Delivering a more sustainable NHS David Pencheon NHS Sustainable Development Unit 14 th February The Brewery, City of London

Transcription

1 Delivering a more sustainable NHS David Pencheon NHS Sustainable Development Unit 14 th February 2012 The Brewery, City of London

2 Sustainable healthcare? Healthcare that meets the needs of the present without compromising the ability of others, in future or elsewhere now, to meet their own needs - Adapted from the Brundtland Commission

3 See notes of this slides for some of the most important specific actions

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5 NHS England CO 2 e footprint with Climate Change Act targets:

6 Views and Values of NHS Leaders Almost nine out of every ten leaders surveyed in the NHS actively engage with sustainability and believe it is important Easy things: Promoting energy efficiency Engaging with staff on sustainability Implementing travel initiatives More challenging: Improving infrastructure Ensuring sustainable pathways and models of care Working with other groups and organisations to achieve more sustainable results Source: RAND survey

7 Results of Public Opinion Survey: Source: Ipsos MORI

8 Table

9 What organisations can do:

10 Regional perspective

11 NHS England carbon intensity kgco 2 e/ 1990 to 2010: Carbon intensity kgco2e/ Year Carbon intensity

12 Breakdown of NHS England 2010 emissions: 16% Travel 65% 19% Building energy use Procurement

13 Procurement Breakdown: Pharmaceuticals Business services Medical Instruments /equipment Paper products NHS Freight transport Food and catering Other manufactured products Manufactured fuels, chemicals and gases Construction Water and sanitation Waste products and recycling Information and communication technologies Other procurement

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15 The role of health services 1. The effect of health services on unsustainable resource use, social inequalities, GHG emissions The effect of unsustainable resource use, social inequalities, GHG emissions on health services and health The exemplar responsibility of health services and health professionals 4. Triple bottom line health care...

16 - Barbier, E.,1987. The Concept of Sustainable Economic Development. Environmental Conservation, 14(2): Adams, W.M. (2006). "The Future of Sustainability: Re-thinking Environment and Development in the Twenty-first Century."Report of the IUCN Renowned Thinkers Meeting, January 2006.

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18 Health co-benefits: What is good for adaptation to, and mitigation of, climate change...is ALSO good for health and healthcare 1. For the public s health More physical activity, better diet, improved mental health, less road trauma, less air pollution, less obesity/ heart disease/cancer, more social inclusion/cohesion For the healthcare system More prevention, care closer to home, more empowered / self care, better use of drugs, better use of information and IT, fewer unnecessary admissions, better models of care 3. For global health inequalities / social justice Contraction and convergence, technology leapfrogging

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20 Every unplanned admission to a hospital is a sign of financial and system failure until proved otherwise: Aligning...clinical / patient / public needs with...financial needs and...environmental needs

21 Why do healthcare organisations take sustainable development and climate change seriously? 1. Save money 2. Comply with regulation 3. Improve resilience 4. Enhance reputation 5. Improve health

22 Priority areas for more sustainable clinical practice? 1. Helping people eat better and move better 2. Enabling women to have control over their fertility 3. Targeting prescribing on those most likely to benefit 4. Promoting a greater sense of belonging 5. Helping people manage care before / without / after specialist hospital care 6. Helping people manage a better death

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24 NHS MAC curve

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26 Case study: Nottinghamshire Partnership with 3 rd sector social enterprise, NEP link organisational health, healthcare and public health. Fewer unnecessary admissions Low carbon NHS trusts, lower bills, more money for patient care Investment Energy Advice Warm, healthy, low carbon homes Low carbon, lower cost, local community health centres

27 Ignoring evidence is risky

28 Some of the lessons so far This is a journey: Therefore engagement is crucial: Ask, listen, understand and re-articulate the win-wins 2. Focus on win-wins, be positive, and remember the evidence about large scale change 3. Communicating the science is as important as doing the science. 4. More R&D > evaluated, costed, and communicated case studies. 5. Measure, compare, track progress, report, in order to help shape system governance that delivers triple bottom line 6. Continued engagement of public, patients, staff, leaders and regulatory/guidance organisations

29 Specific needs during Embedding sustainability in the regulatory and improvement culture during the transition 2. Next stage of Research and Implementation 1. Building on the forthcoming King s Fund / SDO report 2. Addressing known unknowns systematically focussing on co-benefits of triple bottom line of money, health, environment 3. More systematic guidance to the NHS on adaptation as much as mitigation