Facilities: Implementing the NHS carbon reduction strategy

Modest would not be the word to describe the ambition set out in Saving Carbon, Improving Health, the first NHS carbon reduction strategy. With the health sector, like every other, facing the challenges of climate change, carbon taxation, a terminal decline in global oil production and a legally binding target for cutting emissions by 80 per cent by 2050, it would appear to be the only sensible option.

Committing the NHS to lead the way for the public sector in low carbon and sustainability, the strategy sets out some demanding challenges. In just six years from now, and five years before the 2020 reduction target of 26 per cent set in the Climate Change Act, the NHS has determined to reduce its own 2007 carbon footprint of 18 million tonnes of CO2 by 10 per cent.

Furthermore, as the report points out, achieving this would require the service to reverse a trend that has seen its carbon footprint grow by 40 per cent since 1990 and is set against forecasts, under current practices, of a carbon footprint of nearly 23 million tonnes of carbon by 2020.

Simply put, for the NHS to meet the Climate Change Act 2050 target it will need to reduce its 2007 carbon footprint by 86 per cent.

If achieving the ambitions of Saving Carbon, published in January, were just a question of hearts and minds much of the job would already be done. Consultation on the draft strategy attracted responses from two of every three NHS organisations, almost all of which supported the service taking a lead on the low carbon and sustainability agenda. Most also felt that carbon reduction measures in the draft needed to be tougher and that performance in this area should be measured and managed as part of a trust or authority’s core business.

Thanks to research by the NHS Sustainable Development Unit, the team that produced the strategy, those same organisations will be able to derive an initial idea of how their own full consumption based carbon footprint might break down. What the calculations found is that of the total NHS footprint 22 per cent of the carbon emissions are created by building energy while 18 per cent come from staff, patient and visitor travel. Surprisingly perhaps 60 per cent of emissions are from procurement.

“When it comes to developing a trust wide carbon and energy management plan the first thing the leadership should be looking to is raising awareness,” says Sustainable Development Unit director David Pencheon.

“Organisations that do carbon management well address it as a corporate issue. Staff need to know this isn’t just important because it forms part of a political strategy. As well as laws to be obeyed there are more practical considerations, such as saving money and improving health. Cut transport related air pollution and people with chronic airway conditions soon start feeling better,” says Dr Pencheon.

“A large hospital might understand its total energy bill, but it won’t understand so well in which parts of its buildings that energy is being used. So, along with improved awareness there is a good case for smarter and more local metering and monitoring.

“That isn’t easy and it takes investment. But when you have a better picture of your energy consumption and can look at contrasting and similar units such as theatres, intensive care and general wards you can not only manage it but also get staff involved, even bringing a competitive edge to carbon reduction.”

The focus for early sustainability action can almost be entirely driven economically and should be directed at direct energy use, advises Dr Pencheon. This is where it will have the most immediate effect. Once a trust has got a baseline energy consumption measurement, across a wing for example, and then converted it to low energy lighting it can demonstrate to the board how quickly the thousands invested were recouped before roll-out across the whole site.

Carbon management

The Carbon Trust, just one of several agencies or groups that public sector organisations can get low carbon guidance from, runs a carbon management programme that has already attracted the participation of several trusts.

“The appointment of at least one person to a dedicated energy and carbon management role makes a significant difference,” says Carbon Trust public sector manager Tim Pryce.

“It means there is someone who has the time as well as the expertise to get a good handle on baseline direct fuel emissions, identify low carbon technology and equipment and energy saving campaigns that can be introduced and draw together a cost-effective timetabled plan with a carbon reduction target for the board to back financially and sign off.”

Mr Pryce notes that trusts that have taken a lead on this and already shown good results are now starting to look more closely at how much carbon there is in their purchasing practices and consider new contracts and build projects.

“It pays to keep the whole organisation informed about the steps being made towards carbon reduction targets, how much money is being saved, what sustainable technology features have gone into a project and what this means for overall progress,” says Mr Pryce. “With these kinds of messages in place it makes it easier to get staff to think about their own behaviour and how they too can contribute to and be responsible for energy management.”

One trust with a proven track record in sustainability and an HSJ Award under its belt is Nottingham University Hospitals trust. Its sustainable strategy, which takes a holistic approach and enjoys board level support, includes a bus service between town sites that has replaced 500,000 car journeys.

Trust land and property manager Jo Tomlinson says: “While we know how much carbon something like the bus might produce, like much of the rest of the NHS and industries beyond there are many areas, some where more complex medicine is practised, where too little about usage is known.

“We will see what we can learn from the Sustainable Development Unit and the Sustainable Development Commission and try and take some baseline data from BREEAM [Building Research Establishment environmental assessment method].

“We will also run a survey across the whole of the campus to develop our understanding and support our new energy and waste strategies,” she says. “And we will appoint a sustainable development manager in the near future to drive all that work forward.”