Health Service Focus

Top of the league

Simon Smith, executive director of local services and sustainability lead for Nottingham Healthcare NHS Trust, describes the work behind its carbon reduction successes.

Nottingham was the highest-scoring hospital trust in the Environment Agency’s CRC [Carbon Reduction Commitment] performance league table, and the trust’s executive director of local services and sustainability lead Simon Smith said: “We’ve worked very hard at it so it’s something we’re very pleased with.”

He spoke to NHE about how emissions reductions can be achieved through better energy effi ciency. The trust has developed a management plan for its carbon reduction effort, improving energy effi ciency by working with internal facilities to reduce the cost of running the estate.

Efficient infrastructure

Smith said: “We’ve spent time planning through smart metering and we’re changing the way we’re accessing energy.”

This included progressively changing the energy profile at Rampton high-security hospital site from oil and coal to gas, and a woodchip pellet burner which will be a combined heat and power plant to completely heat the hospital.

“We’re trying to make sure the infrastructure that supports healthcare is run as effi ciently as possible and as cost effectively as possible so we can release resources for patient care,” Smith said.

Minimising the procurement trail

But the Nottingham team are not resting on their laurels. Smith said: “We’ve got more to do. We’re looking to improve our carbon areas of transport and travel.

“We’re also looking particularly at procurement in the NHS. Over 60% of our carbon is released through our procurement trail.

“You’d think it would be buildings and all the ambulances and cars – but actually quite often it’s the way we procure.”

Its suppliers will have to have a sustainability and carbon reduction management plan, and Smith described work to identify the number of miles travelled for providers to deliver products to the trust.

Another focus would be the way suppliers are brought together for a particular contract.

“We’re drawing those things together to be more focused on who we procure from, the routes we procure through and being more stringent in our carbon reductions of that provider.”

The emissions of a small country

Smith said: “There is a very strong argument that sustainability is probably the biggest healthcare issue of the century. If the NHS was a country, it would register somewhere in the top 100 countries as a carbon emitter: it’s a very big issue.

“The amount of staff travel we support each year would enable a family saloon to drive something like 29 times around the globe. When you think about what that represents in terms of travel, that’s really quite substantial.”

Patient and staff surveys suggest going green is a key issue, while cutting energy costs obviously helps trusts’ financial management too.

Closer to home

Transforming the way people work is essential to future improvements in energy consumption, as well as the way patients receive treatment and services.

“There’s a very strong imperative to treat people closer to their homes, and in their own homes, rather than in large institutions,” Smith explained. “That can be done much more easily using technology, telehealth, smartphone apps, using Skype; a whole range of different things could be used that would give really good access for patients to clinicians, where they want to have that access, rather than waiting and queuing in a large hospital to see somebody for five minutes.”

The technology is already available to facilitate this and Nottingham is beginning to use mobile technology to support staff in patients’ homes and allow patients to access records online.

CRC league table 2011/2012

The CRC 2011/2012 performance league table ranks the relative performance of CRC Energy Efficiency Scheme participants against the three weighted metrics: Early Action Metric (the average percentage of the proportion of non-mandatory CRC electricity or gas supplies and CRC emission coverage by the Carbon Trust Standard or equivalent); Absolute Emissions Metric (percentage change in the CRC Emissions of a participant); and Growth Metric (percentage change in CRC Emissions per unit turnover or revenue expenditure for an annual reporting year).

The total weighted score is the sum of the score for each metric multiplied by the weighting for that metric. The league table also ranks organisations on CO2 emissions by tonne.

Nottingham received a total weighted score of 1785.10, with 16,969 tonnes of CO2 emissions and 74, 20.27 and 43.06 on the three metrics respectively.

The top five NHS organisations were: NHS Blood and Transplant Nottingham Healthcare NHS Trust Bradford Teaching Hospitals NHS FT University Hospital of South Manchester NHS FT Royal United Hospital Bath NHS Trust.

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