IHEEM 2019 REGIONAL CONFERENCE
The one-day conference, entitled ‘Heatwave’ in the wake of some of the more extreme summer temperatures seen in the UK in recent years, began with a welcome from Graham Stanton, who is chair of the IHEEM AE (D) Registration Board.
into context, the last ice age was triggered by a global temperature change of between 1˚C and 2˚C, so the balance of nature is fragile. The United Nations says there are only 11 years left to prevent irreversible damage climate change-wise. Current climate change is attributed to human activity and our dependence on carbon – which is simply not sustainable – and environmental sustainability is intrinsically linked to carbon change.” Turning to the ‘sustainability’ of the NHS, the IHEEM President said he believed there was a definite link to the service’s carbon footprint and climate change, and that the healthcare engineering and estate management community could contribute significantly to the service’s overall sustainability.
Productivity and efficiency improvements
He added: “I would assert that that the type of ‘productivity and efficiency’ improvements championed by Lord Carter and Sir Robert Naylor across the estate are linked to carbon and carbon reduction for four main reasons: firstly, because carbon has a cash equivalent, directly, in the raw commodity costs of energy and the efficiency of our systems; secondly, because of the tax cost of carbon in its various guises; thirdly, because of the embodied carbon in the physical buildings and assets we use, and, fourthly, due to its relationship to any other form of efficiency – be it procurement, space utilisation, patient flow, or length of bedded stay, all potentially influenced by good building and system design.”
Ian Hinitt said he strongly believed that the healthcare built environment community could contribute to the NHS’s sustainability, and said there was ‘a lot more’ for professionals working in
38 Health Estate Journal January 2020
IHEEM’s President, Ian Hinitt, began by asking the audience, rhetorically, what they reckoned Aneurin ‘Nye’ Bevan might have thought about climate change, and growing evidence of the issue’s seriousness, had he been alive for the past 2-3 decades.
the sector to do, adding: “We are the enablers to change and performance improvement, often up opening strategic clinical opportunities through our estate strategies. I believe that, working with Institute partners, Trusts, and other organisations, such as the Cabinet Office, the BRE, the Carbon Trust, the Carbon & Energy Fund, the Sustainable Development Unit, and the various universities we are affiliated with – including Cardiff, Leeds, Huddersfield, and Cambridge – IHEEM’s membership and resource network can make a significant contribution to the sustainability of the NHS and cut its climate change impact.” With the last IHEEM climate change- themed conferences having run from 2010-2012, Ian Hinitt said he was delighted that IHEEM’s Wales Branch had taken the ‘monumentally important initiative’ of dedicating this year’s Regional Conference to the subject.
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Insight into gases’ global warming potential Graham Stanton then introduced Mike Ralph, who he explained would be ‘providing some insight’ into medical gases’ and inhalational agents’ potential impact on climate change. Mike Ralph began his presentation, entitled ‘Medical Gas or Hot Air’, by explaining that 5-6 years ago, while he was doing some work around oxygen fires with a well-known consultant anaesthetist, Dr Tom Pierce, at University Hospital Southampton, the pair
were discussing the potential global warming impact of some anaesthetics. He explained: “I found some of the data that Dr Pierce came out with quite alarming, to the point that I questioned its validity, so, on the train home, I sat looking at the medical gas usage of a small clinic I had just visited – a user of Entonox with a general anaesthesia session once a week. I was surprised to see that the clinic’s carbon footprint from its anaesthetic and inhalational agents was more than that from its electrical and gas heating load. I thought I had got that wrong, and resolved to investigate the subject further. Based on what I discovered, I have – for the past five years – been determined to get the message out to the healthcare community about the very significant global warning impact that such gases and volatile anaesthetics have. It is an impact many seem completely unaware of.”
The wider backdrop
Looking at the wider context, Mike Ralph alluded to the NHS Long Term Plan’s target of a 51 per cent reduction in carbon emissions (from a 1990 baseline) by 2025, and a 57% reduction by 2030. He said: “These targets are likely to increase, or to be reached earlier, because – for one thing – Net Zero carbon hospitals will become a reality.” Moving to look at some of the specifics, he explained that the propellants from inhalers contributed about 2% of the overall NHS carbon footprint, and anaesthetics 2%, while
There are some significant differences in how anaesthetists work; practices may depend on the anaesthetist’s age. Younger and more recent cohorts are taught to work without Nitrous oxide, although it is still pretty widely used
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