Implementing Sustainable Systems - Health and Care

21st June 2018

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• NHS Improvement was founded in 2016

• We work across the provider sector – 236 NHS Trusts

• We are helping the NHS to meet its short-term challenges and secure its future

• Our 2020 objectives:

• Quality Continuously improving care quality, helping to create the safest, highest quality heath and care service

• Finance and use of resources Balancing provider sector finances and improving provider productivity

• Operational Performance Maintaining and improving performance against core standards

• Strategic Change Ensuring every area has a clinically, operationally and financially sustainable pattern of care

• Leadership and improvement capability Building provider leadership and improvement capability to deliver sustainable services

An Introduction to NHSI

Implementing Sustainable Systems in Health and Care

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• Extensive review of large acute NHS Trusts

• Identified unwarranted variation

• Savings potential of £5bn [Acute Trusts] and £1bn [mental health and community Trusts] by 2020/21

• 15 key recommendations

➢ Clinical

➢ Procurement

➢ Estates and Facilities

• Data Analysis - Model Hospital

“Lord Carter's review of efficiency in hospitals suggests how large savings can be made by the NHS. The final report, productivity in hospitals,

sets out how non-specialist acute trusts can reduce unwarranted variation in productivity and efficiency to save the NHS £5 billion each year

by 2020/21.” (Kingsfund, 2016)

Lord Carters Reviews (2016, 2018)

Implementing Sustainable Systems in Health and Care

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NHS Unprecedented Challenges

Implementing Sustainable Systems in Health and Care

Develop and

deploy integrated

digital strategies

1. Technology & Digitalisation

Engage national

workforce and

cross sector bodies

2. Engagement

Close £30bn

Funding gap and

deliver £22bn

efficiency savings

3. Operational and Financial Efficiency

Respond to

increased demand

and ageing

population

4. Demand and Demographic

Address increased

gap in health and

social inequalities

5. Inequalities and Prevention

Deliver local

accountability

compliant with

national policy

6. Local vs national (policy and

delivery)

Drive long-term

strategies whilst

delivering in year

QIPP/CIP

7. Long term strategy, short

term deliverables

Meet increasing

patient

expectations for

quality of care and

experience

8. Patient expectation and

public perception

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Sustainability can respond

Implementing Sustainable Systems in Health and Care

Data driven change

strategies:

Energy Efficiency

RCM

BIM and IoT

1. Technology & Digitalisation

National SD

Campaigns and

Cross Sector

groups, Local

Behaviour Change

Programmes

2. Engagement

Reduced Opex

Costs £78M-£138M

Improved

Healthcare Estate

3. Operational and Financial Efficiency

Driving behaviour

to improve

outcomes and

reduce system

demand

4. Demand and Demographic

Fuel poverty, Air

pollution and Food

education

programmes

5. Inequalities and Prevention

Locally owned

programmes

delivering key

national policies

6. Local vs national (policy and

delivery)

Addresses short

term deliverables

(QIPP/CIP) and

drives long term

change

7. Long term strategy, short

term deliverables

Measurable

improvements in

patient experience

and public

perception

8. Patient expectations and public perception

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NHSI – Who’s Who in EFMSimon Corben

Director and Head of Profession for Estates and

Facilities

Programme & Strategic Business

LeadVajid Mahmood

Divisional Co-ordinator and EFM

Dashboard Manager

Energy Fund Programme

Coordinator & Support

EFM PolicyMike Bellas

EFM OppsEFM

CommercialJo Dolby

Strategy LeadMartin Rooney

Work streams• Food• Cleanliness• Parking• Mixed sex• Safety• Fire• Care

pathways• HTMS• HBNS

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Work streams• Hard FM• Soft FM• Asset

Management

• Estate code• Energy• Space

Utilisation

Work streams• Alternative

Capital Funding Models

• Backlog• P22+ and

others• Standardisatio

n• Income

Generation• Capability and

Capacity• Contract

Management

• Work streams

• STPS• SEPI’S• Pilots

Chetan TailorPrinciple Analyst

Ian Stone DoHCapital

MOU NHSE PAU

Chris Cale / Mike Lowe– NHSI Finance

P22 Cliff Jones

• Enhanced team to drive through Disposals and staff housing and general housing needs

Disposals LeadIan Burden

EnergyCarbon SavingsImproved resilienceImproved estate compliance Delivers against 5 domains of CQCEFM Workforce

Sustainability and Workforce

Fiona Daly

Implementing Sustainable Systems in Health and Care

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▪ 16 years experience in EFM (mainly Hard FM) and Sustainability

▪ Worked in both Public and Private Sectors

▪ 8 Years working in a provider Trust

▪ Extensive PFI experience – from both sides

▪ Led national programmes: NHS Sustainability Day, Clean Air programmes, Fuel Poverty, Operation TLC

▪ Established Cross Sector Partnerships to drive local and national change

▪ I joined NHSI because:

• I am driven deliver impact

• I love complex problems (and helping solve them)

• I know there is [a huge] opportunity

• I believe sustainability responds to a no. of current challenges

• I believe in the NHS and want to do whatever I can to ensure it is here in the future

But mainly, I joined because I care. I care about the NHS, I care about people and I care about our future

Who I am and why I joined NHSI

Fiona DalyMsC CBIFM MIHEEM FEMA

Implementing Sustainable Systems in Health and Care

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Embedding sustainable practice in organisations is key to our collective success, so at NHSI areapproach is focused around three areas we hope will facilitate this:

• To Lead: help provider organisations embed Sustainability throughout their orangnsaitions,from Board to Ward and out into their communities to deliver the very best care for patientsand the very best environments for our staff

• To Engage: To engage extensively with our stakeholders to drive positive change at both alocal and national level and nurture a culture of engaging behaviour across the system

• To Innovate: To drive and deliver accelerated innovation for positive Environmental, Socialand Economic benefit – the three pillars of sustainability

• To celebrate success: To celebrate the success of those who work hard to deliver thesetransformational changes in their organisations, recognising their efforts and dedication

We know our workforce are key

Our approach

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• Organsiational Leadership underpins the principles of this cultural shift

• Core areas of focus:

➢ Sustainable Development Management Plans (SDMP): Board approved plan setting out

the corporate approach to Sustainable Development with clearly defined objectives and

targets, and updated within the past 3 years

➢ Sustainable Development Assessment Tool (SDAT): Online self-assessment/diagnostic

tool which aligns organisational action(s) with UN SD Goals. Allows organisations to track

progress and benchmark themselves against similar organsiations. Supports collaboration

and aligns/informs SDMP

➢ Annual report: Organisations to report annually on their progress. There is an informal

review annually (SDU) and NHSI + HFMA issue excellence certificates with SDU- top 10-

15% of Providers and CCGs

➢ Trained and knowledgeable workforce: core, job specific training, information and supporton Sustainable Development, with specific SD objectives embedded into performance targets

Strong leadership in Sustainable Development is a demonstrable measure of a well-led organistation

Organisational Leadership

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▪ Focused on creating a sustainable healthcare estate transitioning our hospitals and care

facilities beacons to best practice that improve our patient experience, reduce our use of

resource and connect us with our local communities and environment

▪ Transitioning to LED lighting to provide better lit, higher quality environments for patients

with lower energy and carbon impact

▪ Running our hospitals on renewable energy generated onsite, providing consistent heating

for our patients during the winter months and an all year round supply of hot water

▪ Reducing waste and water usage within our buildings, driving the circular economy

▪ Using our hospitals as anchor organisations to drive wider community and health benefits

▪ Pushing the boundaries of innovation

▪ Developing supportive policies and guidance to underpin current and future best practice

▪ Collect and use useful data - improving quality and granularity

▪ Our aim is to take £150M off our annual energy, water and waste spend (currently

c£720M) by 2021 – reducing financial pressure on our clinical service

Working to deliver Healthy, Resilient, Sustainable Healthcare Estates

Better Buildings for our Patients

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• People are key to our success

• Nursing play a crucial role in how buildings are operated and used, and in what items arebought and thrown away

• Waste/Energy/Sustainability Managers are critical catalysts for implementing best practice,introducing innovation and driving change within hospitals and care facilities

• Service Leads have the opportunity to revolutionise their service and maximise their impacton environmental progress

• Procurement Leads directly influence the buying culture of an organsiation and by applyingthe principles of sustainable procurement, can influence the wider supply chain

• Estate Managers influence the efficiency and impact of our built environment and facilitatechanges that benefit our patients, the environment and local community

• Finance Managers shape how organsiations approach investment for sustainableimprovement

• And these are just a few…the best things happen when we join together in our thinkingand our approach to deliver small changes that can transform our workplaces

Developing the knowledge and expertise of our national workforce around Sustainable Development is key and will shape the future culture of our NHS

Our People

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Waste/Energy/Sustainability Managers are critical catalysts for implementing best practice, introducing innovation and driving change within hospitals and care facilities

Estate Managers influence the efficiency and impact of our built environment and facilitate changes that benefit our patients, the environment and local community

Aims of the Academy:

• Every Energy/Waste/Sustainability Managers in NHS to be formally trained

• Every Energy/Waste/Sustainability Managers to be a member of their professional bidy

• Futureproof the profession with Trailblazers

Online platform with access to:

• Online training

• Links to formal training

• Links to relevant membership bodies

• Mentoring and coaching

• Intern guidance

The future: Trailblazer apprenticeship for a Healthcare Sustainability Manager

Sustainability Academy

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In order to support Trusts deliver their Sustainability goals and stretch theirefficiency programmes, NHSI have developed a stretch programme forSustainability. The programme is broadly focused around 3 core areas, theyare;

1. Leadership: this area looks at organisational leadership; SDMP’s,action plans and annual reporting.

2. Interventions: there are 10 critical interventions which are reviewedand tailored to each organisations needs. These are all either low/nocost, quick ROI (within 24 months max) or come with external funding.

3. Workforce: this area looks at staffing for managing SD ongoing andtraining for staff already in post to improve uptake of innovation andfuture CIP.

NHSI offer full support to evaluate and present plans for consideration bythe Director of Estates and Finance. The plans are supported byimplementation programmes compliant procurement and funding options.

How can I support you?

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• Gateway to the community

• Encourage collaboration

• Share successes

• Informative

• Useful

• Dynamic

• One place joy.heaps@nhs.net

Implementing Sustainable Systems in Health and Care

Collaboration Hub

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Request access by e-mailing nhsi.efmportalsubmissions@nhs.net

Look out for the e-mail invitation from the hub site,

https://nhsi.kahootz.com/connect.ti/estates_and_facilities/grouphome

Access to the hub will be via this notification.

Register as soon as possible following this invitation. You will not be able to use the full functionality of the hub until you have registered. This is a very quick and simple process as follows;

• Click on the link within the invitation e-mail;

• Another page then opens asking for your notification preferences; and

• On completion of your notification preferences click on the JOIN button at the bottom of the page to activate membership.

It is important to note that the invitation is only valid for 28 days.

How to gain access

Implementing Sustainable Systems in Health and Care

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Fiona.daly1@nhs.net

@Dalyfionadaly1

07519 293013

www.improvement.nhs.uk

Contact details

Implementing Sustainable Systems in Health and Care

Fiona DalyMsC CBIFM MIHEEM FEMA