Building a Greener NHS: Reaching Net Zero

Over the last unprecedented year, we’ve all had to re-evaluate our place in the world and we’ve had time to consider the fragility of our planet.  On many levels it’s become increasingly clear to me that the climate emergency really is an urgent health emergency.

I’m pleased to say that at Newcastle Hospitals we had already taken a strategic leadership position to tackle the impact we have on climate breakdown in recognition of the threat that the climate crisis presents not just to our planet, but to our health, wealth and wellbeing locally.

In June 2019 Newcastle was the first NHS trust and the first health organisation in the world to declare a climate emergency and commit to leveraging the efforts of our 17,000 staff and more than £1 billion resources towards fast-tracking our carbon reduction efforts in line with the science.  I want to reflect here on why we did that, and what progress we are making.

Start with the ‘why’

Most people will associate climate change with rising global temperatures and an increase in the frequency of extreme weather events. You might recognise that the extreme heatwaves we have increasingly seen in the UK cause excess deaths.  In fact, heat caused around 1,000 excess deaths in the UK during the summer of 2019.

However, it is possibly not as well known that:

  • Air pollution is associated with increases in respiratory and heart disease.
  • It is the number one environmental risk to human health in the UK
  • It is the fourth greatest long-term threat to public health after cancer, heart disease and obesity.
  • It is linked to around 40,000 premature deaths a year in the UK and a cost to the economy, and by extension the NHS, of over £20 billion each year.

These impacts increase the strain on our healthcare system, as they cause people to need emergency care and inpatient admissions which are highly carbon-intensive interventions.

Continuing the status quo will inevitably lead to us investing more money and effort in dealing with the consequences – that’s money that we can’t then spend on the causes of climate change and prevention.

What we’ve been able to understand over the last year is that mitigating climate breakdown and pollution will reap immediate benefits in terms of our collective health, wealth and wellbeing.

With the NHS representing more than 5% of the UK’s total carbon footprint – around 27 million tonnes of carbon each year – we have to acknowledge that we are a significant part of the problem.  But more importantly, we also have to recognise that we also can be a significant part of the solution if we choose to take action.

As anchor institutions in communities across the country, NHS Trusts can use our influence to decarbonize not just our buildings and vehicles but also our care pathways and medicines and our wider supply chain.

So what are we doing in Newcastle?

It’s important to say that when we declared a climate emergency we didn’t have all the answers, there was no 45 point action plan that would deliver a solution. We knew it was the right thing to do for both population and planetary health and we knew our commitment was the most important first step.

We also had a strong legacy to build on.  We were one of the first Trusts to install on-site energy generation via Combined Heat & Power at the turn of the century, we were the first in Europe to switch to reusable sharps boxes and we have been zero waste to landfill since 2011.  Thanks to our forward-thinking sustainability team and many other passionate individuals, we had already begun to make clear strides towards being a greener NHS organisation.

Now, we have 3 long-term goals:

  • Number 1 is Zero Carbon Care – which includes our ambitious aim to be net zero by 2030 for the emissions we control, and 2040 for those we can influence
  • Number 2 is Clean Air – prioritizing a zero emission fleet and encouraging active clean travel to our sites
  • Number 3 is Zero Waste – reusing and repairing for a circular economy.

We have a well-established brand – SHINE (Sustainable Healthcare in Newcastle) which highlights the 8 strands of our approach and our roadmap is set out in our strategy which sets out the plans we’ve developed across all eight of our Shine priority areas.

This ranges from plans to decarbonize our hospital buildings and transport, to working with our clinicians and supply chain to provide lower carbon care pathways, and also the smaller things that each of us can do every day to make a difference.

Transparency is incredibly important as we progress towards the targets we’ve set, and they are set out in detail in our annual Shine Reports  so that we can be held to account.

We’re making great progress, with some of the best recycling rates in the NHS – almost 50% of our non-clinical waste; continued reductions in our direct carbon emissions – 5% in the last year despite increased activity, and halving the environmental damage caused by our use of volatile anaesthetic gases.

Our work on journeys has led to over 60% of staff commuting by active and sustainable means, we’ve switched our fleet over to electric vehicles, installed EV charge points on site and have commissioned electric buses for staff, patients and visitors to access our hospitals.

We host the Environmentally Sustainable Anaesthesia Fellow, in association with the Association of Anaesthetists of Great Britain & Ireland and the Centre for Sustainable Healthcare, which has led to projects that have significantly reduced not just our own anaesthetic gas environmental impact but that of anaesthetic departments across the NHS.

Responding to covid-19

During covid, as large parts of our social interactions moved online, we seized the opportunity to move many of our appointments online too.

In the last year around 30% – that’s 350,000 appointments – have been virtual, and we’ve seen huge benefits to patients.  It’s saved them time, avoided journeys into hospital and minimized the associated pollution. We estimate this at a staggering 350,000 hours of patient time, 7 million miles and almost 2,000 tonnes of carbon saved by our Trust alone.

Both in our organisation and across the NHS, we need to not go back to the ‘way things were’ and instead ‘build back better’ – this is the only route to true sustainability.  We’re working hard with the #GreenerNHS Team to engage other trusts and to raise awareness of the practical steps they can take quickly to begin to reverse the harmful effects of the NHS on our planet.

Most importantly for me, huge numbers of our people are engaged.  They care about this agenda and are proactively taking action.  I’m grateful to our 300 staff green champions for positive the impact they have had, and to the 1,000 staff who have signed up and undertaken over 15,000 sustainable actions in just six months through our Shine app. Sustainability really is a part of our nature and what drives us to flourish.

Whilst the scope and scale of the challenge may be daunting, our early progress across Newcastle Hospitals tells me that it is possible, and only by working together both as one NHS and with our partners will we be able to meet the challenge.

In the 18th Century, Newcastle helped kick start the industrial revolution with our coal mines and George Stevenson’s railways. This has helped us to thrive but at a cost to our life support system. Our challenge now is to garner that pioneering Geordie spirit to lead a new revolution, one that allows everyone on the planet to thrive whilst living within planetary boundaries, and with the NHS leading the way.