SUSTAINABILITY
engagement. You need to work with clinicians, highlighting areas of environmental impact, and allow them to make the clinical judgement for themselves based on the available evidence. We have also undertaken some behavioural ‘nudge’ activities – such as removing the blue Desflurane containers from the anaesthetic machines after a shift, and putting them away in a cupboard, ‘nudging’ the surgical team to use lower carbon alternatives.”
Electric vehicles
Matt Dunlop, head of Sustainability at Newcastle University, speaking at the 30 January seminar.
lifecycle carbon emissions associated with sharps disposal.
Reducing the use of anaesthetic gases with a high GWP
Another success has been a substantial reduction in the use of anaesthetic gases with a high Global Warming Potential (GWP) in theatres and other clinical areas. James Dixon elaborated: “We have worked with clinicians to highlight the impact of these volatile anaesthetic gases, which are widely used across the NHS, Desflurane being the most environmentally damaging. One of our workstreams entails work to lower the carbon footprint of care pathways, and a number of clinicians have led some really positive work, starting a few years ago, on educating others. One of the analogies they used was to equate our carbon footprint associated with these high GWP anaesthetic gases to the number of miles you could travel in the Clinical director’s Golf GTi.”
Use of other gases
James Dixon explained that the anaesthetist-led initiative to reduce the use of the most harmful gases had seen a 40 per cent reduction in the associated carbon footprint of this one clinical service. He said: “We have achieved the reduction via a number of means. For example, we have all but stopped using Desflurane at the RVI; anaesthetists are using other gases, as well as a mixture of nitrogen and oxygen. While we have significantly reduced Desflurane use at the Freeman Hospital, there is still a clinical need for its use with some of the patients they see. We also have to consider clinician autonomy. Had we suddenly announced some sort of ‘ban’, that would have been a real barrier to
The Sustainability Team has also introduced a policy of procuring electric vehicles. “We have switched to electric for our Estates, Catering, and Security vehicles, and are also buying two electric buses, which will be operated locally by Arriva,” James Dixon explained. “These buses will be free for staff to use to get between our various sites, while the public and patients will be able to get on and pay, subsidising the cost of the service. We hope to have these electric buses operating this summer.”
James Dixon impressed upon me that his team had in fact had considerable Board and management support for its many ‘green’ initiatives, but
acknowledged that this had ‘ramped up considerably’ since the Trust’s Climate Emergency declaration. Moving to focus on the factors behind the declaration, he explained that the Intergovernmental Panel on Climate Change (IPCC) unveiled new science in late 2018 that ‘unequivocally made clear that on its current carbon and global warming trajectory, the world was in dire trouble’. He said: “Even with all the nations’ efforts up until now, the world was, the IPCC’s
The Newcastle Trust was reportedly Europe’s first healthcare provider to bring reusable sharps boxes into the UK. Instead of burning its disposable plastic sharps bins, staff fill the ABS Sharpsmart containers, they are sent off to Sharpsmart’s facility near Durham, where a robot tips them out, thoroughly cleans them, and they are returned to the Trust for re-use. The sharps themselves are sent away for incineration.
interim report maintained, still on a trajectory where we would not meet the Paris Agreement target of keeping global warming to a maximum 1.5 °C temperature rise above pre-industrial levels – seen as a safe ceiling. The scientists essentially said that at the current trajectory, which hasn’t been curbed, the accelerated rate of global warming could prove disastrous. That hit home with me as an environmental professional with young children, the obvious question being: ‘What kind of planet are we leaving for them?’
Spurred to action
Trust Chief Executive, Dame Jackie Daniel, who has been very supportive of the work undertaken to make the Trust more sustainable in many areas of its activities since joining the organisation in 2018.
“In early 2019, having struggled with climate anxiety over the IPCC’s warnings over the preceding winter months,” James Dixon continued, “I was spurred to action, and told Rob Smith that – in my view – although we had done some great stuff up until that point sustainability-wise, it had not been enough, and that we needed to approach our Board to take the whole agenda really seriously. Thankfully, Rob was receptive, and agreed that I could transition some of my responsibilities – for instance around asbestos and fire safety – to other seniors in Estates, enabling me to really focus on sustainability. He also allowed me to present a one-page proposal to the Trust’s Executive. I got the go-ahead for this first proposal last March. Initially, I just wanted the Trust Board and Executive to take carbon reduction and sustainably more seriously as a strategic priority. However, at the time, local authorities and
July 2020 Health Estate Journal 51
©Sharpsmart
©Sharpsmart
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