Trustwide Sustainability Report 2011

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Nottinghamshire Healthcare

NHS

NHS Trust

Positive about mental health and learning disability

Trustwide Sustainability Report 2011 Achieving a sustainable future through conserving the natural environment and its resources

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Welcome to the Trust’s first Sustainability Report.

This document provides an overview of work undertaken by the Trust to help achieve a more sustainable future through conserving the natural environment and its resources.

This includes meeting national targets to reduce our carbon footprint, an increased focus on using renewable energies, investing in more sustainable technologies and reducing waste.

To ensure this is achieved, a Trustwide Sustainable Development Committee was established in early 2010. Since its formation a great deal of progress has been made, with further plans for the future; this is captured on the following pages. However, we all have an important role to play and information is also provided about a range of ways that you can get involved.

As the Executive Lead for Sustainability, I have chaired the Sustainable Development Committee since its formation; however, from June 2011 this responsibility will pass to Peter Parsons, Non Executive Director, who I know will continue to drive forward this important agenda.

I hope that you find this report a useful, interesting and enlightening read.

Simon Smith, Executive Director Local Services

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Mystery artwork – all is revealed!

Anyone recently entering the reception of Duncan Macmillan House will undoubtedly have noticed a giant art installation, which has appeared.

The artwork, which represents a giant energy efficient light bulb, was created by patients on The Peaks Unit at Rampton Hospital.

The purpose of the installation is to raise awareness of the Trust’s efforts to promote the wider environmental agenda and highlight the work currently underway to create a more sustainable future for us all. This is epitomised in the inscription on the base of the art installation which reads “For a brighter sustainable future: re-use, reduce, recycle”.

Due to its very nature, much of the work which is being done to meet very challenging Government targets to cut carbon emissions and reduce environmental impacts often goes unseen. Much of the investment that is being made or has been allocated is for plant and equipment, which most staff and service users will be unaware of. Therefore, the art installation and this report aim to raise the profile of this work and inform you about what is happening, so that where appropriate you can also do your bit for our sustainable brighter future.

If anyone is interested in purchasing the art installation following its display, please contact Neil Alcock on 0115 969 1300 Ext. 10290 or email neil.alcock@nottshc.nhs.uk.

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Sustainable Development & the Trust Feedback from both staff and service user forums shows that one of the major concerns is what action the Trust is taking to conserve the natural environment and promote a sustainable future for us all.

The following is an outline of the work by the Trust’s Sustainable Development Committee, its achievements to date and plans for the future.

‘Sustainable development’ means conserving the natural environment and its resources, so that future generations inherit a planet that is at least as habitable as the one we live in, whilst taking into account the social and economic factors which also affect the lives of current and future generations.

Recent earth summits have been held in Copenhagen and more recently Cancun in Mexico, which have focused on the high level actions Governments have committed to in order to promote sustainability. As a result the UK Government has set itself a target of reducing CO2 emissions by 34% by 2020 and by 80% by 2050. The NHS has also stipulated an interim target of a 10% reduction by 2015.

In order to meet these targets, the Trust formed a Sustainable Development Committee over a year ago headed by Simon Smith, Executive Director Local Services. When reducing

carbon emissions many people automatically think of the carbon emitted to heat and power our buildings.

However, work carried out by the NHS Sustainable Development Unit has shown that carbon production from healthcare settings fall into three broad areas: • Purchasing • Building Energy Use • Transport and Travel Surprisingly, by far the biggest producer of CO2 across the NHS is Purchasing; the pie chart (right) shows the relative percentage production for each of the above in the NHS nationally.

Work carried out to assess the Trust’s carbon footprint shows a similar percentage split. The reason purchasing has such a large footprint is because it includes all the goods that the Trust purchases. This includes the carbon which is emitted in order to obtain the raw materials, process them into finished goods, transport them to the point of sale, and the carbon used to finally dispose of them.

Transport looks at the carbon emitted as a result of vehicles used to carry the goods and services of the Trust.

Travel focuses on the use of vehicles to carry staff and patients to their place of work or treatment.

Nottinghamshire Healthcare NHS Trust • Trustwide Sustainability Report • 2011

NHS Carbon Footprint 2007

Building Energy 22%

Travel & Transport 18%

Purchasing 60%

The Trust’s Sustainable Development Strategy The Trust has recently published its Sustainable Development Strategy which sets out how it will meet the Government targets for CO2 reduction and the wider aims, such as sustainable procurement and waste minimisation.

The strategy sets out a framework for measuring progress across a wide range of indicators and how that progress is then communicated to the Trust Board; this document can be downloaded from the Trust’s Intranet site. A key provision of this strategy is how carbon reduction across the Trust is to be implemented; the following article focuses on the Building Energy Carbon Reduction Plan and the work being carried out to put this plan into action.

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Building Energy Carbon Reduction Plan

1. Replacement of coal fired boilers at Rampton Hospital 2. Rationalisation of Trust Site Use 3. Voltage Reduction Equipment at Wathwood Hospital, Duncan Macmillan House and the Wells Road Centre 4. Building Insulation Upgrades 5. Wind Turbine Proposal for Rampton Hospital

Total Trust CO2 Projection 2009/10 to 2015 20,000

CO2 Tonnes Per Year

Before embarking on a plan to reduce carbon emissions it is vital to understand where carbon is being emitted. The first step undertaken was to look at all Trust owned sites and assess their building energy footprint. Once this had been done it was possible to identify which sites produced the most carbon and to decide on the best strategy for reducing it. Unsurprisingly the largest sites, Rampton Hospital, Duncan Macmillan House, Wells Road Centre, Highbury Hospital, Arnold Lodge, Millbrook Mental Health Unit and Wathwood Hospital, account for the largest proportion of carbon from the Trust.

Using Environment Agency conversion factors the Trust’s building energy carbon footprint for 2009/10 is around 19,000 tonnes of CO2. A survey of Trust buildings was then carried out to identify those areas where investment in energy saving measures would produce the greatest returns in terms of CO2 reduction.

This has resulted in the following areas identified for action:

Total CO2 18,911

15,000

Electricity 8915

CO2 reduction 6465 (34%)

Electricity 4862

10,000

Coal 0 Coal 6020 5000

Gas 7584 Gas 3975

0 2009/10

The chart below shows how the Trust intends to dramatically cut its carbon emissions from building energy use. The reasons why each of the above has been included in the carbon reduction plan are as follows: 1. Replacement of coal fired boilers at Rampton Hospital Currently the boilers which supply the heating to the majority of the Rampton site are coal fired. Coal is the most carbon intensive of fuels when compared to either natural gas or heating oil. The boilers are nearly twenty years old, are inefficient and due for replacement; therefore this presents an excellent opportunity not only to upgrade the reliability of the existing system but also maximise the potential for both energy and carbon savings. A feasibility study is being conducted into such issues as reliability of the operational

How the Trust Intends to Save Carbon Percentage breakdown of savings by scheme to achieve a reduction of 6448 tonnes of CO2 by 2015: Wind turbine (Rampton Hospital) 6.6% Rationalisation of Trust site use (2011-12) 4.6% Rationalisation of Trust site use (2012-13) 1.6% Voltage reduction and insulation upgrades (Local Services) 3.4% Voltage reduction (Wathwood Hospital) 0.5% Boiler house refurbishment (Rampton Hospital) 83.4%

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Total CO2 12,445

2015

system, dependence on fuel supplies, cost of the replacement system, energy cost savings, fuel and CO2 savings. Options to be evaluated include Combined Heat and Power (CHP) and Biomass Boilers. Funding has been allocated in the Capital Plan for 2011/12.

2. Rationalisation of Trust Site Use One area which is often overlooked when considering energy and carbon reduction is whether the buildings occupied by the Trust are being used in the most efficient way possible. If a large number of buildings are occupied and the space often poorly utilised, this places an unnecessary burden on the costs of not only fuel but also rates, council tax and other running costs. By rationalising the number of sites we use and making the services delivered from those that remain more efficient, unneeded buildings can be released for other uses. This will then reduce fuel costs and reduce carbon emissions.

Additionally the buildings that are sold can be used by other organisations that would otherwise have to construct new buildings inevitably causing environmental degradation.

3. Voltage Reduction Equipment Electricity use is the most carbon intensive fuel used to power buildings, every kilowatt hour (kWh) of electricity consumed produces nearly three times the amount of carbon compared with gas and over 1.5 times as much as that produced by consuming coal.

For this reason it makes sense to reduce energy waste from electricity use.

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Due to the way electricity is distributed it is inevitable that some buildings will be supplied with electricity at a voltage which is higher than is actually needed. This can lead to a loss of energy and carbon of up to 10%.

Voltage reduction equipment is fitted to the main supply of the building and reduces this excess voltage, saving energy, carbon and money.

4. Insulation Upgrades One of the cheapest ways to save money on heating is to increase the level of insulation particularly in the roof space. Because many of the Trust properties are quite old some were only fitted with very modest levels of loft insulation. A programme is now underway to upgrade these properties to current best practice standards.

5. Wind Turbine Although many Trust sites are quite small and offer little scope for more ambitious technology such as wind turbines, Rampton Hospital is unique in its size and geographical position. A feasibility study is currently being undertaken to ascertain whether it will be practical to fit a relatively large scale wind turbine of around 500 kW at this site. The main factors that will have to be considered are planning permission, wind speed and carbon savings relative to capital cost. Once these factors have been explored a decision whether to go ahead with this project will be considered.

Changing the Trust’s Carbon Profile Implementing the measures above will have a dramatic effect on the carbon profile of the Trust. The graph above shows the breakdown of carbon production across the Trust for the financial year 2009/10 and how it will look by 2015 if all the measures are implemented. The most obvious changes will be moving away from the use of coal for heating and the reduction of carbon resulting from national grid based electricity generation, both of which are highly carbon intensive. The savings would result in a reduction of 6465 tonnes of CO2 per year which is a 34% reduction on the amount currently produced.

This would mean that the Trust would be able to meet the NHS target of a 34% reduction by 2015 instead of 2020 therefore five years ahead of time.

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The Scope for Renewables & Micro Generation Renewable energy is often cited as the best way to reduce emissions in carbon saving schemes. However the uptake for renewable energy in the UK has been relatively slow compared with other European countries. One reason for this is that although renewable technologies do not emit carbon they can be quite expensive to purchase and install, and therefore take quite a long time to pay for themselves.

In order to address this problem, the Government has recently provided incentives to help stimulate the renewable sector within the UK. It has introduced Feed In Tariffs (FITs) aimed at ensuring installers of renewable technology receive much better payments for the electricity they produce than was previously the case. This now means that the financial support provided makes the uptake of these technologies much more economic.

A Commitment to Renewables One method of supporting renewable technologies is to purchase at least some of the electricity generated centrally by the national grid from these sources. The current Trustwide electricity contract makes use of electricity that is generated from these sources. In fact 10% of all electricity consumed by the Trust is from accredited renewable supplies such as large scale hydro electric and wind

Nottinghamshire Healthcare NHS Trust • Trustwide Sustainability Report • 2011

turbines. In addition two recent refurbishment projects within the Trust have included Photo Voltaic (PV) panels, these being a 503m2 array on the roof of Rutland Ward at Arnold Lodge (see image below) and a 225m2 array at the Mike Harris Learning and Development Centre at Rampton Hospital.

The Future for Renewables The Trust’s Building Carbon Reduction Energy Plan, to reduce carbon emissions over the next five years, has concentrated on relatively large scale projects because they tend to offer the best return on investment. However, because of the recent FIT changes many of the Trust’s smaller properties may now be well placed to benefit from small scale renewable technology. In particular the case for small scale PV panels to produce electricity may now be cost effective.

During the early part of 2011 the Trust will survey many of its properties in order to assess the potential for PV panels in order to identify the most cost effective options. Once this has been done a business case will be put forward to identify funding requirements and take the plan forward where there is an economic case for doing so.

Micro Generation This term is applied to small scale generation of electricity and heating at the point where it is used. Recent advances in technologies such as micro CHP i.e. domestic sized Combined Heat and Power systems now means that systems which were once only economic to fit to large scale industrial or commercial facilities can now be installed in smaller domestic scale properties owned by the Trust. These options will be investigated and where economic a proposal will be put forward.

PV array at Arnold Lodge (top left hand of picture)

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‘Money for Nothing & Energy for Free’ At one point or another, you will have looked at your annual household energy bill and thought, ‘there must be a way to do this cheaper’, especially after a severe winter. Well, the Government has developed and enacted in law a scheme known as Feed In Tariffs (FIT) to encourage homeowners to install ‘renewable energy’ technology, such as small wind turbines and solar panels (www.fitariffs.co.uk). This will help address the balance between what a home system costs and what it gives back in terms of energy bill savings.

Government Incentives The UK is far behind the rest of Europe in terms of percentage power generated from renewable technology. In summary, the average UK household could be around £1500 a year better off. If an average household, for example a three or four bedroom house, installed solar Photo Voltaic (PV) panels that generate electricity, the Feed In Tariffs would provide the following benefits: • The electricity generated would pay the homeowner £836 a year tax free • Remaining electricity costs would be reduced from £450 to £300, saving £150 • Therefore the total benefit would be £986 per year This is based on an average use of 4,500kWh (higher end of users) of electricity per year and the installation of 2.5kW of solar PV panels (source: Ownergy Report).

The payments are guaranteed for the life of the scheme (until April 2030), and are linked to RPI and Income Tax exempt. It is for this reason that investors with property they are not planning to sell in the next 19 years are considering the Feed In Tariff scheme as a form of long term guaranteed investment.

In addition, the finishing touches are being put to a sister scheme, known as the Renewable Heat Incentive (RHI) due the middle of 2011. In exactly the same way as the Feed In Tariffs guarantee payments for energy production capacity at an index linked rate, tax free, so will the Renewable Heat Incentive for any heat you generate using a renewable system (www.rhincentive.co.uk). For a capital outlay to purchase the systems involved for both the electricity generation, and the heat generation under these schemes, typical ‘payback’ times can be as little as 7-8 years, resulting in profit for the remainder of the scheme.

Feasibility The Trust is looking at the feasibility of FIT/RHI installations at its domestic size properties (and some larger, more ambitious projects for Duncan Macmillan House and Rampton Hospital). These projects will not only increase resilience and make the Trust a more sustainable organisation, but provide financial stability for its energy requirements and help the environment.

Before purchasing any renewable energy technology it is important to thoroughly research this; the websites listed in this article provide a good starting point for information on the schemes and companies providing such technologies will be able to assist with any questions. The best rates for FITs are to be had in 2011, so this is the year to get your system; not only can you make money by generating your own electricity/heat but you will have taken a massive step towards reducing both your personal, and the UK’s, carbon footprint.

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Combined Heat and Power (CHP) Mains generated electricity is only around 33% efficient because so much heat is wasted at the power station through cooling towers.

CHP makes use of this waste by placing the electrical generator close to the buildings to be heated, and so can be up to 85% efficient, thereby cutting carbon emissions.

Fuel 100%

Heat for Buildings 55% Electricity 30%

Losses 15%

Help to reduce unnecessary spend on energy & waste services As the NHS faces efficiency savings over the next few years, a small but worthwhile contribution towards this and to ensure that the Trust remains sustainable for the future, can be made by saving energy and reducing waste.

The Trust spends in excess of £3 million a year on heating and lighting and more in addition for waste services. The imperative is growing every year – in terms of wholesale energy cost increases being far above inflation (7-9% currently) – so an even harder push will be needed to make energy reductions that benefit the Trust positively.

We all have a role to play in saving energy and reducing waste and there are several steps that can be taken.

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Biomass Boilers The vital difference between biomass and fossil fuels is one of time scale. Burning fossil fuels such as coal releases carbon which has been accumulated over many millions of years. Using biomass only releases carbon which has been stored whilst the plant fuel was growing. So in effect it is considered carbon neutral. Typical biomass boiler fuels include wood chips and willow coppice pellets.

Sustainable Technologies at a Glance

Wind Turbines Wind turbines are a well known method of generating renewable power. As with PVs the changes to FITs may now make them more cost effective than was previously the case. However, one major obstacle is planning permission and this can often prove time consuming.

There are many ways of making the Trust more energy efficient and so reducing the carbon emitted by the electricity supplied from fossil fuels burned in the power station shown (left). Here is a guide to the technologies referred to in the articles. All are being actively considered and some are already in place.

Voltage Reduction Equipment Electricity supplied to many buildings is often at a higher voltage than the equipment it powers requires, depending where on the distribution system the building is connected.

Voltage reduction equipment regulates the voltage to a lower level and this means that electrical energy is not wasted and carbon emissions are reduced.

Photo Voltaic Panels Possibly one of the best known forms of renewable power is the Photo Voltaic (PV) Panel. Making use of natural daylight (they do not need direct sunlight) they will generate electricity.

Recent Government changes to Feed In Tariffs (FITs) now make this a much more cost effective option.

Step One Contact the Energy and Environmental Team for more information on being an environmental representative, and become a driving force in your area for energy reduction.

• Step Two Begin to implement the following ‘quick win’ energy reduction measures to help the Trust realise immediate cost savings: • Maximise Natural Lighting – assess the

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need for bulbs, turn off when not in use.

All the bulbs in the Trust use fractional amounts of energy being turned off on and on, so turn them off even if you are ‘just popping out’.

Heating – make sure that heating is used as required; do corridors and travel/storage spaces really need heating?

1% of overheating can cause an 8% increase in energy bills.

Air conditioning – resist the temptation to use air conditioning (if available) and maximise natural ventilation where possible; a lot of electricity will be saved using the windows!

Computers – desktop PCs use 85% more electricity to run than a laptop, so leaving them on when they are not needed uses a lot of electricity. Modern PCs don’t use significantly more energy on start up than when running so turning them off for lunch/breaks is worthwhile.

Make sure the orange standby light on monitors is turned off as well.

Office Equipment – printers, photocopiers, scanners etc are only used during working hours, so turn them off when not in use. Fit plugs with automatic timers to turn these devices off, as ‘sleep

Nottinghamshire Healthcare NHS Trust • Trustwide Sustainability Report • 2011

mode’ still uses a lot of energy.

• Electrical Equipment – ensure it is not left in standby mode; power consumption can be up to 30% of the running output.

• Water – is a costly utility and should be preserved wherever possible; report leaks immediately and be conscious of your usage. Remember – it takes 50 million barrels of oil a year to simply make the plastic bottles for bottled water.

• Waste – recycle and reuse wherever possible; in Local Services a 77% recycling rate was achieved in 2010 and we want to increase this rate in 2011.

Segregate those valuable recyclables and follow the guidance on the bin top labels.

If you would like a recycling system introduced in your area contact the Energy and Environmental Team.

Learn More Many of the above steps can also be taken at home. For more advice, help and guidance on how you can help, contact the Energy and Environmental Team at Duncan Macmillan House on 0115 969 1300 Ext. 10522. Further information can also be obtained from the websites listed on the back page.

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Want to do more?

We hope that reading these articles has inspired you to adopt the energy saving habits outlined and to reduce the energy used in your department, ward or building. For more information visit the following websites: www.carbonfootprint.com www.carbontrust.com www.decc.gov.uk www.energysavingtrust.com www.fitariffs.co.uk www.recycling-guide.org.uk www.rhincentive.co.uk www.sustrans.org.uk For further information, guidance and support, contact: Stephen Lee, Environmental Implementation Officer stephen.lee@nottshc.nhs.uk 路 Tel: 0115 969 1300 Ext. 10522 Neil Alcock, Energy and Environmental Manager neil.alcock@nottshc.nhs.uk 路 Tel: 0115 969 1300 Ext. 10290

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To obtain more copies of this document please contact the Communications Team on 0115 993 4530.

Please recycle