Carbon reduction and Net Zero Another attendee asked Dr. Pinto if she had
seen Board leads or senior NHS Trust personnel going through the work being done and trying to find sustainability opportunities. She said: “Yes, definitely. We are just about to do our Net Zero leadership training for Boards. For instance, one organisation we have worked with in London has very demonstrably been pulling out case studies and seeing how they can replicate them. You need a team in charge of this, which focuses on what’s happening nationally and internationally, and then prioritises which actions to implement.” Another delegate asked how the NHS can best
strike a balance between cost-effectiveness and maintaining high standards of patient care. Dr. Pinto said: “With clinical transformation, you are almost invariably saving money, because you’re genuinely streamlining pathways. “Much of what we do around sustainability is actions we need to take anyway – around streamlining, reducing costs, managing capacity, personalisation of care, and making it more effective. Prevention isn’t just out there in the community; there’s quaternary prevention as well – which is about not harming people through what we do.” The speaker said this revolved around aspects such as over-investigation, overprescribing, and overdiagnosis. An attendee from Roche Diagnostics
acknowledged Dr. Pinto’s point about ‘overinvestigation’ of medical conditions, but said there were also many cases of under- investigating patients, which he feels have a negative impact on climate. He elaborated: “There are cases in particular of heart failure where a lack of investigation at the early stages is leading to heavy reliance on secondary care services, and picking up disease at a very late stage, by which time it’s actually more carbon-intensive to treat the patient.” He added: “I think we need to look more at how diagnostic pathway innovation can help meet sustainability targets.”
Looking at specific pathways and the role of diagnostics Dr. Pinto agreed. She said: “Our courses cover
Acknowledgement
This feature is adapted from an article which first appeared in CSJ’s sister title, Health Estates Journal and is reproduced with the kind permission of IHEEM and the author and Editor, Jonathan Baillie.
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We must embed sustainability in a highly visible way from top to bottom. It should be embedded in our accounting, our decision making performance, and in staff training and appraisal. The Royal Navy is making climate change training mandatory. Why aren’t we?
that; there’s real potential for accurate diagnosis. When we discuss prevention, we talk about different levels, so indeed secondary prevention, and early identification. It’s about getting it right, which is a bit more nuanced. It takes looking at specific pathways. “One example we use is a new diagnostic test that identifies pre-eclampsia in
pregnancy. This has significantly reduced the number of people being admitted and outpatient appointments, because it’s more accurate. So there are many examples. I definitely agree with you. We need to be taking a ‘getting it right first time approach’, and that is why we need to make it explicit that this is actually a sustainability agenda.”
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