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Foreword
Sustainability is a critical part of the future of the NHS. How we adapt to our responsibilities as a provider organisation and the way in which we work, will have a huge impact on the carbon footprint of every individual we come into contact with not only as a Foundation Trust, but also as a major employer in our area. That is why we are reviewing how we can deliver our services now, and in the future, in a more sustainable way.
We continue to support the national Government targets to reduce carbon emissions by 2040, and every individual within our organisation has a part to play in helping us achieve this. From the heating, lighting and power supplies within our hospitals, to the use of recyclable and reusable consumables and resources within our daily working environment, we are encouraging and empowering all of our staff to adapt to and adopt a sustainable health and care environment for future generations.
We have already made huge changes to our hospital infrastructure, and we won’t stop there. This strategy focuses on the key things that are important to us as a sustainable healthcare organisation and sets out the things we will do over the next five years and beyond to make significant in-roads on our de-carbonisation journey.
Our Green Plan for the Trust will be constantly reviewed and we will align this with our Climate Change Adaptation Plan; a Healthy Travel Plan for our workforce and communities; and a Sustainable Procurement Strategy for the goods and services we buy.
We will work with our partners and stakeholders to ensure that we give the population we serve and the surrounding area of Tees Valley the best possible opportunities to improve our environment and to live and work in a more sustainable way.
Julie Gillon, Chief Executive
Sustainable development – Background
The goal of sustainable development is to meet the needs of today, without compromising the needs of tomorrow
Brutland Commission
This means that if we carry on using the same amount of resources as we do now, there will not be sufficient sustainable resources for future generations to come.
Reducing carbon emissions is key to living within environmental limits and stabilising the supply of sustainable resources, but it is not the only metric.
The United Nations developed a powerful suite of measures that can help shape and develop global policy and, whilst they encompass more than just good health, the measures set a benchmark for sustainability more broadly.
- No poverty
- Zero hunger
- Good health and wellbeing
- Quality education
- Gender equality
- Clean water and sanitation
- Affordable and clean energy
- Decent work and economic growth
- Industry, innovation and infrastructure
- Reduced inequalities
- Sustainable cities and communities
- Responsible consumption and production
- Climate action
- Life below water
- Life on land
- Peace, justice and strong instructions
- Partnership for the goals
Sustainability and climate change in the NHS
Net zero carbon emissions by 2040
- System-led sustainability planning through the Integrated Care Systems
- Each Trust to produce:
- Green plan
- Climate change adaption plan
- Health travel to work plan
- Sustainable procurement plan
- All plans to be approved and signed-off at board level.
Our strategy
Part 1
Employing over a million people, the NHS is possibly the largest employer in the UK, and is a lead provider to the UK’s health and care system which is one of the largest in the world.
Reduce CO2 emissions and environmental impacts
The Trust has made a firm commitment to reduce its CO2 and Greenhouse gases (GHGs) with the target of net zero carbon emissions within the next 20 years.
Part 2
The procurement of goods and services on a local, national and international scale is a major contributory factor to a large carbon footprint consisting of buildings, infrastructure, systems, services and people that deliver the services that we are so proud of.
Embed sustainability in our Trust
The Trust will embed the knowledge and practices that can lead us to a more sustainable organisation and environment, with all staff involved in our planning and delivery.
Part 3
This requires an economical health and care system that delivers safe and cost effective healthcare from a position that recognises and addresses the negative impact it has on the environment.
Successfully adapt for Climate Change
We will ensure that we are fully prepared for the predicted financial, health and environmental impacts associated with climate change by taking a holistic approach to our adaptation planning.
Sustainability Group
- Board of directors
- Lead sponsor
- Executive team
- Sustainable development group
- Medical director and deputy medical directors
- Clinicians at consultant and junior doctor level
- Managers from estates, engineering and environment
- Waste managers
- Procurement leads
- Corporate managers
- Sustainability leads
- Project/work stream development
- NTH Solutions
- Finance
- Grants
- Communications and marketing
- Workforce
- Culture
- PMIO
Energy and carbon management
Historically, we have seen a reduction in carbon emissions of around 2% year on year. We know that we need to significantly reduce our carbon footprint if we are to achieve the Government’s goal of net zero carbon emissions by 2040.
The Trust’s strategic aim is to reduce our carbon emissions and greenhouse gases each year by a minimum of 5%.
What we aim to achieve
- 5% reduction in carbon emissions year on year
- Reduce carbon footprint by 25% within five years
- Green champions promote cleaner, greener housekeeping
How we will achieve this
- Establish a Trust decarbonisation plan – in collaboration with energy partners to scope long term interventions focused around heating and lighting.
- Updating of combined heat and power/hydrogen fuel cell at University Hospital of Hartlepool – to maximise green energy.
- Replace all lighting stock within the Trust with energy efficient LEDs – currently mid-way through our conversion programme.
- Installation of electric vehicle charging points at all three sites – and promotion of electric vehicles alongside charging via a mobile app.
- Replacement pipe Insulation – to eradicate heat loss.
- Develop a culture of cleaner, greener energy management – amongst all Trust staff by good, considerate ‘housekeeping’.
How we will measure what we’re doing
- Carbon emissions performance as recorded in Trust energy at stake report
- Sustainability Impact Assessments on completed schemes
- Monitoring of electric vehicle charging points by usage and carbon conversion
- Number of ‘Green Champions’ within Trust with agreed sustainability objective
Procurement
Ensuring everything we buy, all products and services that we procure, supports sustainable development and the growth of the low-carbon economy throughout the supply chain.
By implementing social value in our procurement activities we can require and support our suppliers to consider the pillars of social, economic and environmental benefits they can bring to each contract.
What we aim to achieve
- Help the Trust to achieve carbon reduction targets
- All single use plastics to be eradicated in non clinical areas
- Ensure all staff ‘live’ the principles of sustainable procurement
How we will achieve this
- Ensure efficient use of resources in our hospitals – by encouraging suppliers and business partners to adhere to sustainable procurement (and packaging) of goods and services
- Adopting a policy of identifying more recyclable products – through the Greener NHS Group
- Raise awareness of sustainable procurement – practices including social value and work with the Trust and suppliers to help achieve this
- Train and develop our staff in the principles of sustainability – and sustainable procurement
- Undertake whole-life costing when purchasing equipment – to include training, implementation, maintenance and disposal of goods
How we will measure what we’re doing
- Baseline current position on which to build
- Embed sustainability and social value into the procurement process and monitor results through contract management activity
- Report results to Key Stakeholders and set targets for future years
Travel and transport
Air pollution and congestion is a developing concern for the Trust. With over 5,000 staff we are committed to providing alternative, sustainable travel options for our staff particularly as both of our main hospitals are situated within urban conurbations but we also wish to encourage healthier lifestyles for our staff and our immediate population.
What we aim to achieve
- Reduction in car journeys by staff
- Increase in electric vehicle usage within Trust
- Increase in sustainable travel for staff, patients and visitors
How we will achieve this
- Extension of the ‘Cycle to Work’ scheme – enabling purchase of bikes at low/no cost with incentives for staff who ‘remain active’ as part of their travel to work journey. Improve and modernise cycle security e.g. cycle hub
- Provide more sustainable options – for patient, visitor and staff travel to and from our hospitals
- ‘Walk to Work’ scheme – by working with local voluntary groups to coordinate groups and clusters of staff from neighbouring streets, estates and villages and encourage them to leave their cars at home and walk to work to link to our Active Hospital programme
- Work with our local authority colleagues and bus operators – to map better travel planning for public transport
- Ensure greater use of electric vehicles – in Trust fleet and for staff through additional incentives, signage and communications as part of NHS lease arrangements
How we will measure what we’re doing
- Heat/cluster maps to scope and route staff travel patterns to enable green and healthy travel programme
- Six monthly snapshot audit of staff, patients and visitors travel patterns to and from hospitals
- Car park activity audits
- Trust healthy travel plan
Clinical pathways
Transforming our services with sustainable development as a ‘golden thread’ is important in developing improved health outcomes, reducing health inequalities alongside social and environmental benefits.
Continually reviewing and transforming our services provides opportunities to streamline our pathways to deliver more efficient and effective patient care, and that can have a financial and environmental benefit to the organisation.
The potential to improve our services whilst at the same time providing our staff and patients with a greener, environmentally friendlier experience is a powerful tool towards reducing our carbon footprint.
What we aim to achieve
- Reduce number of face to face outpatient appointments
- Develop greater efficiencies in pathways to help reduce emissions
- Design smarter adjacencies within an efficient estate footprint
How we will achieve this
- Increase the number of virtual appointments – for Outpatients by either telephone or video call
- Consider the adoption of software for ‘pre-assessment at home’ – to reduce footfall and carbon footprint and reduce unnecessary appointments for consultants
- Ensure all equipment is fit for purpose – and operates the way it should through audits and asset register compliance and communications that target waste and reduce unnecessary disposal
- Embed ‘population health’ – and ‘make every contact count’ principles within all pathways for the future long-term goals of the Trust
How we will measure what we’re doing
- Establish a baseline through current and future pathway reviews to identify key areas
- Quarterly review of Outpatients virtual appointments
- Review of performance targets linked to appointments/bookings and follow-up appointments
- Annual value at stake of carbon emissions by Department/service area
Water
We consume approximately 140 million litres of water per year within our hospitals in the Trust. By improving the maintenance of our buildings and improve our workforce understanding of consumption efficiency we can reduce existing levels of water consumption by a third (33%) and therefore use the minimum amount of water to the maximum effect within Trust buildings.
What we aim to achieve
- Measure water consumption rates by locality
- Monitor usage against activity data
- Reduce water consumption by 33%
How we will achieve this
- Audit and programme of maintenance works – to all hot and cold supply within both hospital sites
- All hot and cold supply taps replaced – with touch free sensor systems
- Measure and baseline water consumption rates – against tariffs, increase monitoring of water supplies and adopt the latest measuring technology to understand the volume of water used by location
- Rain water capture – to reduce consumption levels in cleaning, laundry, maintenance, valeting
- Ensure all pipe and pump covers are sealed – and fit for purpose, replacing those that are not whilst working with suppliers to reduce water leaks
How we will measure what we’re doing
- Reduction in water consumption within the Trust
- Greater understanding of the water consumption overall
- Reduction in water bills
- Embed water efficiency good practice in all capital projects and new developments
Waste
The Trust is committed to providing environmentally efficient services and recognises that waste in one area can compromise effective patient care in another.
It is essential that the principles of good waste management are integrated into the Trust’s day to day operational processes. Managing healthcare waste is not only an essential part of ensuring that healthcare activities are safe from risk of infection, and securely managed, but also provide opportunities for improving the environment we work in, provide cost savings, safer working practices, compliance with legislation as well as reducing the environmental and carbon impacts on the organisation.
What we aim to achieve
- Create a culture of minimising waste via Waste Hierarchy
- Recruit 1000 Green Champions across the Trust
- Recycle 40% of all domestic waste
How we will achieve this
- Significantly increase the amount of domestic waste that we recycle – we recycle, on average, 24% of all domestic waste year on year;
- Minimise the amount of waste we produce – as an organisation particularly in non-clinical areas, and re-use materials more than once where we can;
- Recruit ‘Green Champions’ – to help create a culture of minimising waste and communicating the broader message (and cost) amongst colleagues;
- Furniture quarantine bay – for large item inspection before disposal as last resort and/or offer to charities.
How we will measure what we’re doing
- Monitor the management of waste on quarterly basis and communicate across Trust
- Measure our performance against the Waste Management Hierarchy
- Drive key performance indicators and metrics through the organisation at service and department level
Climate change adaptation
The Trust is committed to ensuring that all of our staff, systems, resources and infrastructure are fully supported to withstand the risks that are posed and caused by specific events locally, regionally and nationally.
Ensuring our staff receive timely and detailed communications will be critical to our adaptation planning.
What we aim to achieve
- All sustainability planning approved at board level
- All risks mitigated to the best of our ability
- Plans and Strategies are aligned and shared with those of our partners
How we will achieve this
- Establish a Climate Change Adaptation Plan as part of the Trust’s Green Plan – approved by our Board of Directors;
- Ensure all of our business continuity plans and emergency preparedness and resilience plans – are up to date and reflect current strategic risks;
- Create a communication and marketing plan – suitably directed to all staff to enable a broader understanding of climate change deeper in the organisation;
- Use our Board Assurance Framework (BAF) – to detail our risks to climate change effectively and succinctly and reflect this as part of the risk appetite;
- Implementation of controls and assurances – to mitigate risks posed by climate change and significant change within our environment
How we will measure what we’re doing
- Identify all climate change risks to our organisation and align with existing plans and report mechanisms
- Progress will be measured annually with six monthly updates to the Trust’s Board of Directors
- Review and monitor progress through new and existing structures within the NHS NENC ICS and more locally within the Integrated Care Partnership for Tees Valley
Building and green spaces
Our hospitals and wards are at the centre of everything we do as a progressive healthcare provider and we need to ensure that our capital programme at both sites demonstrates high level standards e.g. BREEAM, Carbon Footprint labelling, Environmental Product Declarations for our capital estate.
We need to make the most of our outdated buildings and outdoor areas so that everyone working in or visiting our hospitals can benefit from cleaner, greener spaces. We will enhance all areas as much as we can to make the patient and working experience as good as it can be for everyone.
What we aim to achieve
- Energy efficient buildings – existing and development
- Maximise adjacencies across our estate footprint
- Green spaces with access for patients, staff and the wider community
How we will achieve this
- Maximise the outdoor space at both hospitals – with environmental landscape planning to provide green areas for patients and staff to relax;
- Develop outdoor exercise space – for staff and patients at both hospital sites as part of our active hospital programme;
- Futureproof and planning policy – that set out requirements for all future developments to maximise adjacencies of services and departments and minimise footfall/traffic through the entire hospital(s) via multiple entrance/exit routes;
- Display of energy certificates and environmental product declarations – for each part of our estate are up to date, located in public view, and easy to read
How we will measure what we’re doing
- Carbon emissions performance as recorded in Trust energy at stake report
- Sustainability Impact Assessments on completed schemes
- Adhere to BREEAM standards for all capital/engineering works impacting on the estate
Workforce
Committed to promoting equality, diversity and inclusion whilst attracting, developing and retaining the best possible individuals in our Trust. By changing the culture we can ensure that all staff are able to commit to delivering a carbon free future for our patients and for themselves over time.
We will do this by making sure that our staff are fully engaged with the changes we need to make by adopting sustainable practices and principles.
What we aim to achieve
- Increased environmental staff benefits
- Staff participation in sustainability programmes
- Increase knowledge and awareness through learning
How we will achieve this
- Develop non-mandatory e-learning programme – within ESR for all staff with levels of competence linked to role in organisation;
- All new starter job descriptions to be underpinned by sustainability values and agree a prime objective for every member of staff – as part of the performance appraisal framework;
- Recruit ‘Green Champions’ – to form proactive and responsive sustainability groups across the Trust to drive the agenda deeper within the organisation;
- Establish 1 November 2021 as the Trust’s ‘Green Day’ – to mark the first date of the COP 26 Climate Change event in Glasgow and repeat annually with events, practical displays and profile raising;
- Regularly updated displays and screen savers – to deliver key sustainability messages for staff
How we will measure what we’re doing
- Carbon emissions performance as recorded in Trust energy at stake report
- Sustainability Impact Assessments on completed schemes
- Adoption of BREEAM standards for all capital/engineering works impacting on the estate