carbon and energy reduction


Government lays down gauntlet to NHS trusts


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HS trusts will need to step up their energy-saving efforts after the Government recently


revealed its commitment to reducing greenhouse gas emissions in the public sector to almost zero by 2050. Earlier this summer, former Prime Minister, Theresa May, announced a new plan to tackle climate change that will benefit public health and cut NHS costs. The original target of an 80%


reduction in carbon emissions by 2050 has now be amended to the new, much-tougher, goal of achieving a ‘net zero’ level of greenhouse gases by the same date.


A focal point The NHS currently accounts for around 4% of all UK greenhouse gas emissions – similar in scale to the airline industry – so will be a major focus point for improvements.


Commenting on the issue, Chris


Naylor, a senior fellow in health policy at the King’s Fund think tank, said: “There are good reasons to believe that, given sufficient time, this carbon footprint could be reduced – even to zero – without undermining the principles and goals of the NHS.” But he warned that widespread change would be needed, setting out five areas of focus for the coming years. Firstly, he said, environmental costs


will increasingly need to be reflected in the financial price paid by the NHS for energy, drugs, food and other resources. As a result, low-carbon forms of care will become increasingly cost-effective relative to carbon-intensive alternatives. And, in some cases, this could be expected to tip


the balance when comparing the merits of different treatment options.


Off the road Secondly, when and how patients and staff travel will become an increasing focus of concern, with this accounting for around 16% of the NHS’s total carbon footprint. But, through increased use of digital technologies, including electronic medical records and innovations in the field of telehealth, healthcare can increasingly be delivered remotely. The NHS will also need to use its collective purchasing power much more assertively to drive change in supply chains, says Naylor. Pharmaceutical products, for example, cost the NHS more than £15billion a year and account for a fifth of the total NHS carbon footprint. “While attention is currently focused on the financial savings possible through smarter procurement; in the future we can expect to see this widen so that there is a greater focus on environmental as well as financial costs, with techniques such as lifecycle analysis being routinely used in procurement processes to capture the costs associated with all stages of a product's life, from production to disposal”, said Naylor.


Waste not, want not And there will be a continued focus on reducing waste and maximising value for patients, for example by reducing provision of treatments that are of limited clinical value; preventing unnecessary admissions to hospital; improving communication and co-ordination between different parts of the system; and ensuring that drugs are prescribed appropriately and taken as intended. “In short, anything that involves using


resources and getting little to show for it means wasted money and unnecessary carbon emissions,” said Naylor. “To eliminate this waste, a carbon- neutral NHS would have to be smarter and more personalised, both through the use of new technologies and by getting much better at understanding what actually matters to individual patients.” Lastly, he said the drive to reduce the


NHS’s carbon footprint will be another reason for shifting resources away from curing disease to preventing ill health. “Anything that succeeds in reducing demand for healthcare is also likely to reduce associated carbon emissions, provided that reductions in one part of the system are not undone by increases elsewhere,” he said. “Preventive interventions are not necessarily carbon-free, but in general we can predict that a carbon-neutral NHS would need to focus more on keeping people healthy.” He added: “If enough progress is made in these areas, the NHS could become carbon neutral without having to undertake more-drastic forms of carbon rationing.


Seizing the opportunities “There are plenty of opportunities for carbon reduction to go hand in hand with efforts to improve the health of the population and increase the efficiency of health services.


“But seizing these opportunities will mean taking action sooner rather than later.


“In a time of rising budget deficits and mounting pressures, climate change might seem to be a distant priority for the NHS. But it is one that will need to be tackled if access to comprehensive health care is to be sustainable in the future: the pain will be greater if we leave it until later.”


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