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SUSTAINABLE ACTION PLANNING Workshop 1: Where to Start [Team name & date] 1 A programme of Knowledge into Action | Registered charity No. 1123566. Summertown Pavilion, Middle Way, Oxford OX2 7LG NHS sustainable development Why should the NHS take action? “We’ll do it better tomorrow, and better still the day after” • Improved patient care & experience • Nicer place to work • Reduced carbon in everything we do and use • Resilience 2 Before the programme You should have received this information: • Introduction to Sustainable Action Planning (SAP) o Why, what, how, who • Pre-questionnaire 3 Workshop One Goal Team agreement on 1-2 issues to tackle first Agenda 1. Introduction to environment and health • • Environment and health Climate change 2. NHS sustainable development • • Actions for whole Trusts Actions taken by other teams 3. Discussion: priorities for your team 4 Part 1 Environment and health Climate change 5 Environment and Health • A healthy environment is essential to health • People need clean air and water • Our food and all our material possessions are derived from the world’s natural resources • Green spaces are important to physical and mental health Climate change • One of the biggest threats to a healthy environment today is climate change • Warming of the world’s climate system is creating more extreme weather: floods, storms and droughts • Health researchers have called it the “biggest global health threat of the 21st century 7 Climate change can affect health directly… 1. Malnutrition 2. Deaths and injuries caused by storms and floods. (Flooding can also be followed by outbreaks of diseases, such as cholera) 3. Water scarcity / contamination (droughts and sudden floods) – increased burden of diarrhoeal disease. 4. Heatwaves – direct increases in morbidity and mortality; indirect effects via increases in ground-level ozone, contributing to asthma attacks. 5. Vector-borne disease – malaria and dengue. …but climate change also brings much greater health risks from • Drought • Crop failure • Economic collapse • Mass migration • Civil unrest • Societal collapse Health impacts are worse for the poorest in the world Cumulative emissions of greenhouse gases, to 2002 WHO estimates of per capita mortality from climate change, 2000 Map projections from Patz et al, Ecohealth 2007. WHO Comparative Risk Assessment estimated that by 2000, climate change that had occurred since the 1970s was causing over 150,000 additional deaths per year (WHO, 2002, McMichael et al 2004) Protecting health from climate change • Adaptation: “managing the unavoidable” = preparing for change • Mitigation: “avoiding the unmanageable” = tackling the causes of climate change we need to understand the causes for this… 11 Mitigation: tackling the causes of climate change… 350 million years-worth of carbon locked away in fossil fuels – now being released 150 years 100 years First Oil Well Domestic light bulb 4142 cars, 10 miles concrete road in US 50 years First commercial jet ticket NOW 240,000,000 home PCs 650,000,000 cars 4,800,000,000 passenger flights 4,000,000,000 bulbs pa EU+USA alone (that’s 126 a second) Mitigation: tackling the causes of climate change...(2) Livestock farming accounts for > 18% global emissions Health “co-benefits” of mitigation • Many actions to reduce greenhouse gas emissions which cause climate change are good for health! o Active travel o Eating less meat and dairy o Clean energy o Family planning Leading doctors worldwide have called for governments to act decisively on climate change “Politicians must heed health effects of climate change.” BMJ 2009;339:b3672 16 Part 2a NHS Sustainable Development 17 What is sustainable development? Development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Social Environmental 18 Economic Sustainable development meeting environmental needs • Climate change / carbon Social • Resource depletion o Water o Fossil fuels (plastic etc) • Biodiversity 19 Environmental Economic NHS sustainable development Why should the NHS take action? • Andy Williamson, Chair – GSTT Kidney Patients’ Association: Your answers? “As a kidney patient, I’m acutely aware of my own vulnerability to climate events, and my dependence on drugs and dialysis equipment which rely on cheap oil for their availability.” June 2009 20 NHS sustainable development Why should the NHS take action? “We’ll do it better tomorrow, and better still the day after” • Improved patient care & experience • Nicer place to work • Reduced carbon in everything we do and use • Resilience 21 Climate change / carbon the NHS England carbon footprint 18 million tonnes CO2 in 2004 22 NHS carbon footprint Procurement “things in lorries” www.sdu.nhs.uk NHS sustainable development What should NHS Trusts be doing? • Energy & carbon • Procurement & food • Travel • Water What can’t be done at Trust level? • Waste • Designing built environment 26 NHS Carbon Reduction Strategy NHS sustainable development What can specialties and clinical teams do? • Clinical practice o prevention, supporting patient self care o preparation for health effects of climate change • Local systems o energy, travel, water, waste o medical supplies (drugs & equipment) o non-medical supplies (e.g. food, laundry, paper) o improvements in the way we do things 27 procurement / consumption What could our team do? Clinical Practice Disease prevention Supporting patient selfcare Preparing for health effects of climate change Opportunities? What could our team do? Local systems Energy Travel (staff, patients) Medical supplies Non-medical supplies Water Waste Opportunities? A different way of seeing things Part 2b Actions taken by clinical teams 31 What kind of actions can we take? Current waste 32 - estimated loss (£) Reducing waste to yellow bags £250,000 Return drugs process £300,000 Mis-labelled path lab tests £100,000 Action: energy • Switch off campaign to reduce unnecessary lighting 33 Action: transport • Improve communication with ambulance service – reduce aborted journeys • Cost of aborted journeys 2009 £ June £1500 July £690 Aug £400 Sept - Oct - Nov - Action: water • Recovery of waste water from purification unit • Capital investment £14,000 • Annual saving £7-8,000 • 38% reduction in mains water use • Carbon reduction • 177g/m3 water • 322g/m3 sewerage 35 Action: medical supplies • Significant reduction in packaging • Reduced deliveries 50% (mileage) • More concentrated solutions: smaller volumes needed • Reduced costs by £11,000 a year • Changed suppliers for greener products Action: food • Discussion with catering staff, paper menus • Food waste reduced from 35% to 15% • Cash saving: approx. £4,000/y (£2 per sandwich) • Carbon savings from: • • • • Growing Cooking, preparing, packaging Transport Waste disposal • Happier patients! Part 3 Your priorities 38 Which of these matter to you? building design staff commuting visitor travel medicines food laundry paper dialysis products patient transport number of appointments recycling waste segregation climate risk heating lighting equipment air conditioning water green spaces 39 preventative care Where are you today? What are you most concerned about personally? What are the other priorities for the team? What are your team’s biggest environmental impacts likely to be? What can you influence? 40 Decision • 1 – 2 areas to tackle first (in Workshop 2) • Keep a list of other areas (to tackle later) 41 Next time – Workshop 2 Goals A sustainable action plan! Plan for ongoing improvement Agenda 1. Exploring your chosen areas: • • Describing how the process works today Brainstorming problems and ideas 2. Actions 3. Ongoing improvement • 42 Managing implementation and monitoring