Carbon Copy: Take two

Trusts at the forefront of efforts to cut the health service’s carbon emissions have begun publishing their new green plans for the next three years.

This week’s Carbon Copy analyses what these plans tell us about the challenge ahead for the many more trusts in the process of drawing up their own new plans.  

All organisations are required to have a “green plan” that sets out how they will reduce carbon over typically a three-period. This is part of the larger NHS drive to reach net zero for direct emissions by 2040, and all others five years later. 

Those quickest to draw up original green plans will see them expire this year, with frontrunner trusts now drawing up the next iteration covering the next three years from 2024 onwards. 

Lessons from the first wave (or trickle) of new green plans

The first trickle of these new green plans are now starting to come out – with many more expected over the next year or so.

Central London Community Healthcare is leading the first wave. And it has big similarities with a recent update to York and Scarborough Teaching Hospitals Foundation Trust’s green plan. 

So, here are a few lessons from them: 

CLCH’s plan, published earlier this year, focuses on energy efficiency, stopping natural gas for heating and hot water and waste as its key pillars.

The trust said it has made progress on its active travel programme, and upgrades such as roof insulation and solar panels.

But it also said some areas had achieved “less than hoped” over the last three years, including estates and waste reduction, hindered by a lack of capacity and resource.

This is a common thread across green plans, and the net zero drive in general:  there is no ringfenced recurrent funding that trusts are receiving for their net zero plans.

CLCH said it had assessed the cost to decarbonise its estates will be more than £14m, which is much less than other others. Bedfordshire has estimated £2bn.

Yet CLCH is still concerned about this amount, stating that it was “possible and even likely” that NHS capital allocations will not meet the task. Rather, they are left to battle it out for a competitive national grants for a “small pot”.

This is a sentiment shared by York and Scarborough Teaching Hospitals FT in their new green plan for the next three years. This replaces a previous one for 2021-2026. 

“Much of the action needed to achieve net zero results in a cost of reducing carbon emissions and this currently has to be borne by the organisation meeting the targets.”

It says money awarded through the public sector decarbonisation scheme is “only the tip of the iceberg”.

The trust adds: “It is hoped that government addresses this matter by providing funding to cover the cost burden for organisations like the Trust.”

It has made good progress, with its direct emissions falling by a fifth since 2019-20 by swapping to a renewable tariff, no desflurane and reducing gas consumption.

Its indirect emissions have dropped to a lesser extent, and the trust says it still has a long way to go on its supply chain, as previously reported on by Carbon Copy.

Becoming more than a ‘nice to have’

Other trusts, such as East London FT, are publishing quick annual refreshes on their plans before their current three-year cycle expires.

This has a greater focus on engaging staff and service users, doing more with green spaces, and embedding sustainability through trust policies and process.

Adam Toll from the trust said it aimed to become more than “a sustainability nice to have” and “threaded through everything we do”.

He said it was “getting there” but added: “It is always a constant sort of battle in a way to keep it relevant and keep it in people’s minds.”

Indeed, this is the challenge for everyone. Whether the NHS is able to achieve this without a bit more breathing space is still up for debate. But financial savings, a range of green initiative like, for example, LED lighting and renewables, would surely help to get the point across.

A constant battle to get net zero viewed as a top priority by boards

Up until now, these green plans have tended to be a mixed bag. The standard contract is sufficiently vague to ensure this, with organisations simply required to have one.

Official guidance is similarly wide-ranging, saying it should set out carbon reduction initiatives and have a board-level lead to drive these. This guidance is however set to expire shortly, with a new version expected imminently.

Moreover, there are mixed feelings among sustainability folk as to how seriously they are taken, and how useful they are.

Some want them to go further, and say it is a constant battle to get net zero agenda on the table still. Others believe their trusts are sufficiently focused on them.

It is understood system leaders want the new green plans to have a greater focus on action – rather than high-level aims – with the net zero drive now properly underway.

But the evidence from the first few new green plans suggests that while there is an ambition for more action, local sustainability leaders are still finding themselves stymied by a lack of funding and struggling to be heard by executives with many other competing priorities.