SUSTAINABLE ACTION PLANNING
Workshop 1: Where to Start [Team name & date]
1
A programme of Knowledge into Action |
Registered charity No. 1123566. Summertown Pavilion, Middle Way, Oxford OX2 7LG
NHS sustainable development Why should the NHS take action?
“We’ll do it better tomorrow, and better still the day after” • Improved patient care & experience • Nicer place to work • Reduced carbon in everything we do and use • Resilience
2
Before the programme You should have received this information: • Introduction to Sustainable Action Planning (SAP) o Why, what, how, who
• Pre-questionnaire
3
Workshop One Goal Team agreement on 1-2 issues to tackle first
Agenda 1. Introduction to environment and health • •
Environment and health Climate change
2. NHS sustainable development • •
Actions for whole Trusts Actions taken by other teams
3. Discussion: priorities for your team 4
Part 1
Environment and health Climate change
5
Environment and Health • A healthy environment is essential to health • People need clean air and water • Our food and all our material possessions are derived from the world’s natural resources • Green spaces are important to physical and mental health
Climate change • One of the biggest threats to a healthy environment today is climate change • Warming of the world’s climate system is creating more extreme weather: floods, storms and droughts • Health researchers have called it the “biggest global health threat of the 21st century 7
Climate change can affect health directly… 1. Malnutrition 2. Deaths and injuries caused by storms and floods.
(Flooding can also be followed by outbreaks of diseases, such as cholera)
3. Water scarcity / contamination (droughts and sudden floods) – increased burden of diarrhoeal disease. 4. Heatwaves – direct increases in morbidity and mortality;
indirect effects via increases in ground-level ozone, contributing to asthma attacks.
5. Vector-borne disease – malaria and dengue.
…but climate change also brings much greater health risks from • Drought • Crop failure • Economic collapse • Mass migration • Civil unrest • Societal collapse
Health impacts are worse for the poorest in the world Cumulative emissions of greenhouse gases, to 2002
WHO estimates of per capita mortality from climate change, 2000 Map projections from Patz et al, Ecohealth 2007.
WHO Comparative Risk Assessment estimated that by 2000, climate change that had occurred since the 1970s was causing over 150,000 additional deaths per year (WHO, 2002, McMichael et al 2004)
Protecting health from climate change
• Adaptation: “managing the unavoidable” = preparing for change
• Mitigation: “avoiding the unmanageable” = tackling the causes of climate change we need to understand the causes for this…
11
Mitigation: tackling the causes of climate change… 350 million years-worth of carbon locked away in fossil fuels – now being released 150 years
100 years
First Oil Well Domestic light bulb
4142 cars, 10 miles concrete road in US
50 years
First commercial jet ticket
NOW
240,000,000 home PCs 650,000,000 cars 4,800,000,000 passenger flights 4,000,000,000 bulbs pa EU+USA alone (that’s 126 a second)
Mitigation: tackling the causes of climate change...(2)
Livestock farming accounts for > 18% global emissions
Health “co-benefits” of mitigation • Many actions to reduce greenhouse gas emissions which cause climate change are good for health! o Active travel o Eating less meat and dairy o Clean energy o Family planning
Leading doctors worldwide have called for governments to act decisively on climate change “Politicians must heed health effects of climate change.” BMJ 2009;339:b3672
16
Part 2a
NHS Sustainable Development
17
What is sustainable development? Development that meets the needs of the present without compromising the ability of future generations to meet their own needs.
Social
Environmental
18
Economic
Sustainable development meeting environmental needs • Climate change / carbon
Social
• Resource depletion o Water o Fossil fuels (plastic etc)
• Biodiversity
19
Environmental Environmental
Economic
NHS sustainable development Why should the NHS take action? • Andy Williamson, Chair – GSTT Kidney Patients’ Association: Your answers? “As a kidney patient, I’m acutely aware of my own vulnerability to climate events, and my dependence on drugs and dialysis equipment which rely on cheap oil for their availability.” June 2009
20
NHS sustainable development Why should the NHS take action?
“We’ll do it better tomorrow, and better still the day after” • Improved patient care & experience • Nicer place to work • Reduced carbon in everything we do and use • Resilience
21
Climate change / carbon
the NHS England carbon footprint 18 million tonnes CO2 in 2004
22
NHS carbon footprint Procurement
“things in lorries�
www.sdu.nhs.uk
NHS sustainable development What should NHS Trusts be doing? • Energy & carbon • Procurement & food • Travel • Water
What can’t be done at Trust level?
• Waste • Designing built environment
26
NHS Carbon Reduction Strategy
NHS sustainable development What can specialties and clinical teams do? • Clinical practice o prevention, supporting patient self care o preparation for health effects of climate change
• Local systems o energy, travel, water, waste o medical supplies
(drugs & equipment)
o non-medical supplies
(e.g. food, laundry, paper)
o improvements in the way we do things 27
procurement / consumption
What could our team do? Clinical Practice
Disease prevention Supporting patient selfcare Preparing for health effects of climate change
Opportunities?
What could our team do? Local systems Energy Travel (staff, patients) Medical supplies Non-medical supplies Water Waste
Opportunities?
A different way of seeing things
Part 2b
Actions taken by clinical teams
31
What kind of actions can we take? Current waste
32
-
estimated loss (£)
Reducing waste to yellow bags
£250,000
Return drugs process
£300,000
Mis-labelled path lab tests
£100,000
Action: energy • Switch off campaign to reduce unnecessary lighting
33
Action: transport • Improve communication with ambulance service – reduce aborted journeys • Cost of aborted journeys 2009
£
June
£1500
July
£690
Aug
£400
Sept
-
Oct
-
Nov
-
Action: water • Recovery of waste water from purification unit • Capital investment £14,000 • Annual saving £7-8,000 • 38% reduction in mains water use • Carbon reduction • •
35
177g/m3 water 322g/m3 sewerage
Action: medical supplies • Significant reduction in packaging • Reduced deliveries 50% (mileage) • More concentrated solutions: smaller volumes needed • Reduced costs by £11,000 a year • Changed suppliers for greener products
Action: food • Discussion with catering staff, paper menus • Food waste reduced from 35% to 15% • Cash saving: approx. £4,000/y (£2 per sandwich) • Carbon savings from: • • • •
Growing Cooking, preparing, packaging Transport Waste disposal
• Happier patients!
Part 3
Your priorities
38
Which of these matter to you? building design
staff commuting
visitor travel
medicines food laundry
paper dialysis products
patient transport
number of appointments
recycling waste segregation
climate risk
heating lighting
equipment
air conditioning
water green spaces
39
preventative care
Where are you today?
What are you most concerned about personally?
What are the other priorities for the team?
What are your team’s biggest environmental impacts likely to be?
What can you influence?
40
Decision • 1 – 2 areas to tackle first (in Workshop 2) • Keep a list of other areas (to tackle later)
41
Next time – Workshop 2 Goals A sustainable action plan! Plan for ongoing improvement
Agenda 1. Exploring your chosen areas: • •
Describing how the process works today Brainstorming problems and ideas
2. Actions 3. Ongoing improvement •
42
Managing implementation and monitoring