The Climate Change Summit: Challenges in Delivering a Net-Zero NHS
After it was discovered that the NHS is responsible for an estimated 5% of the UK’s carbon footprint, it became the world’s first national health system to make net-zero commitments, with clear deliverables and milestones.
Whilst the NHS is contributing to climate change, climate change is also having its own effect on the NHS. 900 people were killed by soaring temperatures in 2019 while nearly 18 million patients visited GP practices in areas that exceed the World Health Organisation’s air pollution limit.
Coming just in time to fall in line with COP26 we hosted two webinars to discuss the challenges and solutions to the NHS’s climate impact.
For our first event of the day, we invited NHS staff from a multitude of departments to speak about their sustainability journey and the challenges they have faced so far.
Our webinar was introduced by Co-Founder and host Georgia Halston, who talked us through our panellists and what they would be covering.
Dr.Lucy Brooks, Leadership Fellow in Climate Change and Anaesthesia, Health Education England
Our first speaker of the day was Dr. Lucy Brooks whom talked us through the multitude of sustainability challenges in anaesthesia, and how it contributes to the NHS carbon footprint.
Lucy began by presenting us with a pie chart illustrating the NHS’ carbon footprint to visualise its biggest contributors.
“There are choices that anaesthetists can make to reduce the carbon footprint of the equipment they use. For example, choosing reusable wherever possible. Things like surgical gowns for sterile procedures can be reusable. And other equipment that is single patient use can stay with the patient when they move around the hospital, rather than being thrown away every time.”
“The most obvious one, is anaesthetic gases and Metered Dose inhalers, which you can see makes up 5% of the NHS carbon footprint. But what’s important to think about here is that this represents the whole NHS. Including primary care, and not every area of the NHS actually uses anaesthetic gases.”
Lucy then went on to explain the multitude of other factors that anaesthetists must consider when trying to make more sustainable choices such as single use plastic, IVs, and waste disposal.
Lucy explained that she believes that 40% of anaesthetic waste could be recycled. She then highlighted the energy usage of much of the equipment and machinery used by anaesthetists.
“Nitrous oxide overshadows the other volatile anaesthetics, and in part that’s to do with the sheer volumes that we use.
As well as having global warming potential, Nitrous Oxide has ozone depleting potential as well. Something that is not as great of an issue with other volatile anaesthetics.”
She then went on to speak about the varying environmental impacts of different anaesthetist gases. Including their atmospheric lifetime, global warming potential and the reasons as to why some of the more harmful gases were still in use. Lucy even compared the use of these gases to vehicle driving harm to the environment.
We learnt about how some hospitals were wasting up to 95% of nitrous oxide before it even reached a patient due to fault canisters and leaky pipes. Something which heightened its ecological damage as this was wasted. Finally, Lucy ran through some amazing new technology and practices which will be improving this area of healthcare.
Heidi Barnard, Group Head of Sustainability, Northern Care Alliance
“Then the year of COVID came. Which actually hasn’t slowed us down at all but has allowed us to get on with a lot of the things that we wanted to do but at a faster pace because we’ve had the capacity to do it.”
For our second speaker of the day, we had Heidi Barnard. Heidi focussed on decarbonisation with a highlight on energy usage for her talk on the webinar. Heidi talked us through the sustainability journey of a fairly new organisation. She talked about how she quickly came to realise that sustainability was not going to be a one-woman job and how she built a team from within. We then learnt about how then pandemic had given the trust the chance to really accelerate its sustainability agenda.
Heidi spoke about the steps that were made to switch over to green energy tariffs and focus on waste management.
“We kicked off a waste revolution! We are completely, radically overhauling how we manage waste across the organisation. It is not a short programme. We need to make and the systemic changes to how we manage waste.”
Heidi made the point that it is important for people to have an image of a burning bridge in their minds, that we need urgency and for those in the position to do so to act fast.
“The Climate Crisis is a Health Crisis! Our target is net-zero by 2045, but our ambition is to get 80% of that done between 2028 and 2032. That is six years away.”
She then spoke in turn to any organisations that may be struggling with their sustainability plans.
“One thing to remember about your plan is to focus on every decision you take, every choice you make should contribute to delivering that zero carbon for your organisation. If you do that, the green plan would have done its job. Obviously, there’s lots of detail in the plan about how and what we’re going to be doing. But fundamentally, we need our organisation to have this at the forefront of their mind when they’re making choices and making decisions.”
Heidi’s final point was on the weight that electricity is playing in peoples sustainability plans and how this in itself is not sustainable as many NHS buildings will not be able to cope with providing that level of electricity.
“We’ve all heard about a big push to electrify a lot of the heating within the NHS. That scares me because I know at our sites we’re at electrical capacity.”
Dr. Bhagyashree Meenu Netke, Consultant Anaesthetist, The Royal Wolverhampton NHS Trust
Our final NHS speaker on this webinar was Dr.Meenu Netke. Meenu spoke to us about the challenges and opportunities that have developed within her trusts sustainability journey so far. She spoke about how sustainability has been embedded in their culture since 2009.
“We performed really well from what was expected of us. By about 2015 we already had a 15% reduction in carbon emissions.”
She spoke about how the trust experienced a slight blip in their sustainability journey in 2019 when they expanded. They then had a larger catchment area to deal with which increased their activity and natural increased areas such as energy usage.
Meenu explained that the trust has a goal of reaching net-zero as early as 2032 utilising the procedures set out within their green plan.
She then went on to talk about their departments use of the gas desflurane, linking back to earlier points in the webinar made by Lucy. She spoke about how they decided to try to change behaviours to reduce the amount of the gas used within the trust.
“I think we are probably quite unique in terms of the sustainability team that we have. We have a non-clinical head of sustainability and also myself as clinician lead of sustainability for the trust.”
She spoke about a gradual increase in the usage recently which has led the trust to make the decision to stop procurement of the gas. The trust also found gases such as nitrous oxide being used in areas they would not typically be expected to be used and how this was creating higher usage levels.
The trusts next big project has been waste management.
“We speak with staff coming in to find out what are the barriers to our waste management and one of the questions is ‘Do you recycle your waste at home? Then what is the barrier for recycling at work?”
Meenu spoke about the need to pay attention to the behaviour of staff members and focus on education and providing as much guidance as possible on correct waste management to ensure they are moving forward.
“We presented our data at anaesthetic meetings and decided to withdraw all our vaporizers and cartridges from the anaesthetic machine and it did have significant impact, in just four weeks usage fell from 13% down to about 1.8%”
Finally, she spoke us through The Royal Wolverhampton Trusts future intentions from their green plan which includes everything green energy, to travel and tourism.
This webinar discusses the challenges faced by NHS staff when driving forward their sustainability agenda. Examining alternatives and enacting change within our NHS will require a collaborative approach and the exchange of ideas. If you would like more information, please contact us.