader adoption. The NHS has spearheaded this, and we have supported it in this endeavour, focusing on providing guidance and support for small organisations as well. I believe this is an excellent demonstration of effective policy and collaboration in action.
The Social Value Act functions similarly in that it emphasises using policy to prioritise sustainability upfront, reducing the need for extensive work afterwards. Collaborating with organisations like ours can alleviate the burden on suppliers and the NHS, enabling the implementation of the right approach from the start.
Furthermore, the NHS’s Evergreen Assessment, which we’ve actively supported, serves as a means of standardising how suppliers approach their journey towards net zero and assists them in understanding how to enhance their sustainability and social value maturity. However, for all of this to work effectively, everyone needs to be on board. The policy is only as effective as the individuals implementing it.
Collaboration is crucial in achieving net zero NHS, encompassing not only policy and digital solutions but also people, engagement, communication, and education.
Policy is a fundamental component, but it must be reinforced by engagement across all these areas.
