NHS Chief Sir Simon Stevens has announced the NHS and its staff will step up action to tackle the climate ‘health emergency’ this year, helping prevent illness, reducing pressure on A&Es, and saving tens of thousands of lives. The initiative follows the launch of the Climate Assembly UK this week, which is discussing how the country can best get to ‘net zero’.
The health and care system in England is responsible for an estimated 4-5% of the country’s carbon footprint. As the causes of air pollution and climate change are often the same the new campaign, ‘For a Greener NHS’ will help address both.
Sir Simon Stevens has confirmed the NHS will take three immediate steps during 2020 to tackle this problem.
Expert panel
NHS England is establishing an expert panel to chart a practical route map this year to enable the NHS to get to ‘net zero’, becoming the world’s first major health service to do so.
Dr Nick Watts, of University College London, will chair the NHS Net Zero Expert Panel. He is a medical doctor and Executive Director of Lancet Countdown, the independent international expert group that tracks the links between climate change and health.
The NHS in England is the only healthcare system in the world that is routinely reporting on greenhouse gas emissions. The Expert Panel will look at changes the NHS can make in its own activities; in its supply chain; and through wider partnerships – thereby also contributing to the government’s overall target for the UK.
These include the Long Term Plan commitment to make better use of technology so that as many as 30 million outpatient appointments become redundant, sparing patients thousands of unnecessary trips to and from hospital. It is estimated that 6.7 billion road miles each year are from patients and their visitors travelling to the NHS.
It will also look at changes that can be made in the NHS’s medical devices, consumables and pharmaceutical supply, and areas the NHS can influence such as the energy sector as the health service moves to using more renewable energy.
The Panel will submit an interim report to NHS England in the summer with the final report expected in the autumn, ahead of the COP26 International Meeting in Glasgow.
Sir Simon Stevens says: “With almost 700 people dying potentially avoidable deaths due to air pollution every week we are facing a health emergency as well as a climate emergency. Patients and the public rightly want the NHS to deliver for them today, and to help safeguard the future health of our children and grandchildren.
“While the NHS is already a world leader in sustainability, as the biggest employer in this country comprising nearly a tenth of the UK economy, we’re both part of the problem and part of the solution. Indeed if health services across the world were their own country, they’d be the fifth-largest emitter on the planet.
“That’s why today we are mobilising our 1.3 million staff to take action for a greener NHS, and it’s why we’ll be working with the world’s leading experts to help set a practical, evidence-based and ambitious date for the NHS to reach net zero.”
Sir Simon will also act as an adviser to Climate Assembly UK.
Dr Nick Watts, Chair of the new NHS Expert Panel, says: “The impact of climate change on our health is there for all to see and at the Lancet Countdown, we have amassed the evidence to encourage health systems across the world to take action.
“The NHS in England leads the world in taking action on climate change and improving public health along the way, so I am delighted to have been asked by Sir Simon Stevens to help chart a route to a net zero health service.
“Everyone who works in healthcare has a responsibility to take action on the health emergency posed by climate change, and I encourage all NHS staff to join the campaign to feed in their ideas and help drive this forward.”
New NHS Standard Contract
The proposed new NHS Standard Contract will call on hospitals to reduce carbon from buildings and estates, whilst switching to less polluting anaesthetic gases, better asthma inhalers, and encouraging more active travel for staff.
Grassroots campaign
‘For a Greener NHS’ is the health service’s very own grassroots campaign that will encourage staff and hospitals to cut their impact on people’s health and the environment.
The campaign will be supported by the UK Health Alliance on Climate Change – which includes representative bodies covering over 650,000 NHS staff. The campaign will build on the work already underway to help Trusts and staff to cut emissions, energy use and waste, including phasing out oil and coal boilers and increased use of LED lighting and electric vehicles.
Staff and local NHS organisations are being encouraged to feed in ideas to the Expert Panel, and evidence of steps they may have already taken within their own hospital. A new website https://www.england.nhs.uk/greenernhs will help local NHS bodies to share ideas and ramp up initiatives that are already working across the health service.
Collectively the 1.3 million NHS staff could make a huge impact on the campaign. For example, each person switching to refillable water bottles instead of plastic bottles could save 65kgCO2 per year. One London Trust showed that just by turning off printers, computers and other equipment overnight and managing heat loss each staff member was able to reduce CO2 emissions by an average of 70kg a year.
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, says: “This is an important initiative for the NHS, and we would encourage all staff to sign up.
“The air pollution and increased frequency of adverse heat events caused by the burning of fossil fuels lead to higher rates of respiratory and cardiovascular diseases and mental health crises, all of which will increasingly impact on the already stretched emergency care system.
“The Royal College of Emergency Medicine has declared a climate emergency and is exploring ways in which we can help tackle the problems, both as an organisation and a specialty. We encourage every organisation and specialty in the healthcare sector to look at what they can do to be ‘greener’ and supporting the ‘For a Greener NHS’ campaign is a great place to start.”
Whilst encouraging every single NHS employee to engage with this campaign and take what action they can towards a greener NHS, it is clear that the journey to net zero carbon will require change on a much bigger scale and estates and facilities will be at the heart of much of that. Niall Dickson, Chief Executive of the NHS Confederation cautions: “Britain will not achieve its green ambition unless we transform the way the NHS operates.” He adds that this is a challenge, but also an opportunity. “Working with local government, its thousands of suppliers and its million plus staff, the NHS can be a major force in building a green future.”
UNISON General Secretary Dave Prentis throws the spotlight onto the infrastructure. “Involving staff is crucial if the NHS is to help the UK meet its emissions targets in good time. They know more than anyone how the health service ticks and so are best placed to make practical green suggestions to get the NHS to where it needs to be,” he says.
“But the implications for the NHS building stock are huge. Everyone must now work together to understand how environment-harming heating and lighting systems can be replaced without redirecting funds from patient care.”
Impact of climate change on health
Air pollution is linked to killer conditions like heart disease, stroke and lung cancer, contributing to around 36,000 deaths annually.
A recent study by Kings College London looking at nine English cities demonstrated that on high pollution days there are 673 additional out-of-hospital cardiac arrests and hospital admissions for stroke and asthma, with spikes in ambulance 999 call outs. Last month a group of 175 doctors warned that air pollution is directly adding to current pressures in accident and emergency departments.
The changing climate is leading to more frequent heatwaves and extreme weather events such as flooding, including the potential spread of infectious diseases to the UK. Almost 900 people were killed by last summer’s heatwaves while nearly 18 million patients go to a GP practice in an area that exceeds the World Health Organisation’s air pollution limit.
Scientists believe perhaps a third of new asthma cases might be avoided by cutting emissions while Lyme Disease and encephalitis are among conditions expected to become more common as temperatures rise.
Professor Andrew Goddard, President of the Royal College of Physicians, says: “The climate emergency is a health emergency, with doctors and other clinicians already seeing the impacts associated with air pollution, rising temperatures and extreme weather events on the patients they treat. Climate change isn’t something we can afford to delay acting on so it’s positive to see the NHS showing leadership on the issue.
“The NHS as an employer can support staff to do small things which can all make a difference. However, it’s clear that we must also focus on the impacts of the system as a whole, and how the NHS can move towards net-zero as quickly as possible. It must use all the levers available to it, particularly those which encourage suppliers to move towards net-zero.
“Hospitals also have an opportunity to use their influence as key anchor institutions in local communities to drive positive change beyond their walls. Together staff and hospitals can make a big impact relatively quickly, by reducing wastage and promoting active transport. I know our members stand ready to help.”
