NHS England / Improvement (NHSE / I) has published a report setting out how it intends to meet the government’s commitment of net zero carbon in advance of the 2050 deadline. It will involve significantly reducing emissions, as well as off-setting using carbon capture, for instance, planting trees.
The health and care system in England is responsible for an estimated 4-5% of the country’s carbon footprint and therefore has a major role to play in enabling the government to reach its target.
The NHS has committed to reaching net zero as soon as possible. An expert panel, chaired by Dr Nick Watts from the Lancet Countdown (recently appointed as the new NHS Chief Sustainability Officer), examined how and when this may be possible. An open call for evidence also collected over 650 pieces of evidence across a broad spectrum of areas, from food and transport to clean energy production and increasing use of technology to manage health conditions.
As a result of this work, the NHS is committed to reaching Net Zero for emissions under its direct control by 2040 and by 2045 including its wider supply chain with an ambition for an interim 80% reduction by 2036-2039.
The report, ‘Delivering a ‘Net Zero’ National Health Service’, sets out more detail over a number of areas critical to carbon reduction across the NHS. It will be used as the basis of an engagement process over the next six months, which will inform further commitments to be published throughout 2021.
Secondary care estate and facilities
A Net Zero Carbon Hospital Standard will be available from spring 2021, which all new hospitals, to be built as part of the Health Infrastructure Plan, will have to comply with. The Standard will involve using low-carbon materials and adopting a new design that will provide flexibility for the delivery of healthcare in the future.
In the existing estate, initiatives will include:
• Upgrading to LED lighting
• Interventions on air conditioning and cooling, building fabric, space heating, ventilation and hot water
• Optimising the way the NHS uses its buildings with intelligent, real-time energy monitoring and control including the use of artificial intelligence
• Shifting to on-site renewable energy and heat generation by better utilisation of roofs and adjacent ground space
• Removing all coal and oil heating systems from its sites as soon as possible
• Purchasing 100% renewable energy from April 2021.
Travel and transport
Approximately 3.5% of all road travel in England relates to patients, visitors, staff and suppliers to the NHS - that’s around 9.5 billion miles and 14% of the system’s total emissions.
The Long Term Plan has already set a commitment for 90% of the NHS fleet to use ultra-low and zero-emission vehicles by 2028. There is now a target for the entire owned fleet of the NHS to eventually reach net zero emissions. Staff should also be incentivised to use electric vehicles.
The NHS will also develop and test the world’s first hydrogen-electric hybrid double-crewed ambulance through the London Ambulance Service as part of project ZERRO (Zero Emission Rapid Response Operations Ambulance), funded by Innovate UK.
Cycling, walking and alternative means of transport are to be encouraged and all Trusts will be required to have a green travel plan as part of their annual planning and reporting.
Food, catering and nutrition
It is estimated that food and catering services in the NHS produce 1,543 ktCO2e each year, equating to approximately 6% of total emissions. The report states that “healthier, locally sourced food can improve wellbeing while cutting emissions related to agriculture, transport, storage and waste across the supply chain and on NHS estate.”
This would appear to go against much of the recent emphasis of NHS Supply Chain: Food, which has seemed to focus on scaling savings through bulk purchase, leading to concerns that smaller, local suppliers will be squeezed out.
Sustainability and the impact of the whole supply chain is expected to feature in the ‘root and branch’ Hospital Food Review, which is due to be published this month. Alongside this, NHSE / I will develop new national standards for healthcare food for patients, staff and visitors later this year. The standards will signal a more systemic approach to procuring and producing sustainable and healthy food.
