www.nhssustainabilityday.co.uk

Welcome

NHS Sustainability Day
A call to action for the NHS
• A platform for whole system thinking on sustainable actions
• Showcase for innovation, excellence and best practise
• Opportunity to learn, share, collaborate
• Engage - staff/patients/visitors/supply chain
• Help develop an NHS that is fit for the future
• Do one thing differently
• We hope you will be inspired to take part in 2014

Motivating Success
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Day of action and engagement across
NHS
100 organisation participated 2013
300 participating in 2014
Key endorsements
Royal Colleges, associations and Institutes
Sharing knowledge, experience and best
practice
Creating a legacy
National Road Shows
Awards
Internationally showcasing NHS

#dayforaction
If the NHS can deliver a sustainable focus collectively on
one day, why can't we do it every day - think what a
difference it would make

NHS Sustainability Day 2014
launch event

Organisation / date

Understanding sustainability
Rick Walker
Corporate Social Responsibility Senior Manager
NHS England
T: @Rick_Walker1

Section number

7 NHS | Presentation to [XXXX Company] | [Type Date]

Sustainability
The goal of sustainable
development is to enable all
people … to satisfy their basic
needs and enjoy a better quality
of life, without compromising the
quality of life of future generations
… meeting the needs of today,
without compromising the ability of
future generations to meet their
needs …

8

NHS England – vision & purpose
The idea
High quality care for all, now and for future generations

NHS constitution

• “… committed to providing best value for taxpayers’ money
and the most effective, fair and sustainable use of finite
resources … accountable to the public, communities
and patients … taking decisions…should be transparent
and clear to the public, patients and staff.”
Public health outcomes
• “… wider factors that affect health and wellbeing and health
inequalities e.g. children in poverty, green space for
exercise/health
• “…. healthy lifestyles – healthy choices – reducing health
inequalities
10

Our purpose

We create the culture and conditions for health
and care services and staff to deliver the highest
standard of care and ensure that valuable public
resources are used effectively to get the best
outcomes for individuals, communities and
society for now and for future generations.

Sustainability in NHS England
Corporate Social Responsibility – is the way we
understand and manage our impacts and take
steps to use them in a positive way, encompassing
• Patients – Doing the right thing for patients –
towards sustainable models of healthcare
• Community – Managing our impacts to support
communities
• Healthy environments – Reducing negative
impacts and protecting the environment
• Our people – Striving to be the best employer we
can
• Our organisation – Having the highest
standards of accountability
12

Towards a plan
• Offices (energy, carbon, waste, water)
• Travel
• Local community benefits/community impact
(e.g. local procurement)
• Engaging & involving staff – our personal
responsibilities
• Volunteering  connecting to our priorities
• Exploring employability / access to work 
links to health outcomes
• Processes e.g. NHS Standard contract

• Exploring the scope of Commissioning tools &
support, CSU products, primary care
commissioning
13

Rick Walker
Corporate Social Responsibility Senior Manager
Email: rick.walker@nhs.net
Twitter: @Rick_Walker1

15

Gracefield Gardens Health Centre
April 2013
How it begins: Building food growing capacity inside
the Streatham located Health Centre.

Gracefield Gardens Health Centre
April 2013
Patients get to work preparing a planter

Paxton Green Group Practice
June 2013
Participants planting crops

Lambeth Walk Group Practice
Summer 2013
Using space at the side of the surgery to full
potential

Lambeth Walk Group Practice
October 2013
Participants harvesting produce

Lambeth GP Food Co-op

Funded by the London Borough of Lambeth and NHS Lambeth
Clinical Commissioning Group.
Supported and grown by the people of Lambeth

Anaesthesia related electrical energy
use and anaesthetic gas scavenging
(AGSS)
Dr JMT Pierce
Gemma Morris
Tom Dugdale
University Hospital Southampton

Nitrous oxide 100ppm
Isoflurane
50ppm

Where is electricity used during
anaesthesia?
• Plug-in energy meters for all
anaesthesia related equipment
• Surreptitious observation
of radiant heater use
• AGSS
– Obtained the total power consumption from all
the locations from Estates Department
– Power clamped each of the 3 phases of the supply

Energy use and surgical speciality

Anaesthetic gas scavenging pumps

Up in the loft
• 31 operating rooms
• Total load 25.15 kWh
• Mean derived load per room 0.8kWh/theatre
– 19.47 kKw/theatre /day

• Mean measured load 0.75 kWh/theatre
– 18.03 kWh/theatre/day

• In addition AGSS in radiology, ICU, catheter labs
– Additional 21kW
– 504 kWh/day

Average daily anaesthesia related
energy consumption (UHS kWh)
1.35
5.00

3.90

Mean AR

Mean OR
Mean AGSS
Radiant heaters

18.03

How big is the issue?
• Theatre use 24/7
– 204,000 kWh / year

• Other use in radiology 24/7
– 184,000 kWh / year

230 tonnes CO2
OR used for 40% of the time

What was the state of knowledge?
• 7 Night time surveys 11pm
– All AGSS left on

• Survey anaesthetic department knowledge of
– On / off switches
– Anaesthetic machine AGSS indicators

• Informal telephone survey of other
anaesthetic departments
• Anaesthetic machine servicing teams

Confirming the AGSS is working

The future?
• Initiatives have a honeymoon phase
– Staff turnover

• Interface the anaesthesia machine with the
AGSS proven too difficult
• Occupancy sensors to activate AGSS
– Current project

• Move to low FGF may prove safe enough to
allow a significant reduction in the AGSS flow
rate

Award 2013
For Best Community Engagement
Initiative

Centre for Sustainable Health Care
NHS Forest Annual Awards
Most Innovative Site 2013

Network Name
Corporate Services

Question:
Can more be done to choose safe, environmentally
sustainable food and a healthier diet?

Teamwork – Compassion – Integrity – Respect – Excellence – Accountability

Network Name

Yes its possible adopting the Grow Your Own Model
We reduce supplier related CO2 emissions by growing
organic, seasonal crops. Food miles have become food steps!
We have reduced food waste, harvesting produce to meet
patient menu requirements.
We can assure food quality and growing standards as there is
no external involvement in the growing process.

Network Name

Providing a Healthier Diet
Fruit and vegetables are one of our main sources of vitamins
and minerals, which the body needs to perform a variety of
functions well. Vitamin A helps to strengthen our immune
system, B vitamins help us process energy from food, vitamin D
helps us maintain healthy teeth and bones, and vitamin C helps
to keep cells and tissues healthy.

Network Name

Louise Treasure, Team Leader Property Services. “Part of the GYO project is
to introduce locally grown, organic food in to the food chain for the Service
Users at Guild Lodge. This summer we have had fresh strawberries, which have
been harvested, prepared and served all within a few days, providing the
Service Users the best quality fresh ingredients which is the priority. An
abundance of fresh salad vegetables and herbs have all been provided to the
kitchen to be used in patient feeding, this not only gives the Service User a
freshly made dish but also cuts down on food miles, cost and waste. These
issues are high on the agenda at Lancashire Care and as we get more and
more established the planning of vegetable growing to match menus will
increase and we can cut down on the above on a bigger scale”

Network Name

Chris Rowe, Head of Support Services. “The project plays a vital
role in minimising waste within the catering industry and builds
towards planning for the future, establishing a sustainable resource
that is multi facetted and can be of benefit to the reduction of food
miles and locally sourced produce. We will endeavour to move
forward in the future building on what we have already achieved
broadening involvement in the local community and encouraging a
stable method of procurement for the future .”

Network Name

Question:
How can gardening support mental health recovery?

Network Name

Network Name
Teamwork

– Compassion – Integrity – Respect – Excellence – Accountability

Blake Shaw, Associate Practitioner, “At Fellside unit we started the project with a selfcontained poly tunnel which was full of weeds and overgrown. With encouragement service
users have embraced the concept, showing self-motivation by participating in the „grow your
own‟ project. therefore Chris A and I started to recruit volunteers to work on the
land, clearing the weeds and making the tunnel and surrounding area fit to grow our own
produce. With a lot of hard work and dedication from the Fellside grow your own team the
Polytunnel is being redesigned with the help of the service users. We have started to
cultivate and replenish the growing beds with seedlings and an assortment of vegetable and
fruit plants which in time will be sourced as part of our on-going health promotion projects.
Many of us know that being more active outdoors is good for our physical health but getting
outdoors and into nature can improve mental health too. Even simple activities like taking
a stroll in the park, or gentle outdoor exercise can have big benefits for our mental
wellbeing.”

Network Name

Paula Pemberton, Associate Practitioner, “On Forest Beck we have used
produce from delicious apples, juicy sweetcorn and my favourite - honey. It is
a project that saves money at Forest Beck, it provides produce for healthy
eating groups, communal meals which encourages service users to use skills
in preparing and cooking food. At Forest Beck service users are preparing to
go out into the community and cooking skills are important for their future. It is
something that service users can see from beginning to end. From plot to
plate. It is outdoor exercise which is stress busting and a way to enjoy the
great outdoors. NHS campaign „Change 4 Life‟ with eat well, move more live
longer is exactly what this project promotes.”

Network Name

Carol Bristow, SEED Project Lead Service User Involvement “Please can
I take this opportunity to say what a fantastic project you lead on you must
be very proud of your achievements!! The person who I escorted down did
not stop talking about your project “ Grow Your Own” on the way back. I
wish I had a camera to capture his expression when we arrived down at Grow
Your Own. I have not seen a service user so emotionally enthusiastic for a
long time. What hope you gave him by just experiencing your project for a
short period of time – that‟s called Recovery!! The service user champion
has now gone away to design a promotional leaflet and poster to advocate
your project to other service users and staff here at Guild Lodge.”

Network Name

Service User Comments Fellside and Forest Beck
“Great opportunity to learn new skills that I can take away with me
on discharge”

“Very good quality and produce was well presented on arrival
looking very fresh and tasty.”
“Help with having a healthier lifestyle and personal fitness”

Network Name

Question:
Does community engagement matter?


Network Name

Community is the fundamental building block to our society
Through community we promote healthy
eating, outdoor spaces and organic produce

living

and

We
help
to
development
positive
personal
skills, teamwork, confidence, achievement, pride, ownership and
engagement
We interact with staff, service users and community groups to
share skills, network and develop friendships, overcoming
stigmas and perceptions

Network Name

We promote positive community engagement with real benefits
for the local health economy
We provide opportunities for people to volunteer and make a real
difference to outcomes, being a team makes us stronger
We support service user recovery and actively help to reduce the
need for service user dependency

Network Name

Community Feedback
"I really enjoyed the day, thank you"
"A one and only experience to help out" "Amazing experience"

Esther Wilks Assistant Programme Manager, The Challenge
Network, ”I've not had a chance to write to say the HUGEST of thank you’s
for last weekend (I can't believe it was only a few days ago, seems like ages
ago!!) I, for one, had so much fun on the day, and all the feedback I got in
the staff debrief suggests that the staff and young people did too. It was
such a nice way to end their time at The Challenge. The level of effort you
put into the day was so evident, from the team signs to the hand sanitiser
and biscuits in baskets, thank you. I hope we managed to get a lot of the
apples picked for you and that the service users enjoyed the labyrinth.”
"Always willing to answer questions" "Would love to get the opportunity again"
“All instructors were excellent, very informative”
Network Name

Grow Your Own Project
Food Security
Mental Health Recovery
Community Engagement

Network Name


Network Name

Thank You
From the Grow Your Own Project Team

Elizabeth Harrison, Volunteer Project Lead : Email Elizabeth.Harrison@lancahirecare.nhs.uk : Tel 01772 773580

Network Name

Sustainability at
BHR University Hospitals
NHS Trust
17th October 2013
NHS Sustainability Day 2014
Official Launch

Queen‟s Hospital Romford

Beds
Staff
Contractors

Companies

~

1,000

~

4,242
~

King George Hospital Ilford
~

400

~

1,581

610

~

194

70

~

50

~

Estates & Facilities Division
Director of
Estates, Facilities & Capital

Range of
contractors,
ppliers,

Jackie Nugent

su

Head of Estates
Capital, PFI Portfolio & Contracts

PFI
Contractor

inter
Peter Harris

nal and external
stakeholders

Sustainability & Carbon Manager
Estates Sustainability
Hyder Mohammad
Sustainability Communications Officer
Estates Sustainability

SODEXO

Success Story
NHS Sustainability Day 2013 Campaign
Best Carbon Reduction and Best Overall Initiative

Invest Time
& Money

Predicted
Savings

Implement
Projects
Stakeholders

Upset sustainability plans

Water
conservation

Waste
reduction &
recycling

Out-of-hours / bank holidays
savings

Culture change
in FM

Retain SMT support

Meet
Drivers

NHS Sustainability Day 2013 Campaign

Objectives:
organise a
high profile
launch

engage, ed
ucate, enco
urage

implement
simple
measurable
actions

energy &
carbon –
awareness

energy &
carbon –
savings
initiatives

waste &
water –
awareness

NHS Sustainability
Day 2013 Campaign
planned activities

waste &
water –

Travel awareness
& support

changing
behaviours better ways of
doing

reduction
initiatives

energy & carbon – awareness
LIVE energy
consumption –
check
anywhere, anytime

Cardboard
monitor says
“switch me off”

Green
Champions in
Action

Real-time Energy Display:
A high profile launch by CEO with
Head of Estates, Sodexo FM
Managers and eco|Driver Director at
Queen‟s Hospital.
Big A1 size “PC monitors” crafted out of cardboard
“Switch off your monitor overnight and save as
much as 2% of Queen’s electricity costs. That’s
£30,000!”

Green Champions raised local
awareness with provided
information and tools.

energy & carbon – savings initiatives
Lights go
off, when no
one on stairs

Let our
buildings
sleep

Secret Energy
Audits

Implementation of light sensors in multistorey car park staircases at Queen‟s
Hospital.

 Review and making changes to AHUs
operating times to match business hours.

 Easter Bank Holiday switch-off

Green Champions were encouraged to do walked-

around in their local areas to identify potential
energy savings.

waste & water – awareness
How to save
water?

Empty paper
boxes display

Which bin to
use?

Essex & Suffolk Water
company, distributed their Water
Saving kit.

Stacked empty paper boxes were
in display in the Atrium with an
awareness raising animated
movie.

A stand raising awareness with
bins, posters and interactive quizzes to
teach staff how to segregate waste
properly.
Join us to learn more
On 28th June

Queen’s Atrium

Disposable cup

Empty card box
packaging

On 28th June

Queen’s Atrium

Plastic/paper
packaging from
clinical equipment

Mask worn by staff

Gloves exposed to
blood/body fluids

Paper towel used
for hand drying

Paper towel
contaminated with blood

Join us to learn more

Empty Spirigel
container

Disposable hat worn
by staff

Disposable gown
with blood stain

Nurse wasteful
vs.
Nurse greenway

An activity based pictorial guide
showing the behaviour of a
“waste producer vs. waste reducer”.

waste & water – reduction initiatives
IV Bags
recycling in
Pharmacy

In Pharmacy Unit awareness and facilities
are provided to send saline & dextrose
bags, as Food Waste stream.

Aperlan waste
bottles
recycling

In Renal Unit and Endoscopy Unit facilities
were arranged to collect Aperlan plastic
bottles for recycling

Water reduction
opportunities

Identified ways to work in collaboration
with water supply company.

travel – awareness & support

Free

Free

BUG

Dr. Bike

Breakfast

Bike
marking
sessions

Sessions

Changing behaviours –
better ways of doing things
Stakeholders engagement and training

Domestics

M & E Team

Medical Records Store

FM Supervisors

Security

Porters

Outcomes / Achievements
increased
awareness
at all levels

Connection
to wider
teams

monitoring
& targeting
tools

Contractors
participation

Opportunities,
external
funding &
services

Integration
into Estates
and FM
plans

Sense of
“never
done, can
be done &
achievable”

Completion
of Travel
Plan

Recorded
progress, c
hange and
savings

Invest Time
& Money

Predicted
Savings

Implement
Initiatives

Meet
Drivers

Stakeholders

with a desire to make a BIG difference, it is vital to RETAIN
SMT support
and
leadership

timely
available of
resources

stakeholders
full support

Barking, Havering and Redbridge University Hospitals
NHS Trust

Sustainable Catering
NHS CATERING
Andy Jones
National Chair of HCA

Caterers Responsiblity
• People

• Communication

– Trained/Focused/Committed
– Local Community

• Good Food
– Good Ingredients
– Well Presented
– Served with Knowledge

• Waste

– Local Suppliers Showcase
Stalls
– Customers Information
Point - Patients and Staff

• ASK
– Case Studies
– NFU, MSC, Red Tractor

Served with Passion
Nothings IMPOSSIBLE

Suppliers Responsiblity
• Supply Partners
• Co-operatives
• Meet the Supplier Days

• Procurement – Food Chain Guardians
•
•
•
•

Seasonal and Local
British First Goods
Sustainable Sourced
Clear and True Labelling

• Packaging
90

Together we can CHANGE

ANY QUESTIONS?
OH YES I HAVE ONE!
NOTHING‟S IMPOSSIBLE

91

Carillion Services – Community
Engagement

Gemma Lynch
Operations Director, Carillion Health

Tracy Williams
HR BP, Carillion Health,
Barts Health Contract

KEEP UP TO DATE WITH
SUSTAINABILITY
Get involved at
www.stnlive.info

Making tomorrow a better place
through our 2020 sustainability strategy

Carillion plc
Carillion plc is one of the UK’s leading support services companies with
a substantial portfolio of Public Private Partnership projects and
extensive construction capabilities. Our services have the potential to
contribute significantly to society, as well as providing employment
within the communities in which we operate.
The Group’s annual revenue in 2012 was £4.4 billion and we employ
around 42,000 people across the UK, Canada and the Middle East and
North Africa.
To fulfil our mission and vision, we seek to behave in accordance with
our Values in everything we do and to embed sustainability across all
our business units. Our sustainability vision:
To be recognised as a leading sustainable business and the
leading sustainable support services company.

SUSTAINABILITY
Get involved at
www.stnlive.info


Our six positive outcomes
Building a successful business

Enabling low-carbon economies
Protecting the environment
Supporting sustainable
communities
Providing better prospects
for our people

Leading the way

SUSTAINABILITY
Get involved at
www.stnlive.info


Supporting sustainable
communities
• Charitable giving
• Employment opportunities
• Engaging with schools and hard-to-reach
groups
• Local spend
• Use of Community Needs plans

SUSTAINABILITY
Get involved at
www.stnlive.info


Community Engagement at
Barts Health
•

Business Action on Homelessness

•

Harpley School

•

HM Prison Send

SUSTAINABILITY
Get involved at
www.stnlive.info


Sustainability and DH

Professor David Walker
Deputy Chief Medical Officer
Department of Health

Sustainability and DH
General Outline of Talk

• DH contacts and partners

• National work on SD and Climate change
• International work and the inspiration you provide
for others…

DH Contacts
• Prof David Walker – DCMO, SD & CC Champion
• Helen Shirley-Quirk – Director, Health Protection
• Robert Edmondson-Jones CBE – Director, Estates &
Information Services
• Dr Louise Newport – Policy lead for sustainability and CC
• Ian Rowlan – Senior Engineer
• Christine Hardy – Estates & Sustainability Manager
• David Wathey – Sustainable procurement

Partnership Working
• NHS-England
• Public Health England
• Sustainable Development Unit

• Defra
• Decc
• Environment Agency
• Local Government Association

Climate Change Act (2008)
• DH provides health input to cross-government
implementation of the Climate Change Act (2008)
– Input to Carbon Reduction Strategies
– Five year cycle to understand and act on the
consequences of climate change, CCRA and NAP
– Climate Change Risk Assessment (January 2012) –
what are the likely consequences of climate change
– National Adaptation Programme (July 2013) – how are
these risks addressed – for Healthy and Resilient
Communities

Guidance produced…
NHS Sustainable Development Unit
• NHS Sustainable Development
Unit.
– Adaptation to Climate Change in
NHS Organisations – what you
need to know (2012)
– PHOF – SDMP indicator
– ARP
– SD Strategy consultation 2013

www.sdu.nhs.uk

Procurement
• Procurement is 60% of the NHS’S carbon footprint

• Sustainable messaging in contracts
• Procurement for Carbon Reduction (P4CR)
• WHO looking at P4CR use internationally

ERIC AND PAM
• Important to measure progress across the system.

• Updating to include necessary information on
sustainability and climate resilience

• BREEAM for healthcare – Phase III – increase

sustainable building construction in healthcare for 2020

Health Impacts of Climate Change
Developing the UK evidence – 2002/08/2012
•

Heatwave-related health problems

•

Aeroallergens – pollen etc

•

Air pollution – Respiratory &
Cardiovascular effects

•

Indoor environment

•

UV - Sunburn, skin cancer and cataracts

•

Flooding / mental health consequences

•

Vector-borne diseases

•

Water & Food-borne disease

•

Extreme weather-related events
(injuries/death)

•

But, decrease in cold-related illness &
deaths

Health Co-benefits
•

Lancet co-benefits research, Nov 2009, LSHTM

•

Health benefits of low carbon actions in
transport, built environment, food and
agriculture, both in the UK and the developing
world

•

Eg Health benefits from low car use
– increased active transport
– reduce obesity,
– reduce urban pollution,
– reduce road traffic accidents.
– „Greener‟ fuels also lead to reduced indoor
and outdoor air pollution.

•

Currently 800,000 deaths per year from outdoor
air pollution, 1.5 million from indoor air pollution,
1.9 million from physical inactivity and 2.6 million
from obesity (WHO European region).

•

WHO „Health in the Green Economy‟ series

Lower carbon saves lives! – and money!

International collaboration
„Climate Change is Global‟
•

WHO Resolution on Climate Change
and Health (61.12), 2008

•

Commonwealth Ministers
agreement to cooperate on climate
change and health. WHA, May 2008

•

UK co-chaired the WHO (Europe)
Climate Change Task Force, to
develop a Framework for Action on
Climate Change and Health.

•

WHO European Environment and
Health 5th Ministerial Conference,
Parma, 2010

•

DH chairs the WHO Euro Working
Group on Health Impacts of Climate
Change (HIC)

Greening Healthcare
• WHO Europe Meeting in Bonn, 2013

• Inspiring examples from other countries
• Solar power in hospitals in Kyrgyzstan and Montenegro
– Uninterrupted power supply for the first time
– Able to function outside daylight hours
– Improved patient outcomes and staff morale

Thank you

Professor David Walker
Deputy Chief Medical Officer
Department of Health

NHS Sustainability Day 2013 Awards

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