PUBLIC SECTOR SUSTAINABILITY


CARBON, COST AND CARE WHAT MAKES A SUSTAINABL


emissions, how can care homes be supported to reduce their environmental impacts, build in resilience to rising costs and improve the health and wellbeing of residents? What is the environmental impact of residential care in the UK to start with? These are the questions addressed in a report on sustainable care home published this month.


Jerome Baddley BSc Hons, AIEMA, Sustainable Energy Development Manager, Nottingham Energy Partnership writes: With a growing demand for residential care, at the same time as increasing natural resource costs and a need to reduce CO2


A


s observed in the Dilnot report last year (Fairer Care Funding, July 2011), people can now expect to live much longer after they retire, compared


with their parents or grandparents. This is something to celebrate. In 1901, there were just over 60,000 people aged 85 and over in the UK. Today there are 1.5 million – a 25-fold increase. Many younger people with a care and support need are also living longer.


By 2007, around 420,000 frail older people, 0.65% of the UK population were living in care homes or long-stay hospitals. UK population projections from the Government Actuary show that if age- specific rates of usage per unit population were to remain as they are now, there


Table 1: UK Cost of natural resources in care


would be 1,200,000 by the time the older population peaks in 2071 (Joseph Rowntree Foundation, 2008). The environmental sustainability of care homes will become and area of increasing importance


In 2011 NHS Nottingham City secured funding from the NHS East Midlands Regional Innovation Fund to work with a sample of care and nursing homes, investigating the components of sustainable care. The Nottingham Energy Partnership was commissioned to deliver the project. The aim was to undertake a holistic assessment as to how care homes could be supported to reduce their environmental impacts, build in resilience to rising costs and improve the health and wellbeing of residents.


During the process of the focussed


Table 2: Carbon emissions from the use of natural resources in care


study, it became clear that while there had already been some work undertaken looking at sustainability in new build homes, the existing UK literature on sustainability in operational care homes was very thin. Much reference and benchmark data had to be derived from studies looking at proxy information, such as costs or specific areas of focus such as drugs waste. No other study had tried to look at the care home holistically or to calculate the UK wide carbon impact of the residential care sector.


Many of the measures to reduce carbon emissions in the residential care sector are also beneficial to residents health and wellbeing and almost all of the measures to reduce carbon emissions also reduce the costs of residential care. A key output from this work was to identify critical interventions that would support improved sustainability, lower carbon emissions and reduce waste. We also aimed to identify examples of good practice that could be replicated by others


16 PUBLIC SECTOR SUSTAINABILITY • VOLUME 2 ISSUE 6


in the sector. We focused on quantifying amounts and categories of waste in natural resource flows, such as energy, fuel, water and food. Where possible costs and carbon emissions have been attributed to relevant responsible parties in the prescription or procurement pathway between commissioner, GP, care home operator or pharmacy.


NATURAL RESOURCE IMPACTS The residential care sector accounts for at least 3.4million tonnes of CO2


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each year and £1.07billion in natural resource costs. The social cost of carbon adds a further £76million in costs to the economy per year.


In 2008/9 energy use in residential homes accounted for around £468.5million in utility costs and around 2.3million tonnes of CO2


equivalent to the carbon footprint as the country of Eritrea. This represents 0.42% of the 2009 UK carbon footprint. (National Statistics, 2012 )


In 2008/9 residential homes also accounted for around £505million in food costs generating around 622,250 tonnes of CO2


e.


Annual pharmacy waste from UK care homes amounts to a value of product of around £49million and up to 28,764 tonnes of CO2


e.


While pharmacy waste from care homes only represents a fraction of pharmacy consumption in care homes, there is clearly a different scale of magnitude in terms of the potential for carbon savings from reduced pharmacy waste to the opportunity represented in improving food procurement and energy use. Reducing over-prescription and good medicines management, however, both have significant potential to improve


e. This is roughly


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