Following the news last week that the Government has committed to cutting the NHS’s carbon footprint to net zero by 2040, health trusts will be able to bid for funding as part of a £1billion Public Sector Decarbonisation Scheme (PSDS).
The scheme was announced in the Chancellor’s ‘Plan for Jobs 2020’ commitment, supporting the UK’s economic recovery from COVID-19 and supporting up to 30,000 skilled jobs in the low carbon and energy efficiency sectors.
And public-sector bodies, including NHS trusts, will now be able to bid for funding for energy efficiency and heat decarbonisation measures.
Public sector leaders have been provided with a huge opportunity to facilitate the transition to net zero carbon and include interventions that were previously difficult to fund
The fund will be delivered by Salix and will finance up to 100% of the costs of capital energy-saving projects that meet the criteria.
Commenting on the news, Alexandra Hammond, sustainability director at multi-disciplinary infrastructure advisory consultancy, ETL, said: “This is an exciting turning point for the UK.
“Public sector leaders have been provided with a huge opportunity to facilitate the transition to net zero carbon and include interventions that were previously difficult to fund, such as heat pumps and other renewable sources of energy.
“But organisations must act quickly to secure funding and progress net zero carbon and sustainability ambitions.”
Under the PSDS efficiency technologies will be required to achieve savings of a minimum of one tonne of carbon per £500 spent, and it also requires organisations to plan out their journey to decarbonise heat.
In addition, the fund will cover technologies that do not have a direct carbon saving, but enable emissions reductions, such as battery storage, metering, and electrical infrastructure.
Hammond said: “Most public sector organisations have set targets ahead of 2050, with the NHS announcing its 2040 target last week. We need to act now to make changes that will have a significant impact in years to come.
While attention is currently focused on the financial savings possible through smarter procurement, in the future we can expect to see this widen so that there is a greater focus on environmental as well as financial costs
“There is funding available to support site visits and application development – and there’s never been a more opportune time to take action towards net zero.”
The NHS currently accounts for around 4% of all UK greenhouse gas emissions – similar in scale to the airline industry.
And, with many of the more-obvious interventions having already been implemented, NHS trusts will need to think more holistically about their efforts moving forward.
Chris Naylor, a senior fellow in health policy at The King’s Fund think tank, said the NHS needed to concentrate on five key areas.
First, environmental costs will increasingly be reflected in the financial price paid by the NHS for energy, drugs, food and other resources.
As a result, low-carbon forms of care will become increasingly cost effective relative to carbon-intensive alternatives, and in some cases this could be expected to tip the balance when comparing the merits of different treatment options.
Anything that succeeds in reducing demand for healthcare is also likely to reduce associated carbon emissions, provided that reductions in one part of the system are not undone by increases elsewhere
For example, social support and psychological interventions generally have a smaller carbon footprint than highly-medicalised forms of care and could play a greater role in the treatment of some conditions.
Secondly, when and how we travel will become an increasing focus of concern.
Naylor said: “Patient and staff travel accounts for around 16% of the NHS carbon footprint.
“Through increased use of digital technologies, including electronic medical records and innovations in the field of telehealth, healthcare can increasingly be delivered remotely.
“And, when people – whether staff or patients – do need to travel, walking or cycling will be the preferred options, which could serve two ends simultaneously – promoting health while also cutting carbon.”
The NHS will also need to use its purchasing power much more assertively to drive change in supply chains.
Currently, more than half of the NHS carbon footprint is attributable to procured goods and services, in particular pharmaceuticals, medical devices, and food.
Naylor said: “While attention is currently focused on the financial savings possible through smarter procurement, in the future we can expect to see this widen so that there is a greater focus on environmental as well as financial costs, with techniques such as lifecycle analysis being routinely used in procurement processes to capture the costs associated with all stages of a product's life, from production to disposal.”
And there will be a continued focus on reducing waste and maximising value for patients, for example by reducing provision of treatments that are of limited clinical value; preventing unnecessary admissions to hospital; improving communication and co-ordination between different parts of the system; and ensuring that drugs are prescribed appropriately and taken as intended.
In short, anything that involves using resources and getting little to show for it means wasted money and unnecessary carbon emissions,” said Naylor.
There are plenty of opportunities for carbon reduction to go hand-in-hand with efforts to improve the health of the population and increase the efficiency of health services
“To eliminate this waste, a carbon-neutral NHS would have to be smarter and more personalised, both through the use of new technologies and by getting much better at understanding what actually matters to individual patients.”
Finally, there needs to be a shift in resources from cure towards prevention.
Naylor said: “Anything that succeeds in reducing demand for healthcare is also likely to reduce associated carbon emissions, provided that reductions in one part of the system are not undone by increases elsewhere.
“Some public health measures may also have direct environmental benefits. For example, eating less meat can improve your health while also reducing your carbon footprint – and can also help the NHS if the alternative is vascular surgery.
“Preventive interventions are not necessarily carbon-free, but, in general, we can predict that a carbon-neutral NHS would need to focus more on keeping people healthy.”
Seizing the opportunities
He concludes: “If enough progress is made in these areas, the NHS could become carbon neutral without having to undertake more-drastic forms of carbon rationing.
“Top priority should be given to steps that can improve health today, as well as in the future.
“For example, reducing fossil-fuel usage can improve air quality now, and also mitigate climate change over the decades to come.
“There are plenty of opportunities for carbon reduction to go hand-in-hand with efforts to improve the health of the population and increase the efficiency of health services.
“But seizing these opportunities will mean taking action sooner rather than later.”