Our Pledge for a Sustainable Future

Transcription

1 The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust Our Pledge for a Sustainable Future Delivering Outstanding Patient Care

2 Sustainability is improving the quality of human life while living within the carrying capacity of supporting eco-systems Contents Executive Summary 1 Introduction 2 Key Drivers for Change 3 What is Sustainability? 3 National Context 4 Trust Values 4 RJAH Sustainability Hallmarks 4 Our Ambition 5 Financial Strategy 5 Our Commitment to a Sustainable Future 6-12 Governance 13 How Everyone Can Help 13 Forward Look 13 Communication and Engagement 14 Conclusion 14

3 Executive Summary The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust (RJAH) is committed to embedding sustainability across the organisation across the organisation as part of its ongoing aim to be the leading centre for high quality sustainable orthopaedic and related care achieving excellence in both experience and outcomes for its patients. The Trust recognises that if it does not address sustainability as an issue, it is contributing to climate change which is believed to have a detrimental effect on health and wellbeing. Delivering outstanding patient care remains the Trust s primary focus, but it is understood that it must play its part and tackle the challenges of sustainability within the organisation because of the longer term impact on the health and wellbeing of service users, employees, visitors and the wider community. The Trust Board is unanimous in its commitment to work towards a low carbon NHS which is good for health. It is an opportunity not only to help the NHS to become a sustainable, high-quality healthcare service but also to save the Trust money. Our Aim To be the leading centre for high quality, sustainable Orthopaedic and related care, achieving excellence in both experience and outcomes for our patients. Our Goals To ensure the Trust s commitment to sustainable development is reflected in management structure and accountability To ensure full compliance with all applicable environmental legislation and other requirements To reduce energy consumption and carbon footprint, normalised against m 2 of occupied floor area, and in absolute terms where practical To embed Sustainable Procurement principles in specifications and procurement of goods and services on behalf of the Trust To ensure a coordinated approach to encouraging low carbon alternatives for all travel associated with the Trust staff, patients, visitors and suppliers To reduce waste produced, waste sent to landfill and water consumption To work with local partners and networks to embed sustainable development and lead by example To embed Carbon literacy and analysis into finance models and business plans To ensure that all levels of staff have the appropriate understanding, skills and accountability for support of and engagement with the sustainability strategy To capture opportunities for reduced carbon intensity and improved energy efficiency as well as other sustainability benefits arising from waste, water, transport and procurement management page 1

4 Introduction The Government introduced The Climate Change Act in 2008 which requires a reduction in carbon emissions of 80% by 2050, based on a 1990 baseline, supported by reductions of 34% by 2020 and 50% by The NHS must ensure it complies with the mandatory provisions of the Climate Change Act and related legal requirements, and, in January 2014, the Sustainable Development Unit (SDU) launched a new Sustainable Development Strategy for the NHS, Public Health and Social Care System this replaced the previous NHS Carbon Reduction Strategy This National Sustainable Development Strategy is underpinned by three goals based on the challenges faced to achieve the ambitious targets set for 2020 and beyond: Goal 1: A healthier environment A healthier environment can contribute to better outcomes for all. This involves valuing and enhancing our natural resources, whilst also reducing harmful pollution and significantly reducing carbon emissions. Contributing to the Climate Change Act target with a 34% reduction in carbon emissions by 2020 is a key measure of our ambition across the country. Goal 2: Communities and services are ready and resilient for changing times and climates When periods of heat, cold, flooding and other extreme events occur it is vulnerable people and communities that suffer the worst. Those communities and their services bear the responsibility of addressing the consequences of these events. Multi-agency planning and organisational collaboration, underpinned by local plans and assurance mechanisms, provide a better solution to these events than working independently, individually and ineffectively. Goal 3: Every opportunity contributes to healthy lives, healthy communities and healthy environments Every contact and every decision taken across the health and care system can help build the immediate and longer term benefits of helping people to be well and reduce their care needs. There are multiple mechanisms that can support this approach from improved information, more integrated approaches and smarter more aligned incentives that help minimise preventable ill-health, health inequalities and unnecessary treatment. A sustainable system cannot be achieved without taking every opportunity to support communities and people to be independent and self-manage conditions and events. As the largest single organisation in the UK the NHS has huge purchasing power and is responsible for major consumption of resources. Working towards becoming a sustainable organisation will impact on health outcomes, Public health, reducing health inequalities and sustainable development, all of which are linked to each other. Increases in human conditions such as obesity, diabetes, asthma and heart disease are in part caused by adverse environmental factors such as poor air quality, poor quality food, over-reliance on cars, and badly-designed environments which limit opportunities for physical activity. Mental health and health inequalities are also linked to these factors. The health and wellbeing challenges facing society require new ways of thinking and acting. Adopting the sustainable development goals of valuing the environment, enabling people and places to be resilient and taking every opportunity to maximise health and well-being can help support this transformation. page 2

5 Key Drivers for Change The SDU is funded by, and accountable to, NHS England and Public Health England to work across the NHS, public health and social care system. The Unit has developed the latest Strategy in line with a number of national documents, requirements, strategies and initiatives, including: Economics of Climate Change Stern Review 2006 Government Buying Standards Principle 6 NHS Constitution HM Treasury Sustainability Reporting Framework HPA Health Effects of Climate Change 2012 Civil Contingencies Act (2004) Climate Change Act (2008) What is Sustainability? NHS Standard Contract SD requirements Health and Social Care Carbon footprint NHS Carbon Reduction Strategy 2009 Sustainable, Resilient, Healthy People & Places, NHS England NICE Guidelines Active Travel The term sustainability refers to delivering economic viability, environmental performance and social wellbeing. Only when all three elements are balanced together is an organisation truly sustainable. Social Bearable Sustainable Equitable Environment Viable Economic Sustainable development refers to our commitment to meet the needs of the present without compromising the needs of future generations Sustainable development considers energy efficiency, carbon reduction, recycling and also ensuring social justice and equity, by integrating environmental, health, social, political and economic issues into decision making for all to benefit Sustainable development is the framework within which carbon emissions will be reduced Sustainable development aims to ensure the basic needs and quality of life for everyone is met, now, and for future generations The strategy focuses on ensuring a strong, healthy and just society, living within environmental limits whilst recognising that achieving a sustainable economy, promoting good governance and using sound science responsibly are inherent pillars that support such a society. page 3

6 National Context The UK Government has committed to take action now. The Climate Act sets binding targets to cut carbon emissions. As the largest public sector contributor to carbon emissions the NHS has committed to achieve the following carbon reduction targets: Despite an increase in efficiency, the NHS has increased its carbon footprint by 40% since Therefore, achievement of these national targets will require the current level of growth of emissions not only to be curbed, but the trend reversed and absolute emissions reduced. Trust Values Embracing the five Trust values which have been developed with staff involvement to underpin high quality care will lead to a consistent and sustainable approach to our delivery. Excellence Professional Respect Trust Values Caring Friendly Achieving Excellence by ensuring we nurture a Professional approach to the Sustainability Agenda. Caring and Respect for the environment by embedding the principles of sustainable development throughout the organisation in a user Friendly way. RJAH Sustainability Hallmarks The Trust Values are linked to Sustainability Hallmarks which will be utilised to apply a consistent approach to sustainability throughout the organisation: We will strive to reduce wastage of Trust resources We will strive to reduce energy use by ensuring each unit of energy is used as efficiently as possible We will always consider sustainability from the patient perspective We will challenge poor sustainability practices We will use sustainability to underpin high quality care page 4

7 Our Ambition To be the leading centre for high quality, sustainable Orthopaedic and related care, achieving excellence in both experience and outcomes for our patients. The Trust as a minimum must ensure it complies with the mandatory provisions of the Climate Change Act and related legal requirements. The Trust is committed to being a visible and empowering example in leading on sustainable development. Everyone served by the Trust can benefit from these achievable aims: Reduced environmental impact: Local Trust initiatives to help the NHS meet or exceed the national target of a 34% reduction CO2e emissions by 2020 Prepared communities: Ensure that the Trust is well prepared for the impacts of climate change and have plans in place to deal with events such as heatwaves, flooding and cold snaps Local community leadership: The Trust will liaise with Health and Wellbeing Boards to further develop strong and proactive Health and Wellbeing Strategies within new and existing services that integrate the principles of sustainable development to achieve public health and sustainable development outcomes Embedding sustainability: Decision making processes take account of sustainability in purchasing, investment, operational and strategic decisions, influencing the behaviour of those both inside and outside of the health and care system Improved health outcomes: Measurable progress is made against national NHS, Public Health and Social Care Outcomes Frameworks Recognition and replication: The public can be proud of our efforts made at a community level; we can truly benefit from the changes, and we can carry that experience into other areas Financial Strategy Businesses which embrace sustainability to undertake fundamental changes are more successful in tough economic times than those which cut sustainability budgets and embrace PR stunts over more fundamental redesign (Foundation Trust Network 2010). It is important that our sustainability aligns with our wider and supporting strategies. The Trust s capital expenditure programme recognises the importance of continual investment in our site with the reduction in our carbon footprint one of our key aims. The Trust has recently invested heavily in updating the site as part of the Estate Strategy which supports our commitment to consequential sustainability improvements, such as the new main entrance and corridor refurbishment - improving energy consumption utilising more efficient insulation and lighting. Looking forward we are continuing to invest in the site with an 30m financial programme over the life of this strategy. Investments will include the general upkeep and improvements of building through to major schemes such as our theatres redevelopment and new tumour unit. All works and projects will improve the sustainability of our site. Partnership working with external professional bodies, such as The Carbon Trust and energy management consultants, has enabled the Trust to carry out energy savings opportunity assessments and develop an Energy Strategy, which has prioritised the Trust s opportunities for investment in low carbon technology. page 5

8 From these assessments, which included investigation of new technologies such as solar, wind and biomass, the Trust has prioritised in the first year of this strategy to complete the business case for a Combined Heat and Power (CHP) unit that will have a significant reduction on our carbon footprint and utilities consumption. The backlog maintenance programme will support the sustainability agenda, renewing and replacing dated plant and equipment with more efficient and sustainable alternatives where appropriate. Across the site the Trust spends over 1m on utilities every year. In addition, the organisation exceeded the Carbon Reduction Commitment (CRC) threshold, which means it now has to purchase Carbon Credits at a cost of 90k per annum through to We plan through this strategy to ensure that when assessed in 2019 that we will be below the threshold which will save 90k of revenue costs for reinvestment. Additionally, all of the actions we take in support of this strategy will further reduce our carbon footprint and the associated costs, which subsequently we will be able to reinvest in direct patient care. Our Commitment to a Sustainable Future The NHS as a whole, mirroring the national trend, acknowledges there are areas for focus when tackling sustainability. The themes of the National strategy were developed by the NHS Sustainable Development Unit (SDU) and are intended to cover the key areas of sustainability. Waste minimisation: Promoting appropriate use of materials and sorting of waste Energy and carbon management: Reducing carbon dioxide and other greenhouse gas emissions Water conservation: Promoting efficient use and innovative solutions for conservation Procurement and food: Addressing sustainability in the supply chain Low carbon travel and transport: Encouraging active and sustainable travel for patients and staff Designing the built environment: Building sustainability into the trust estate Communications and engagement: Communicating to staff and patients, training and developing staff to encourage sustainable behaviour as the norm The role of partnerships and networks: Collaborating and sharing lessons with other businesses addressing their environmental impacts Adapting to a changing climate: Building resilience into clinical services and the Trust estate Governance and finance: Budgeting for, financing and integrating sustainability into Trust processes The Trust will embrace all areas outlined above. This strategy will focus on five key areas of commitment, Waste, Energy, Water, Procurement and Travel. These areas have been chosen to reflect both the National trend of areas requiring the most improvement and those themes upon which this Trust can make the greatest measureable impact. The Trust s commitment to a sustainable future is deeply entrenched in within its mission statement and is a theme of all strategic documents. The Information Management and Technology Strategy will ensure we achieve sustainability through our use of information and information technology The Estate Strategy demonstrates a commitment to sustainable development, environmental targets and legislative requirements Our Quality Strategy provides details of what we want to achieve as a Trust, how we will achieve it and how we will measure that achievement over time to ensure the quality of care is sustainable Human Resources and Organisational Development Strategy enables staff to deliver business critical performance to ensure the sustainable success of the trust, which is good for patients and staff page 6

9 Realistic, measurable targets form the basis of our commitment on five key sustainable themes. Waste Energy Water Procurement Travel page 7

10 Waste Waste The Trust is committed to minimising waste where possible and increasing the proportion of its waste which is recycled. Our commitment Monitor waste streams and ensure compliance with waste legislation Ensure waste is managed legally, effectively and cost efficiently Meet waste reduction targets as a minimum and where viable reduce waste further Focus on actions before something becomes waste How will we achieve it? Assess and divert existing waste streams to increase recycling where feasible Encourage paper-light offices Educate staff to improve understanding of the Trust s waste minimisation and landfill diversion options Reduce waste production through stock management, minimising food waste and other initiatives What we are already doing The Facilities team have introduced dry mixed recycling (DMR), where staff can recycle paper, card plastic and tins in the same bin. Scrap metal is recycled as a commodity by the Estates team, generating income from a sustainable activity. The Orthotics team reclaim the metal work from their casts removing the plaster which itself gets recycled by our contractor. How will we measure it? Regularly audit sites and buildings Review data provided by contractors Monitor waste streams and waste to land fill Trust Target Increase the volume of waste that is reclaimed or recycled from 70% to 90% page 8

11 Energy Energy The Trust is committed to reducing our energy consumption and greenhouse gas emissions. Our commitment Regularly monitor our energy consumption in conjunction with our Sustainable Development Management Plan Successfully identify and deliver opportunities for energy efficiency and where feasible introduce low carbon technologies and renewable energy sources Help staff to take responsibility for energy reduction measures within their departments How will we achieve it? Regularly record and monitor our consumption and educate staff to better understand our energy use Install gas and electricity metering, and building energy management systems across the Trust Ensure robust assessment methods and detailed feasibility studies are conducted with all energy efficiency projects What we are already doing Low carbon technology is being utilised in all new builds and refurbishments. Old lighting technology is being replaced by new, incorporating room occupancy sensors where appropriate. Awareness messages are being displayed on Trust computers, reminding staff to take turn their computers off and save energy. Heating controls continue to be updated, reducing energy waste. The Trust buys its electricity from renewable resources. page 9 How will we measure it? Annual Kilo Watt Hours consumption Tonnes CO2 generated annually Sub-metering in key areas Trust Target To reduce electrical consumption per patient from 42kWh to 35kWh

12 Water Water The Trust is committed to monitoring and reviewing the consumption of water and is committed to ensuring more efficient use of water across the organisation. Our commitment Reduce our water consumption using water efficient technologies Consider water efficiency with all maintenance, refurbishment and new build projects Report on water consumption annually How will we achieve it? Implement water metering, monitoring and leak detection where feasible Install water saving devices as standard into building projects Educate users, patients and visitors towards water efficiency Provide knowledge and support to drive water efficient behaviour change How will we measure it? Water consumed in cubic metres Water consumption per patient What we are already doing In washrooms around the site water saving technology is being used, controlling taps so they are not left to run and minimising water flow in toilets. There is an ongoing programme at the Trust, replacing old plumbing infrastructure with new Water usage is monitored and high usage raises the alarm to a potential leak. Trust Target To reduce water consumption per patient from 660 litres to 560 litres page 10

13 Procurement Procurement The Trust is committed to minimising waste and will consider whole life costs in its procurement of goods, works and services. We will work to embed sustainability into our processes and those of our suppliers. Our commitment Consider whole-life cycle costs of products purchased Increase staff awareness of sustainable procurement Work with suppliers to improve sustainability and ensure low carbon procurement How will we achieve it? Evaluate all contracts on a whole life cost basis Work with suppliers who are environmentally aware and hold the relevant accreditations Educate Trust buyers on sustainable issues to enable positive change What we are already doing We work with NHS Supply Chain to optimize the volumes ordered and standardise products. Full life costs of equipment, i.e. maintenance, consumables, energy consumption and disposal costs, are assessed prior to purchase. Sustainability criteria of the products and suppliers are included in the assessment of European Tenders for goods and services. How will we measure it? Audit of tender invitation documents Suppliers with relevant accreditation Trust Target To procure 70% of our capital building works from within a 30 mile radius page 11

14 Travel Travel The Trust is committed to developing and regularly reviewing a comprehensive sustainable travel plan to minimise, where possible, carbon emissions arising from travel by staff, patients and visitors. Our commitment Reduce carbon emissions from staff, patient and visitor travel Reduce carbon emissions from fleet, grey fleet and business travel Promote public transport, green travel initiatives and schemes How will we achieve it? Develop our transport plan to incorporate sustainable travel Phase out inefficient forms of transport and replace with low carbon alternatives Ensure public transport is fully utilised How will we measure it? Monitor forms of transport, fuel types and distance travelled Produce annual travel information and data Questionnaires and data collection from Trust staff, patients and visitors Monitor green travel take up What we are already doing The Trust has installed electric vehicle charging points in the main visitor car park to encourage the use of electric vehicles. There is active support for the cycle to work scheme, assisting staff who wish to purchase a bicycle, an initiative to promote greener journeys and reduced environmental pollution. Video and teleconferencing is being used to conduct weekly meetings with colleagues nationally to avoid travel altogether. Trust Target Reduce annual business mileage from 200,000 to 150,000 through remote working initiatives page 12

15 Governance Sustainable Development and carbon management are corporate responsibilities. Clear governance provides an assurance process that considers requirements, both in terms of the law and to achieve high quality health and care. Demonstrating high quality health and care will be enhanced by embedding sustainable development into management and governance processes. The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust has developed a structure of governance through its committees and processes to ensure sustainability is embedded throughout the Trust. The Trust will update its Good Corporate Citizenship Assessment Model and produce a Board approved sustainable development management plan. The Trust will set interim targets and trajectories to meet the provisions of the Climate Change Act. In the first instance, this will set at 10%, as a minimum, of the 2007 levels by The Trust will develop and oversee the delivery of this Sustainability Strategy agenda through the Sustainability Working Group (SWG), as a sub-group of the Business Risk and Investment Committee (BRIC). The Trust has both a named executive and non-executive director for sustainability, the executive lead chairs the SWG, which also benefits from the input of departmental leads and strategic partners. How Everyone can Help Some simple reminders about how we can all contribute to a more sustainable future Continue to report suspected water leaks as soon as possible Make sure taps are not left running for excessive periods If an area is too warm for comfort during heating periods notify Estates; don t just open the windows! Reduce stockpiling where possible Turn off manually switched lights to unoccupied rooms /areas Turn off your PC when you leave for the day Support the many initiatives launched through the Healthy Horizon Strategy, such as Change 4 Life Forward Look Sustainability is a rapidly evolving initiative liable to change with advancements in technology and research, as such this strategy provides a summary of the Trust s focus, with the measured approach being driven by a management plan. The below points outline our initial areas of focus: Internal Actions Complete the business case for a Combined Heat and Power unit Introduce an awareness campaign, highlighting sustainability and the part everyone can play Launch refreshed sustainability management plan, with realigned key performance indicators (KPI) Introduce additional monitoring/measuring equipment to record sustainability data Introduce a revised reporting template for the sustainability metrics Working in Partnership Audit the highest spend suppliers to encourage them to align their practices with national sustainability targets Work closely with suppliers to ensure that the Trust s current sustainable working practices remain viable and future sustainable working models are explored page 13

16 Continue to liaise with expert advisers and those performing considered best practice, such as the Carbon Trust Improve links with stakeholders, regularly reporting and sharing sustainability information Long term goals To be a leading centre in environmental sustainability both within the local community and wider healthcare sector The Trust will ensure that it is well positioned to fall below the CRC threshold when reassessed Communication and Engagement We will take every opportunity to promote good sustainability practice. We will engage with our stakeholders to develop and continually improve the sustainability agenda. The strategy will be shared both internally and externally with relevant stakeholders for comments and as a completed document including: Local Clinical Commissioning Groups Local Providers Healthwatch England Patient Panel Community Health Councils (Wales) Local Authorities Joint Consultative Group The strategy will be promoted to patients, staff and stakeholders using existing communication systems including: Leading Today lectures Team Brief Communicate staff magazine Internal and external websites Conclusion Promotion through specific presentations at relevant committees Patient panel The Sustainability Development Strategy provides a framework for the development and implementation of a holistic approach to delivering high quality care using sustainable values. The Strategy will provide the structure and direction to support embedding the principles of sustainable development throughout the organisation. page 14

17 Delivering 7 Outstanding Patient page Care 13