Each week seems to highlight the critical importance of sustainable healthcare solutions, to ready the service for undeniable changes in our climate. Having recognised the emerging threat and defining its Net Zero target timeline, the NHS is now in a pivotal phase for turning ambition into action
Sobering reminders of climate change and continued pressures on our health services have reinforced the significance of delivering against net-zero targets. The NHS has set itself two targets for delivering net zero carbon healthcare and aims to be the world’s first net zero national health service.
The NHS has made significant progress in its advancement for sustainable healthcare this year
At the beginning of the year, NHS England announced the decommissioning of desflurane by early 2024. Desflurane is a volatile anaesthetic used for surgery, but it has a global warming potential 2,500 times greater than carbon dioxide. The commitment and progress made in 2023 build upon the continued hard work of anaesthetists who had already successfully reduced desflurane from 20% of all anaesthetic gases to just 3% over the last five years.
From April 2023, all new contracts above £5 million per year require suppliers to publish a Carbon Reduction Plan for their UK Scope 1 and 2 emissions and a subset of Scope 3 emissions as a minimum (aligning with PPN 06/21). This is the latest driving force embedding net zero commitments within procurement.
Moreover, a wealth of guidance and toolkits has been published to educate, guide and embed net zero within the NHS. These include the Carbon Literacy toolkit, which provides resources to engage staff in national net zero policy and encourage low carbon actions; the Net Zero Building Standard, which provides technical guidance to support the development of sustainable, resilient, and energy-efficient buildings; and the newly published NHS Net Zero Travel and Transport Strategy, the latest roadmap to support NHS bodies to achieve a zero-emission fleet by 2040.
Funding for heat decarbonisation
With NHS buildings contributing 15% of the total NHS carbon footprint, reducing emissions from hot water and space heating systems, which account for 80% of NHS greenhouse gas emissions, and improving the energy efficiency of the ageing estate will be essential. Stringent limits on capital budgets, however, mean ICBs and Trusts must source external backing through funding rounds such as the Public Sector Decarbonisation Scheme and the Green Heat Network Fund.
Feedback on the award process has highlighted concerns over allocations being made on a first-come, first-served basis. As the policy landscape evolves and with a general election likely in 2024, increasing green funding opportunities for the NHS will be crucial to deliver heat decarbonisation and reach its net zero goal.
Increasing climate resilience
As global temperatures rise and extreme weather events become increasingly common, the need for climate-resilient health systems has never been more important. Risk management and adaptation will, therefore, play a vital role in protecting the NHS from climate-related hazards.
The World Health Organisation has recently published the Operational Framework for building climate-resilient and low-carbon health systems. This, along with the publication of the third National Adaptation Plan, reinforces the magnitude of embedding climate adaptation and resilience in existing and new building infrastructure globally.
Of climate change hazards, heat stress presents a key risk, with the summer heat waves of 2022-23 highlighting the vulnerabilities present within again building infrastructure, with a third of the estate having been built before 1965 and designed to keep heat in when the climate was cooler. Employees, patients, and visitors are regularly experiencing heat stress and the NHS faces many obstacles in attempting to reduce its impact. The population continues to require self-help about how to keep cool and hydrated, placing more demand on the service, and there is an economic disconnect between government, developers and retrofitters, with different agendas and motivations.
Addressing these challenges and safeguarding healthcare systems from climate risks will become a much more pressing matter for the NHS in 2024.
Prioritising and embedding Social Value
Alongside emissions reduction efforts, social value continues to be a high priority on the sustainability agenda for the NHS. Driven by the public procurement note (PPN 06/20), social value delivery within the NHS’ supply chain provides a mechanism to align targets, obtain Scope 3 footprints and deliver additional value to the communities served by national healthcare.
Investment in social prescribing
Another key initiative is social prescribing, which presents a significant opportunity for public health benefits through engagement with ICBs and their systems. This alternative treatment method aims to reduce demand for healthcare facilities and strengthen community support. Non-pharmaceutical medical interventions, such as green social prescribing, also work to address the importance of being outdoors for people’s mental and physical health. Social prescribing is important to reduce pressure on the existing NHS services but also increase focus on preventative care (such as treating pre-diabetics through lifestyle changes to prevent diabetes). Continued investment into robust community care and support will be key for NHS sustainability in adopting joined-up, efficient and low-carbon care models for the future.
Increase innovation for sustainable healthcare
Continued investment into technologies and processes will be a point of focus within the healthcare sector. In 2023, the National Institute for Health and Care Research partnered with UK Research and Innovation to launch the £30 million programme ‘Realising the health co-benefits of the transition to net zero’. Award of the successful researchers in 2024 and further funding is expected to identify the carbon impact and material waste associated with emerging health and social care delivery models and pathways.
To maintain momentum and progress against Trust Green Plans, 2024 is expected to be a year of shared learning and innovation, keystone commitments and data-driven action. As technology advances, so must the speed of access to capture the carbon benefits that arise. Similarly, suitable funding and commercial solutions must be brought back to the NHS to allow full benefits to be unlocked.
The efforts of NHS staff across the country have proven the potential and scalability of several solutions. Now is the time to commit and reap the associated wider societal, environmental, and economic benefits.
This piece was written and provided by Jessica Brown, Senior Sustainability Consultant at Lexica.
