Last reviewed 18 March 2014

Martin Hodgson looks at how the NHS Sustainability Day on 27 March 2014 is a focus for tackling the challenge of sustainability for NHS organisations.

The NHS Sustainability Day in March is designed to support efforts to create an environmentally sustainable and resilient health service. It follows the publication in January of the latest Sustainable Development Strategy for the NHS.

In 2013, more than 100 NHS organisations took part in a similar day of action, and this year the organisers are hoping for even more organisations to become involved. It is hoped that a series of nationwide roadshows will further inspire staff and spread best practice.

The previous article in this series examined the public health issues related to climate change and the unique issues that make environmental sustainability more or less difficult in the NHS. This article will look at examples of NHS sustainability in action, particularly in relation to NHS buildings and facilities.

The NHS sustainability agenda

The new strategy, Sustainable, Resilient, Healthy People & Places, was published by the Sustainable Development Unit of NHS England earlier this year. The strategy supports a “call to action” and looks to the NHS and care sector to help lead the economic, social and environmental sustainability of the country.

A Sustainable Development Strategy for NHS Scotland, published in 2012, and One Wales: One Planet — The Sustainable Development Annual Report 2011–12, echo the new NHS England strategy in their belief that sustainable healthcare buildings and facilities should be developed that are not only better for the environment, but also for communities and for the health of patients, staff and visitors.

To contribute to the sustainability agenda, especially where it relates to buildings and facilities, all NHS organisations should therefore have environmentally sustainable policies in place, which include:

  • board-level commitment to sustainable development

  • energy use and efficiency policies

  • waste management policies that advocate waste reduction and recycling

  • water use and water efficiency policies

  • sustainable procurement systems for goods and services.

Leadership and engagement at all levels with the public, service users, trade unions and staff is vital in the development of buildings that are an integral part of communities that not only minimise their impact on the environment but are also resilient to the impacts of severe weather events, such as heat waves, cold snaps, and flooding.

Energy sustainability

Energy use is a huge issue in modern society. Many believe that global warming and climate change are perhaps the biggest environmental threats to the world. The threat is driven by energy-intensive lifestyles and an overdependence on fossil fuels, which cause pollution and carbon emissions, including so called “greenhouse gases” that damage the environment.

The UK Government has a number of carbon reduction targets within the Climate Change Act 2008, backed up by national strategies for improving the efficiency of energy use. Through the current Energy Bill, it is attempting to modernise the energy market and introduce more sustainable energy sources, such as so-called renewables — wind, solar and biomass energy. It is also trying to increase the energy efficiencies of buildings through its “Green Deal”.

As a major consumer of energy, the NHS supports this agenda. Conserving or making best use of energy is not only good for the environment, but also makes economic sense. All NHS organisations should therefore strive to reduce energy waste, saving costs as well as reducing their carbon footprint.

The new NHS Sustainability Strategy includes an ambitious aspiration for the health and care system to achieve a 34% reduction in carbon dioxide-equivalent emissions from building energy use, travel, and procurement of goods and services by 2020. Best practice is to develop energy sustainability policies that deliver even better energy efficiency savings by:

  • increasing the energy efficiency of buildings — improving insulation, etc

  • investing in renewable energy sources

  • upgrading heating systems, and utilising fuel-efficient technologies and smart energy management systems.

NHS building design should include features designed to cool buildings naturally in summer, and heat them efficiently in winter. Innovative design examples might include such things as “green roofs”, which not only add further insulation, but encourage local biodiversity.

Water sustainability

Water is costly and all modern organisations should be water-efficient. Much of the water used by organisations is actually wasted and it is estimated that careful water management, together with an effective education or awareness programme, can reduce water use by two-thirds.

Our relationship with water has come under particular focus in recent years with droughts and flooding blighting many communities. The new strategy involves improving the resilience of NHS buildings and communities to extreme weather events, and this includes introducing new forms of water management, such as sustainable drainage systems.

Many NHS organisations have been able to improve water conservation by adopting modern methods of grounds management. An example that will be showcased at the NHS Sustainability Day in March is the “AquaFund” Project, a multi-million pound fund available to public sector organisations to reduce water consumption. The scheme includes consultancy services, site audits, and state-of-the-art water-saving technologies, tariff and water data analysis.

Traffic and travel

Another so-called “carbon hotspot” identified in the NHS is travel. There are increasingly more cars on the roads, and vehicle use is set to rise even further in the future. Rising vehicle use adds to congestion, road accidents and pollution, including carbon emissions, and is thought to be a key contributor to global warming.

NHS organisations are encouraged to have sustainable travel policies in place. NHS transport services should invest in energy-efficient ambulance fleets and other vehicles, and should keep them well maintained. Sustainable traffic policies for staff include car-sharing, using public transportation, and encouraging walking and cycling, which also boost fitness and well-being. Unnecessary travel should be reduced by providing more care at home for patients, and using technology, such as teleconferencing, rather than holding meetings.

Sustainable waste

Waste management is another critical part of a realistic, sustainable development policy.

All organisations are increasingly required to ensure that they deal with their waste in an environmentally acceptable way. The majority of non-clinical waste is disposed of to non-sustainable landfill and this raises many issues.

Government strategy is to limit landfill waste, reduce the amount of waste produced, and increase the amount of waste reused and recycled. NHS organisations should comply with this policy. There are many examples of good practice in this area in the NHS, and innovative schemes have cut waste drastically in some areas.

Sustainable procurement

A major part of any sustainable resources policy is the issue of procurement. Sustainable commissioning and the ethical procurement of products are very powerful levers for change, and all NHS organisations should ensure that goods, services and materials are procured from suppliers who also have sustainable use policies. It is the responsibility of purchasers of equipment and materials to ensure that their suppliers are running environmentally sustainable organisations.

The way that buildings are designed, constructed and managed contributes to the sustainability of an organisation. Sustainable buildings not only save water and energy but are constructed to include materials and equipment that reinforce sustainable procurement and low-carbon construction technologies.

Best practice examples in NHS case studies include whole lifecycle and responsible sourcing approaches to the procurement of goods.