SUSTAINABILITY
UK buyer of goods and services, and has more than 80,000 suppliers. The NHS can reduce emissions from its supply chain in three ways – more efficient use of supplies, low-carbon substitutions and product innovation, and by working with suppliers to decarbonise their own processes. As evidence of its wholehearted commitment to this mission, NHS England is working with 500 of the NHS’s largest suppliers to disclose their carbon emissions. The NHS supply chain accounts for
Although medicines account for 25% of emissions within the NHS, it is a small number of medicines that account for a large portion of the emissions in question.
2021, and to develop refreshed Green Plans by February 2022. These Green Plans need to set out the ambition and strategy for each NHS Trust and ICS to significantly reduce carbon emissions. Achieving Net Zero emissions in healthcare will be possible only with radical and immediate engagement of the clinical community, and this includes work around sustainable models of care, procurement, food and catering, and medicines.
Sustainable models of care It is critical that Net Zero principles are embedded across all clinical services. Consideration needs to be given to how emissions can be reduced in the way care is delivered. Many clinicians are beginning to develop new service models, but often the impact of carbon is not considered. NHS Trusts need to engage with their clinicians and introduce some joined-up thinking. This isn’t a battle that can be won in isolation; all areas of the organisation need to engage in achieving the targets. The NHS Long Term Plan set out a
commitment to deliver a new service model for the 21st century. However, if the NHS is to achieve its ambitious goals, any new service model will require a focus on sustainability and reduced emissions. The NHS isn’t alone in this, as all industry sectors are having to revisit their processes and review how they operate. As part of the new service model for the 21st century, multiple commitments are in progress, including boosting ‘out-of-hospital’ care – empowering people to have more control over their own health, where appropriate. Progress has been made around digitally- enabled care through virtual consultations and clinics in the past 12 months, with over 22 million virtual outpatient appointments being delivered. The COVID-19 pandemic was a big catalyst for the rapid adoption of digital health tools, and more work
34 Health Estate Journal April 2022
needs to be done in supporting clinicians to understand what technology is available, or could be available, to support improvements in the delivery of clinical interventions, as well as providing investment to support the change.
Need for a carbon analysis Whenever changes are being considered, it should be part of the process that a carbon analysis is carried out in the planning stages. It needs to become an automatic consideration, as there will be little point in implementing changes that ignore the importance of emissions and push the onus onto someone else.
Procurement and supply chain One of the biggest areas where change needs to be implemented is in procurement and the supply chain, especially given that the NHS is the largest
approximately 62% of its total carbon emissions. In order to deliver a Net Zero health service, a Net Zero supply chain is a must. All Trusts need to use their individual or collective purchasing power to reduce the carbon embedded in their supply chains. While Trusts cannot directly influence the emissions of a supplier, they do have the option of voting with their feet – and the introduction in April 2022 of a mandatory social value weighting of 10%, which will include carbon reduction among its factors, will force those companies who want to supply goods or services to the NHS to be proactive in improving their green credentials. In November last year, NHS England published a Net Zero Supplier Roadmap to help suppliers align with the Net Zero ambition. After 2030, any supplier not meeting minimum expectations will not be contracted. It is expected that all suppliers will publish a carbon reduction plan from April 2024, but embedding this requirement into contracts will be challenging. If the NHS is to include a requirement on suppliers to reduce their carbon emissions and publish their carbon reduction plans, then NHS Trusts will need support, including the introduction of standard contract terms as part of the NHS terms and conditions. This is a very positive step towards tackling Scope 3 emissions.
Steps are already being taken by NHSE / NHSI to develop new national standards for healthcare food, which should see improved procurement.
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