Sustainability the health estateFor This and Future Generations?

Jerome BaddleyHead of UnitSustainable Development Unit

Why Health?

• NHS constitution: ..committed to providing the most effective, fair and sustainable use of finite resources

• NHS England strap line: High quality care for all, for now and future generations.

• Primum non nocere: First do no harm

Our problem?

Staff- 1.2m staff in NHS 5% of working population

£20bn goods and services-biggest procurer

Health C5% all road traffic

UKs largest estate C30m m2 C1/3 public GHG emissions

Sustainable Development

• "Sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs” Brundtland

commission (Our Common Future) 1987

Sustainable Development Strategy

Estates and Public health?

• District heating: BEIS/LEP/capital funding, fuel poverty

• Community energy projects: local share issue?

• Oil and coal fired energy: contribute to local air pollution

• Electric vehicle charging: EVs reduces onsite pollution

• Greenspace: staff and patient health

• Cooling/adaptation: Ward Overheating

• Nitrous oxide: Estates, procurement or clinical?

© 2015 Intelligent Health

Green Space exposure reduces Health Inequalities

1.0

1.2

1.4

1.6

1.8

2.0

2.2

No green Little green Some green More green Very green

Exposure to green

HighestIncome

MiddleIncome

LowestIncome

Linear (HighestIncome)

Linear (MiddleIncome)

Linear (LowestIncome)

Mitchell, R. and Popham, F. (2008) Effect of exposure to natural environment on health inequalities:

an observational population study. The Lancet 372(9650):pp. 1655-1660.

Incidence Rate Ration

© 2015 Intelligent Health

Nature and the Unborn Child

HighBlood Pressure

in pregnantwomen increasedby 14% for every300 meters away

from greenspace

Birthweight andbaby’s head

size were largerwithin the 500

metres ofgreen space

1. Grazuleviciene R et al Int J Environ Res Public Health 2014 11 2958-2972

2. Dadvand P Env Health Perspectives 120 10

© 2015 Intelligent Health

© 2015 Intelligent Health

Dementia care

Great practice-Saving lives with solar

• University Hospitals N. Midlands

• Public investment raised £336K

• Community owned solar on hospital.

• £600k saved lifetime energy costs

• No capital cost to NHS

• £300k to tackle local fuel poverty

EmbeddingSustainable care

Building resource efficient care into buildings eg.

• U-Drain-water savings?

• Lights with colour temperature phasing?

• Operation TLC?

• Flute- waste cardboard bought to create desks?

• Walking aid re-use: checkout +return facilities?

2015 Public opinion survey

‘One definition of a sustainable lifestyle is to use the planet’s resources in a way that minimises the negativeimpact on the wellbeing of others and on the environment, both now and in the future.’

Financial Case

From energy measures alone

• C£2bn saved since ’07

• C£400m potential savings pa by 2020 across 35 measures

• Also 1m tonnes CO2 savings

• Tool for local planning

• See how your trust is doing

NHS Improvement

• Ed Smith- Chair, NHSI‘savings and investment are lasting and effective when the efficiencies and transformations we make are also socially and environmentally sustainable.’

So…

Sustainability is:

– Good for health

– Saves money

– Part of the NHS constitution

– Legally and contractually required

– Is cross cutting in all aspects of healthcare

– A moral obligation to society

– In line with public, staff and patient values ….

Beyond cost savings

‘Sustainability’ in STPs for the health estate should:

• match public expectations

• match our own values

• embed health creation

Estates are local community health assets; required to ensure local Accountable Health + Care systems are truly sustainable for this and future generations.

Jerome Baddley CEnv MIEMA

Head of Unit

Sustainable Development Unit (SDU)

0113 8253217

Jerome.baddley@nhs.net

www.sduhealth.org.uk

Follow us on Twitter @sduhealth