Sustainability Day Birmingham 2016

Welcome to the Birmingham Sustainability Day 2016 Road Show

#Dayforaction

Welcome and introduction

#Dayforaction

Morning session

09:10 Introduction to the day

09:15 The Paperless NHS an important factor in sustainable HealthcarePaul Fleming, Head of Digital Technology, Midlands and East Region, NHS England

09:35 Food Procurement and Catering Management- Northampton General HospitalClaire Topping, Estates Manager, Northampton General Hospital

09:55 Smart Cities and how they have the potential to be an integral part of Health & Social CareMark Griffiths, Regional Director, Bouygues Energy & Services FM Division

10:15 Self-Funding Energy Cost & Carbon Saving ProgrammeJames Carson, Energy Performance Programme Analyst, Virtus Consult

10:35 Reuse as a gateway habit for behavior changeDaniel O Connor, CEO, Warp-It

10:55 Refreshments and Networking

www.england.nhs.uk

Digital at scale

Paul FlemingHead of Digital Technology

Midlands & East of England

[email protected]

@Healthiapps

mailto:[email protected]

www.england.nhs.uk

Current

policy

landscape

Wachter Review Recommendations

1. Carry Out a Thoughtful Long-Term National Engagement Strategy

2. Appoint and Give Appropriate Authority to a National CCIO

3. Develop a Workforce of Trained Clinician-Informaticists at the Trusts,

and Give Them Appropriate Resources and Authority

4. Strengthen and Grow the CCIO Field, Others Trained in Clinical Care

and Informatics, and Health IT Professionals More Generally

5. Allocate the New National Funding to Help Trusts Go Digital and

Achieve Maximum Benefit from Digitisation

• The £4.2 billion the Treasury made available in 2016 to promote digitisation, while

welcome, is not enough to enable digital implementation and optimisation at all NHS

trusts.

6. While Some Trusts May Need Time to Prepare to Go Digital, All Trusts

Should be Largely Digitised by 2023

7. Link National Funding to a Viable Local Implementation/ Improvement

Plan

8. Organise Local/Regional Learning Networks to Support Implementation

and Improvement

9. Ensure Interoperability as a Core Characteristic of the NHS Digital

Ecosystem – to Promote Clinical Care, Innovation, and Research

10. A Robust Independent Evaluation of the Programme Should be

Supported and Acted Upon

The Advisory Group believes that trying to achieve the aims of the Five Year Forward View without giving highest priority to digitisation would be a costly and painful mistake.

www.england.nhs.uk

Why Local

Digital

Roadmaps?

Why scale?

www.england.nhs.uk

Developing a vision :

Digitally-enabled Transformation

Key Digital Themes

Paper-free at the Point of Care

Digitally-enabled self-care

Real-time data analytics

Whole systems intelligence

Address the 3 National Challenges

1. How can ‘digital’ drive transformation to close the care and quality gap?

2. How can ‘digital’ support closing the health and wellbeing gap?

3. How can ‘digital’ help close the finance and efficiency gap?

www.england.nhs.uk

Transfers of Care

Use technology to seamlessly transfer

patient information at discharge,

admission or referral“Having the ability to quickly

access an individual’s medical

history will enable me as a

paramedic attending a call to

make informed decisions when

responding to an emergency.”

Paramedic

Records, Assessments and Plans

Capture information electronically for

use by me and share it with other

professionals through the Integrated

Digital Care Record

Medicines Management and

Optimisation

Ensure people receive the right

combination of medicines every time

Decision Support

Receive automatic alerts and

notifications to help me make the right

decisions

Remote Care

Use remote, mobile and assistive

technologies to help me provide care

Asset & Resource Optimisation

Increase efficiency to

significantly improve the quality

and safety of care

Orders & Results Management

Use technology to support the ordering

of diagnostics and sharing of test

results

7 areas / domains your projects and

capabilities will fit into

www.england.nhs.uk 10

Halton

St Helens

Knowsley

Liverpool

South

Sefton

Southport &

Formby

Patient story


Halton

St Helens

Knowsley

Liverpool

South

Sefton

Southport &

Formby


Halton

St Helens

Knowsley

Liverpool


Halton

St Helens

Knowsley

Liverpool

Specialist Acute

North West Ambulance Service

Palliative plan on paper

2 Weeks

Later


Why should we scale?

Why haven’t we scaled already?

www.england.nhs.uk

Challenges

&

Realities


CulturesServices

Technology workforce

Public

www.england.nhs.uk

Approaches

Opportunities

www.england.nhs.uk

Emerging Digital Areas

Infrastructure

Integration

Empowerment

Intelligence

Cross Sector Leadership, Governance and Collaboration


Example, collaborative IT governance model

Integrated Care / STP Board

Joint Digital/Informatics Enabling board

Integration

Project

Group

Joint Digital

Self Care

Project

Group

Joint Infrastructure

& Technology

Project Group

Joint Business

Intelligence

Project Group

Joint Operational

IG & Information

Sharing Group

Practitioner

Reference

Group

Joint Caldicott

Guardians Group

Health & Wellbeing Board

CIOs, CCIOs, Finance,

LMC, Healthwatch, care

service leads. Nominate

a programme lead and

SRO.

Practitioners working

through detailed

requirements, design and

implications of change

CEOs, AOs, Directors etc

Apps, online

access, self care

Integrating &

connecting

care systems

Unifying back end

infrastructure and

systems

Detailed working

on policy,

Information

sharing, close link

to Caldicott

Group

Advisory

Looking at new

ways of using

and combining

data

Project/working group level

Programme level

Executive level

www.england.nhs.uk

Our stories

Our Health

Food for Thought

Clare ToppingEnergy and Sustainability ManagerNorthampton General Hospital NHS Trust

Thou shalt not eat stuff that’s bad for you or the environment!

Food – the basis of good healthcare

7.3.Healthier EatingHospitals have a duty of care to take reasonable steps to preserve and promote their patients mental and physical wellbeing. Health promotion is integral to all aspects of food provision, including staff and patient catering systems, vending machines and on-site retail operations. Principles of healthy eating must be considered during any reviews of foods provided.

Food – the hospital reality

Food – the basis of good healthcare

NGH catering department

• Produce around 2,100 meals per day (inc breakfast) that’s 14700 meals per week

• Around 80% of all the food is prepared in house, with a team of 7 chefs an 6 catering assistants working over 7 days to manufacture, then a further 20 to assemble and distribute to the 28 wards.

• All the meat is Red tractor and we also produce Halal meals in house which conform to the animal welfare standards.

• We use around 3200 pints of milk per week on our patient services and over 9000 rounds of toast!

Where to start?

We started the week before last in the #3 outlet, mixed reactions and two customers walked out!

i am really angry having arrived for breakfast to find out that today is a meat free day. HOW DARE YOU enforce vegetarinismon us!!!!!! please inform me of a meat only day with NO vegatarianoptions or i will consider this discrimination and take matters further.

Kitchen Gardens

Food for Life

Food – it’s not just about the food

Food – the big issue

But…

Mark Griffiths

Regional Director

Bouygues Energies & Services

Smart Cities can they be an integral part of Health & Social care?

AGENDA:

• Introduction

• What is a Smart City

• Building Smart

• Delivery

• Drivers and Benefits

What is Smart City?

The Bouygues Group: Building Smart Cities

Communications Construction Power

£36 B turnover

Bouygues’ French Headquarters - Challenger

First building in the world to achieve triple certification (2011)

• LEED® “Platinum” (US)

• BREEAM® “Outstanding” (UK)

• HQE® “Exceptional” (FR)

Delivery Challenge

• Phased works from 2010 to 2014, Shifts over 67,000m2

• Occupied site

Energy

• 90% Energy and CO2 savings

• Ventilated, double skin façades

• Geothermal energy from heat pumps

• 25,000m2 photovoltaic panels on roofs, terraces and solar farm

• 100% of available BREEAM energy credits achieved

Water

• Rainwater harvesting

• 60% water savings

• 100% of sewage will be treated and re-used on site (phyto-filtration garden)

Human Activities: City Impact!!!

More Cities: More Carbon Impact!!!

• 80% Global CO2 due to Cities

• More People in Cities

• Reduce the impact

• Less Energy

• Eco Communities

• Eco Buildings

• Challenge of Eco Cities

Smart City Challenges

1616

Autonomous BuildingABC

for Citizens

• A… for Autonomous. Self‐sufficiency in energy (electricity, heat, etc.) and water, and optimised waste management.

• B… for Building.

Innovative construction processes,optimisation and standardisation

• C… for Citizens.

Residents engagement

Smart City Challenges: Approach

Lots of Independent solutions

Process – Identify the needs

Public Spaces

Infrastructures

Housing

Public amenities

Commerce and

business

New

usages

Local

services

Nature in the

city

Water Energies Wastes Mobility Digital

Create the best solution with the best partners

More lively, more communal and more intense

More efficient, more renewable and greener

More connected, smarter and more intermodal

Group

Global

Local

FM

Smart Grid Local

PARIS | FORT D’ISSY

FIRST DISTRICT SMART GRID IN FRANCE Issy‐des‐Moulineaux:

> 160,000m2

> 10,000 people

1. Energy consumption will be measured for all types of use, including: office, home, business, public lighting and electric vehicle recharging stations

2. Installation of solar panels, co‐generation units and other energy production resources andother energy storage devices (batteries, flywheels…)

3. Production, consumption and storage systems will be shared and managed as a whole in order to identify areas of energy optimization

GreenCity – Zurich2000W Community

Today

5.000 W/hab

Accomodation1.500 W

Transportation900 W

Consumption1.100 W

Infrastructure900 W

Electricity600 W

Goal

2.000 W/hab

Smart City Solution

Smart City & Health and Social Care Drivers & Benefits

Internet Of Things

High-Tech Ecosystem

Data Development

Sensor networks

Data Collection

Storage

Mobility

Predictive Healthcare –App based ?

Improved environment –Air Quality

Reduced inpatient time

Social Inclusion

Benefits

Driv

ers

There is one game changer that will help us deliver these benefits

www.bouygues-es.co.uk

Thank You

Sustainability Day: Birmingham Roadshow

Awards2013Building

Finalist

Awards2014

Finalist

BuildingFinalist Finalist

www.virtus-consult.co.uk

Healthcare Efficiencies at Heart of England NHS Foundation Trust (HEFT)


Contents

Introduction

HEFT Background / Targets

Project 1: Energy

Project 2: Asbestos Consultancy

Procurement

Project 3: Value for Money

Project 4: Capital Works PMO

Questions

James Carson

Energy Analyst, Virtus Consult


Introduction

Virtus deliver exemplary results;

ensuring every stage of a project’s

life is meticulously planned and

perfectly executed

Respond to the unforeseeable with

innovation and pragmatism

Save money and minimise risk

Have a team of passionate and

driven industry specialists

Virtus Consult is an award winning

construction and management

consultancy firm offering tailored

solutions to our broad range of

clients

“I can’t remember ever working with such dedicated and

personable people with such integrity”

Rolls-Royce


Introduction

“You make us think differently”John Sellars, Director of Asset Management, HEFT

Do not shoehorn our solutions to

fit, we listen to our clients to tailor

the perfect solution

Are trusted partner to a number of

blue chip organisations

Build long term relationships

Services

Cost Consultancy

Project Management

Development Management

Energy Consultancy

Principal Designer

Construction Claims Consultancy

Sectors

Education

Energy

Healthcare

Hotels & Leisure

Industrial

Nuclear

Offices

Residential

Retail

HEFT Background / Targets

5

One of the largest Trusts in England, employing approx.

11,000 people

Annual budget of £650m

General and specialist hospital care for the people of East

Birmingham, North Warwickshire, Sutton Coldfield,

Tamworth and South Staffordshire; in excess of 1,800

beds

Continually striving for excellence and efficiency

Targets and Constraints:

CIP Targets of 5% year on Year

Carbon Reduction - 34% 2020 / 50% 2025 / 80% 2050

Spend to Save / Guaranteed Savings

Introduce Market intelligence and competition

Compliance with OJEU Guidance


Project 1: Energy - Client Brief

5 www.virtus-consult.co.uk

Current Energy Spend £5.2m

Carbon reduction targets

5% year on year cost savings

OJEU compliant solution

No disruption to the Trust’s core activity

Option for 3rd party funding

Continued improvement

Low implementation costs

Project 1: Energy


Site Survey, Interviews and Questionnaire

OJEU Competitive Dialogue

9 month process

Project management of

the installation

Monitoring of

performance to ensure

HEFT received

guaranteed savings

Estimated Demand Side Reductions of c20%

Energy Cost and Carbon Reduction c£1m p/a

Project 1: Energy - Initiatives


LED Lighting & Controls

Pipework Insulation

Variable Speed Drives

Pump replacement

Display energy meters

Refrigeration Control

Solar PV

Energy Manager

Project 1: Energy - Achievements


Guaranteed savings of circa £900k per annum (18% of

annual spend)

Payback of 4.3 years

Low implementation costs – 0.05% of savings

Speed of implementation – 9 months

Options for 3rd party funding

Continued improvement over 4 year framework

Combined with CHP, exceeded Carbon Target

Project 1: Energy - Review


Project 2: Asbestos Consultancy Procurement


Current Status, Compliance / Budget / Spend / Supply

Chain (one supplier doing everything) / Asbestos Spend

£1.5m pa

Improved Service, Performance and Cost

Savings through Market Testing

OJEU Tender Process / Specialist Input /

Performance / Quality of Service

4 Year Framework with 4 Suppliers

Providing Support with

Procurement of Packages

Monitoring of

Performance against

Savings Targets

Project 2: Asbestos Consultancy Procurement - Achievements


Self-Funded procurement process delivered:

4 Year Framework, Local Suppliers

4 Compliant Qualified Suppliers ISO 17020:012

Prices and Rates reduced by c20% on previous supplier

Quality of Performance through KPI’s

Familiar with In house Systems MICAD

Project 3: Value for Money


Data Analysis / Desktop Exercise /

Interview / Questionnaire / Benchmarking

Rationalisation of Personnel, Stores,

Suppliers, Contracts and KPI’s

Managing the Programme

of Improvement

Monitoring of

Performance against

Savings Targets.

Improved Service, Efficiency, Cost Through

Operational and Procurement Improvement

Efficiency Savings of 10 - 15%

Project 3: Value for Money - Findings


Initiatives included:

Service Contracts – procurement and rationalisation

Rationalisation of Stores – procurement and rationalisation

Contracts Management – opportunities for outsourcing, procurement

and rationalisation

Centralisation of Administration – reduce duplication and

standardisation of reports

Resulted in identification of savings ranging from 10% - 15% in operational

costs



Compliance / Pipeline Review / Cost, Resource and

Expertise Appraisal of In-House Team

Provision of 2 NHS Specialist Associate

Directors

Managing the £100m

Programme of Improvement

Monitoring of

Performance against

Savings Targets

Improved Knowledge Base, Expertise,

Systems and Processes Capacity, Service

Offering, Efficiency



Virtus are working with HEFT to deliver a capital

improvement programme valued at £100m and have

supported the Trust’s Programme Management Office

(PMO)

Virtus seconded two Directors to the Trust

Extensive experience developing business cases,

procurement and healthcare projects

Implemented exemplar systems and processes

Created a PMO team

Engaged with the Trust’s Estates and Operational

teams, as well as key clinical stakeholders to deliver

capital improvement programme

Project 4: Capital Works PMO -Achievements


Projects Delivered include:

A&E

Operating theatres

Pathology

Research facilities

Car parks

Radiology

Endoscopy

Significant operational efficiencies have been achieved through streamlining

the programme management and client liaison process

HEFT is benefitting from state of the art facilities which are appropriate for

today’s medical challenges as well as being more operationally efficient

Dermatology

Oncology/Rheumatology

Urgent care centre

Hybrid theatre

Maternity and Neonatal

AMU

Restaurant

Questions


B I R M I N G H A M O F F I C EThe PenthouseLancaster House67 Newhall StreetBirmingham B3 1NQt 0121 200 2855

O X F O R D O F F I C E267 Banbury RoadSummertownOxford OX2 7HTt 01865 339 439

L E E D S O F F I C EGround and First Floor1200 Century WayThorpe Park Business Park Colton Leeds LS15 8ZA

L O N D O N O F F I C E16 Upper Woburn PlaceLondon WC1H 0BSt 0203 741 8037

Daniel Bede O’Connor

Head of Customer [email protected]

078 0707 0339

@WarpIt_


Overview

Reuse Study Organizational

habits Story How it applies to

reuse or other sustainability activities

Staff get visibility on what is available elsewhere

Friend requestsSE over 35 orgs….

Priority 3

Priority 1 , 2 and 3- turn on and off

Like eBay-increases participation

Controls.

Diverse range of equipment.

Increase participation.

Increase impact.

Plan building moves.

Direct transfer.

External collab

Access to other organisation’s items

External Collaboration

NHS London save £3K , NHS Tayside save £15K

Demonstrate savings.

Metrics from NHS Tayside

The power of habitWhy do we do what we do and how to change.

Charles Duhigg

What habit would you like to develop or change?

You want to improve things right?

Organisationalhabits

Why habits form

Habit basics

The habit loop

The habit loop

New habits

Craving reward!

Changing habits

Increased participation

Keystone habits

Keystone habits in organisations

Reuse as a Keystone habit

Frame within crisis, not sustainability

Unacceptable to dispose of assets to skip

Change

Other sustainability behavioursor any change

Reuse as a Keystone habit

“Once a small win is accomplished , forces are set in motion that favouranother small win”

Small wins

“Small wins fuel transformative change by leveraging tiny advantages into patterns that convince people bigger achievements are within reach”

Small wins

Small wins

Small wins for reuse

Just start off with a stationery amnesty? Show impact?

Ask procurement to block purchase of stationery

Demonstrate savings let’s do full reuse system

Develop intranet content

Deliver newsletter

First £20K saving

Feedback to staff

Feedback to senior staff

1st year review

Yes we’ve got the CE on board!

Review

Anatomy of habits

Keystone habits

Small wins

Do you want to improve things?

Collaboration

Procurement

Facilities

Logistics

Communications

Space manager

Asset manager

Capital development

H&S

IT

Contractors

Do you

Hate buying new when the organisationalready has it?

Do you

Hate seeing surplus assets in skips?

Do you

Like reducing waste?

Do you

Like reducing procurement?

Do you

Like helping staff collaborate?

Do you

Like saving money and carbon?

Do you

Like collaborating with other Trusts?

Do you

Want to get me in to illustrate the hooks and benefits of reuse for each department?

MaximiseReuse

Clipboard

Pen

First name and second name only

I will find your details and book in a meeting

What habit would you like to develop or change?

Habit?

Cue

Routine

Reward?

Craving!

Daniel O’Connor

Head of Customer [email protected]

078 0707 0339

@WarpIt_


Refreshments & Networking

#Dayforaction

Mid-morning session

11:15 How to deliver sustainable health outcomes through healthy eatingLouise Needham, Environment & Sustainability Manager, Quorn Foods

11:35 Funding energy efficiency to create a sustainable NHSBeth Williams, Programme Co-ordinator & Binayak Basnyat, Client Support Officer, Salix Finance

11:55 Supporting sustainable Communities- CarillionJennifer Bragg, Sustainability Manager (Graduate), Carillion

12:15 Interactive workshop -A patient’s view of wasteSian Fisher, MSc MCIWM, Director, Catalyst Waste Solutions Ltd

12:45 Lunch & Networking

…becoming experts in delicious, healthy

and sustainable alternatives to meat

Louise Needham

Environment & Sustainability Manager

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=Mp-9F1R9j2JVlM&tbnid=QvvE-uyULyJEtM:&ved=0CAgQjRwwAA&url=http://www.lifeinabreakdown.com/quorn-a-healthy-alternative/&ei=TOa5UeeaPMGxhAeD8oCoBQ&psig=AFQjCNH10m2qrbVlQ-cuCSPB5QPFdjSEGg&ust=1371224013031851

Source: FCRN Food

Source, 2016

The 1960s was a time of

huge achievements...

Quorn in context

....And growing concerns

Quorn in context

A man with a big idea

Remember the history…

“What we need is a new and greener

revolution, like the one we saw in the

developing world in the 1960s, but which

tackles BOTH food security and climate

change.”

~Professor Sir John Beddington

2009 as UK Chief Scientific Advisor

At the heart of all Quorn foods is

mycoprotein…

So, what is

it?

Natural appeal

Our 50 year ‘overnight

success’……….

So it can be done

Belasis Process Overview

Fermentation

To grow the

organism

RNA

Reduction

To meet

specification

Centrifuge

Separate

solids and

liquid

Chillers

Harvesting of

Mycoprotein

paste

Despatch

Chilled to

Stokesley for

onward

processing

Raw

Materials

Utilities

Deep shaft

fermenter

to process waste

Clarifier

to separate

Clean Water

To River Tees

Sludge

to land injection

129

No other protein can create the meat

like textures achieved by Quorn

Unique attributes

Micrographs reveal unique fibrosity

Quorn has a unique meat like texture

Soy

Poultry

Mycoprotein

Additional InterestSCFA productionFibre (chitin and ẞ-glucans)

Mycoprotein as a food ingredient

Physical

Properties (shape)

Denny, A, Aisbitt, B and Lunn, J (2008) Mycoprotein and health. BNF Nutrition Bulletin 33: 298 – 310.Bottin, J. (2014) Nutrition and Surgical Influences on appetite regulation in obese adults. PhD Thesis Imperial College London

BENEFITS

Texture creation• Authentic meat-like texture• Creation of fibrosity through fibre assembly

General Nutrition• High quality protein• Low fat content (membranephospho-lipids)

• High fibre (cell wall)• Low energy densityClinical Research Programmes• Lowering serum cholesterol• Satiety• Insulinemia and

glycemia in diabetics

Composition

Source: FCRN Food Source,

2016

Growing population: 9-10bn by 2050

Changing population: Africa & Asia

urbanising fastest

Rising incomes =

• Changing lifestyles

• Dietary change – “Western diet”

• Changing burden of disease (e.g.

obesity, heart disease, stroke,

diabetes, some cancers.)

The bigger picture…

‘Greenhouse Gas emissions from the

livestock sector account for

15% of the global total…

…more than direct emissions from the global transport sector’

Chatham House Report, 2014

Challenges for a scalable meat based

sustainable food futureOur biggest lever globally is to eat less

meat

GRAPHIC: N. CARY/SCIENCE

Changing the food system to provide sustainable healthy diets

Unique recipe of benefits…

Health &

nutrition

Taste &

texture

Versatility &

familiaritySustainability

Behaviour Change

The importance of evidence base…

Over 30 years of clinical research into

the benefits of diets rich in

mycoprotein

An exciting programme for 2016

ANABOLIC PROPERTIES

OF PLANT PROTEIN

BEHAVIOUR CHANGE

Quorn Environmental Footprint

Key Comparisons vs

Quorn

GHG LAND WATER

Beef Mixed

x9 more GHG

x9 more land

x10more water

Beef Grazed

x36 more GHG

x12 more land

x11 more water

Chickenx3 more

GHGx2 more

landx2 more

water

By working closely with Carbon Trust we have established that

Quorn Foods offer significant environmental benefits relative to

meat.

Quorn is the first and only meat free brand to have carried out

such a systematic third party analysis of its environmental

footprint.

NHS Sustainability Day 2017

Join us

on 23th March 2017

Quorn “ Sausage Swap ”

&

Sustainability “ Dish of the day”

Please come and visit us at our stand to understand how you can support and to

gain details of how to download your recipe and POS support packs.

In 2 hours on Thursday 24th March 2016,

Quorn Sausage Swap and ‘sustainable dish

of the day’ saved………..

348,000 Calories

14kg of Saturated Fat

35,000 Baths of water

Increased 9kg of Dietary Fibre

4,000kg of Carbon

* Figures based on 3417 portions of Quorn declared by

participating NHS trusts

The Quorn Mince Challenge

Swapping for 3 meals a week could save

you:-

106.7 days of personal water usage

23.5 Jaffa cakes in Calories

26.4 teaspoons of butter in dietary fat

reduction

Enough carbon to boil a kettle 4660.7 times

Tuesday Wednesday Friday

Quorn Cottage Pie Quorn Bolognese Quorn Chilli

During the month of October 2016 , Broomfield

Hospital has removed minced beef from its

restaurant menu and replaced with Quorn mince to

highlight the health benefits in making simple meal

swaps to its staff and visitors.**

** Initial feedback gathered on 12/10/16 at Broomfield hospital suggested that over 80% of all staff and visitors who

completed the survey supported the initiative and would be happy to eat Quorn as a healthy and sustainable alternative to

meat.

145

Sampling Quorn to over

2000 NHS Staff and Visitors

Great Ormond Street Hospital

Guys Hospital

St Thomas Hospital

St Barts Hospital

ULC Hospital

Whipps Cross Hospital

Newham University Hospital

Royal London

Mile End Hospital

Nottingham City Hospital

Nottingham QMC Hospital

Sheffield Teaching Hospitals

146

Quorn fits easily into everyday life and makes meat reduction simple…

[email protected]

Tel: 01642 717306

Mob: 07891 484256

Thank you


Beth Williams Programme Co-ordinator

Binayak BasnyatClient Support Officer

100%INTERESTFREE

Introduction

To demonstrate how Salix can help Trust and Foundation Trusts

Knowledge sharing and case studies

Summary of the loan application process

Our goals for today

The challenge…

241 Trusts and Foundation Trusts spend over £634m on energy and utilities 1

Average of £2.5m per hospital 1

Typically 3rd largest expenditure

The most expensive Trusts spend 6.2 x more on energy per m2 than the least expensive 1

1. Health and Social Care Information Centre, Hospital estates and facilities statistics 20152. Salix Finance – loan applications since 2008

Our NHS clients have saved on average £236k per year 2

Introduction to Salix funding

Who we are

Established in 2004

Publicly funded, not-for-profit company

100% interest-free capital finance for the public sector

Over 120 technologies funded

Funded by BEIS, Scottish and Welsh Government, EFA and DfE

Support public sector bodies such as local authorities, educational establishments and NHS Trusts and Foundation Trusts

Our funding model

Client contribution

(were applicable)

Salix Activity within the NHS

Top 10 NHS Clients*

Imperial College Healthcare NHS Trust

Northern Devon Healthcare Trust

Hinchingbrooke NHS Trust

Bradford Teaching Hospitals NHS FT

Princess Alexandra Hospital NHS Trust

Northampton General Hospital NHS Trust

St George’s Hospital NHS FT

Poole Hospital NHS FT

Wrightington, Wigan and Leigh NHS FT

Frimley Health NHS FT

* By project value


Case StudiesProject Knowledge Slides

Social Media

@SalixFinance #SalixFunded

News & Blog

Best Practice Calculations

Salix project case studies

Imperial College Healthcare NHS Trust - case study

Estate covering 5 sites providing specialist care for over 1 million people.

Salix funded solution

Total project cost £7.4m

Projects include BEMS system, LED lighting upgrades, steam traps, variable speed drives and plate heat exchangers

3.8 year payback

£1.9m annual £ savings

£26.7m lifetime £ savings

Project overview Salix helped Imperial College Healthcare NHS Trust to deliver a suite of new projects across their estate saving the Trust over £1.9m per year

Blackpool Teaching Hospital NHS FT - case study

Provides care for 440,000 residents across Blackpool, Fylde, Wyre, Lancashire, South Cumbria and the North of England.

Salix funded solution

Total project cost £477k

Replace outdated heating plant with more energy efficiency plate heat exchangers

4.6 year payback

Lifetime savings of £2.9million

Project overview Salix helped Blackpool Teaching Hospital NHS FT to deliver a suite of new projects across their estate saving the Foundation Trust £103,143 per year

Project knowledge slides

Sharing of knowledge between clients

Before and after

Supporting comments

experiences

lessons learnt

supplier

contact details

SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTORWWW.SALIXFINANCE.CO.UK

Salix application process

FeasibilityInternal

ConsultationProcurement Mobilisation Installation

Forming a business plan and calculating savings

and paybacks

Trust Board approval for large scale projects

Design of installation programme

OJEU, Framework, Pre-qualification

questionnaire

Product availability and delivery windows

Business case checks

Meet with finance department

Offer reservation of funding for Trust Board

Workshops and calls with other Trusts for advice

Interim Payments

Phase works over financial years

Salix working with the Public Sector


Online application process


Six simple steps to apply

4

6

5

3

2

1 Log on to the Salix website: salixfinance.co.uk/loans/NHS

Complete the compliance tool with project details

Provide supporting information

Submit your application online

Salix will do a technical assessment

Salix will commit funding for your project


Our clients“ The team at Salix Finance were extremely good to workwith and the application process was very swift.”Cathal Griffin, Carbon Reduction Manager, Kings College Hospital, London

“Our ambitious carbon management plan hasbeen mostly funded via Salix, and is a major contributing factor in

our goal to achieve a 15% reduction in CO2 by 2015.”Gillian Brown, Environment Manager, Frimley Park Hopsital NHS Foundation Trust

“ Due to the success of this project, the Foundation Trust is nowin the process of developing a three year energy efficiencyproject plan to utilise Salix funding.”Carla Wilson, Energy Technician, Blackpool Teaching Hospitals NHS Foundation Trust

Summary

NHS Trusts and Foundation Trusts – no maximum loan amount

Help achieve energy and carbon reduction targets

Long-term funding plans, SDMPs, estates strategies

Reduce energy bills at your Trust

Thank you

[email protected]

Binayak. [email protected]

020 3102 6910



A Tale of Three HospitalsJennifer Bragg – Sustainability Manager (Graduate)

We seek to achieve 6positive outcomes

Building a successful business

Enabling low-carbon economies

Protecting the environments

Supporting sustainable communities

Providing better prospects for our people

Leading the way

2020 Sustainability StrategyMAKING TOMORROW A BETTER PLACE

Sustainability in Action

172

A TALE OF THREE HOSPITALS

Southmead (Bristol) opened 2014

Midland Met (Birmingham) opens 2018

RLUH (Liverpool) opens 2017

Sustainability Targets

• Challenging targets for Southmead, RLUH and Midland Met

– BREEAM ‘Excellent’

– High % Local Employment

– High % Local Spend

• Emphasis on ‘Leaving a lasting Legacy’

173

GREAT EXPECTATIONS


• My work is centred on the new ‘Midland Met’ hospital

• Notable challenges for my colleagues and me are:

– Success at Southmead & RLUH mean tighter sustainability targets

have been set for Midland Met

– Relatively fast construction timescale (only 33 months)− More to achieve with less time to do it

174

MIDLAND METROPOLITAN HOSPITAL (BIRMINGHAM)


• Construction sustainability targets for ‘Midland Met’ Hospital:

– Achieve BREEAM ‘Excellent’

– 80% local spend (i.e., within East & West Midlands)

– 70% of employment within 20 miles of site

– 50% of employment with ‘B’ postcode and local priority wards

– 10,342 ‘person weeks’ of apprenticeships, training and work

experience for local community & schools

– that’s 199 years by the way!

175


Sustainability Challenges

• To meet the challenge, we recognise that we need to :

– Enhance our relationships with subcontractors & local firms− Gather their BREEAM data

− Instil positive sustainability behaviours

− Allow them to fully contribute to BIM

– Build long-term strategic local stakeholder partnerships− Mutually rewarding corporate and community benefits

– Make sure we actually ‘help’ not ‘hinder’− Use a full risk management approach to community action

176



• Subcontractor relationship:

– West Midlands Virtual Hospital

– WINFO data tool for BREEAM

177


http://westmidlandsvirtualhospital.co.uk/media/about-us/


• Long-term Strategic Partnerships:

– Centre of the Earth (Birmingham)− UK’s first community environmental education centre

− Operated by the Wildlife Trust

− 30 years old and now needs some TLC and restoration

− Our apprentices and construction ‘waste’ can help

− Reconnect to local schools, community & volunteer groups

− Recuperative peaceful wildlife space for NHS patients

− Long term 30 year support from Midland Met (Carillion Services FM)

178



179


Centre of the Earth


• Help Not Hinder

– Ready for Work Programme− Carillion ‘Sky Blue’ support for anyone offered a job by subcontractors

− Prompt payment of wages

− Elimination of paperwork and red-tape (by not being self-employed)

180


THANK YOUJennifer Bragg – Sustainability Manager (Graduate)

A patient’s experience of waste

Sian Fisher

Catalyst Waste Solutions

About Catalyst

Working with Trusts since 2003

Wholly focused on interests of waste producer

Did you know…..?

In reality…

Our audits would suggest patients and visitors do not necessarily behave responsibly when dealing with their waste!

May not recognise their own role in sustainable waste management

But, they do have concerns and make judgments about how they see you deal with waste

Why is it important what patients think?

It could be one of their first impressions of your site – before they even get to the treatment room.

Hopefully you want to make the patient experience better!

The Care Quality Commission do…

But how else might waste impact on the patient experience?

In your groups, discuss and identify ways in which waste may impact, directly or indirectly on a patient’s experience and perception of their healthcare provider.

You have 10 minutes

Engaging patients & visitors

Patients & their visitors have a role to play in an effective waste management process

They will produce waste

Give them a bin and they will use it!

Put yourself in a patient/visitor’s shoes when deciding where to locate bins

Education and awareness?

Don’t forget your employees

Engaging, educating and motivating your staff to care about waste is not easy

Focus on what is important to themSome may care about cost or environmental concerns

Most will care about health & safety (but not necessarily their own) as well as compliance

All will care about their patients.

If we could harness that, we would have a very powerful engagement tool.

Final thoughts…

Unlike me, most people aren’t passionate about waste!

We need to bring creativity to our thinking in this area

We now have a better idea of how waste might impact on the patient experience but what are we going to do about it?

The message is more important than the medium

Find the messages that resonate with your audience

Make the changes….get the results!

Sustainable waste

management

Compliance

Health and safety

Environmental protection

Cost saving

Thank You

Sian Fisher

[email protected]

www.catalystwaste.co.uk

http://www.catalystwaste.co.uk/

Lunch & Networking

#Dayforaction

Welcome back

#Dayforaction

Afternoon session

13:25 Welcome back

13:30 North Bristol NHS Trust- Overall winner for 2016 Sustainability Day awardsEsther Coffin-Smith, Sustainable Development Manager, North Bristol NHS Trust

13:50 Sussex Community NHS TrustSusie Vernon, Head of Environment, Sussex Community NHS Foundation Trust

14:10 Carbon, Cost, Savings, as easy as 1, 2, 3Sid Siddiqui, Environmental Manager, Derbyshire Community Health Services Trust

14:30 Closing comments

14:40 Event close

Sustainable Development at NBT

Esther Coffin-SmithTanya Saker

NHS Sustainability Awards 2016

1. Behaviour Change Award: Winner - Sustainable Healthcare at NBT

2. Water Award: Winner - Water Efficiency & Sustainable Urban Drainage

3. Community Award: Highly Commended -Collaborative working with University Hospitals Bristol NHS Foundation Trust

4. Overall Winner 2016

NHS Sustainability Awards

Our journey so far….

Sustainable Development Management PlanAdopted by Trust Board Sept 2015

Objectives, targets and action plan

• NHS Sustainability Strategy

• Delivering the vision at NBT

• Communication

• Reporting (GCCA results)

• Corporate vision and governance

• Leadership engagement & development

• Healthy sustainable and resilient communities

• Sustainable clinical and care models

• Carbon hotspots

– Commissioning and procurement

– Energy and water

– Waste and recycling

– Travel and transport

• Food and catering

• Biodiversity

• Sustainable Development Indicators

• Supported by detailed action plan

Environmental Policy

Adopted by Trust Board in February 2015

The Environmental Policy commits North Bristol Trust to the following;

To reduce our environmental impacts in carbon, energy, travel, waste and water.

To work with key suppliers and contractors to reduce the environmental impact of the goods and services we buy.

To source local, organic, seasonal and fairly traded ingredients for the food we serve.

To protect and enhance the environment, including the prevention of pollution.

To train our staff on environmental matters.

To prepare our community for climate change through adaptation planning, resilience and response.

To engage with staff, patients, visitors, stakeholders and the wider local community to communicate the economic, social and health benefits of sustainability.

To comply with all relevant obligations in relation to the environment.

To continually improve our environmental performance.

To report our performance.

Our journey so far….

Corporate Vision and Governance

Our journey so far…

“We value the importance of protecting our natural environment for the benefit of the physical and mental health and wellbeing of our community, including our patients and staff, now and in

the future”.

Sustainable Development Governance Structure

• Sustainable Development Steering Group (Executive Leads, Carillion, The Hospital Company, Patient Panel, Unions, HR, General Managers, Bristol & Weston Purchasing Consortium)

• Working Groups (energy, procurement, food, travel, sustainable models of care, workforce, health and wellbeing, biodiversity, technical compliance etc.)

• Sustainable Development Unit (Sustainable Development Manager, EMS Co-ordinator (p/t), Waste Advisor (p/t), Travel Co-ordinator, Green Impact Assistant (p/t), Energy Manager)

• Staff Champions (Environmental Awareness Reps, Green Impact Teams, Travel Smart Reps, Energy Champions, Health & Wellbeing Champions)

Simon WoodDirector of Estates, Facilities and

Capital Planning

Liz RedfernNon Executive Director

Behaviour Change Award: Winner

• Sustainable Healthcare Campaign

• Green Impact

• Travel Smart

• Sustainability and Health and Wellbeing Events

• Supporting Communications

Communication & Engagement

Sustainable Healthcare Campaign


• Overarching campaign for all sustainability work at the Trust

• Developing the Sustainable Healthcare brand

• Launch event - Bristol European Green Capital 2015

• Engagement tools & resources (TLC, Less waste more care, Get fit take the stairs posters, stickers, lanyards, travel mugs, re-usable salad boxes)

Green Impact at NBT


• Strengthening existing local Green Impact schemes (University Hospitals Bristol & University of Bristol)

• Promoting the links between sustainability and health and wellbeing amongst staff.

• Promoting team building and staff morale following extensive organisational change and the opening of the new ‘Super’ Hospital.

• Launched during Bristol’s Healthy City Week

• Supporting Trust energy, waste & travel campaigns e.g. TLC, Get fit Take the Stairs, Less waste, more care, Travel Smart, etc.

• Supporting local & national campaigns e.g. Fairtrade Fortnight, Big Commuter Count, Avon Wildlife Trust #do30things, RSPB Big Garden Bird Watch, Festival of Nature, Healthy City Week, NHS Sustainability Day.

• Joint local award ceremony with UoB and UHB.

Travel Smart


Travel Strategy GroupCorporate inductionPersonal travel plans for staff Travel Smart Roadshows (with freebies!)Staff & Patient Travel SurveysTravel Smart Reps

Cycling1,245 cycle spaces & numerous change facilitiesFree monthly bike maintenance & classesElectric/Standard/Folding Bike Loan SchemesSalary sacrifice for bicycle purchaseEmergency cycle repair kitBicycle security taggingElectric Pool Bikes for staff

Car sharingEmergency ride home for car-sharersDedicated lift-share website and user-group

Public TransportDiscounted bus tickets (15% - 7.5% bus company, 7.5% Trust)Real time bus information13 service routes entering the hospital site

Electric vehicles3 hybrid Co-wheels cars for business use2 rapid EV charging point on site

Sustainability & Wellbeing Activities


Finding innovative ways to engage staff, patients and visitors on sustainable health;

• NHS Sustainability Day Fair (CSE, Fresh Arts, Sustainable Travel, Food, etc.)

• Healthy City Week

• Green Impact launch

• Fresh Arts

• Weekly fruit and veg stall

• Sustainable March (lunchbox talks, workshops)

• Insect building hotels (public & staff)

Planned projects;

• Herb Garden• Staff / Patient allotment• Path to wellbeing walk (green map)

External Communications

– Environmental Policy

– North Bristol NHS Trust Website www.nbt.nhs.uk/sustainablehealthcare

– Your Hospital Magazine

– Social Media (Facebook, Twitter)

Internal Communications

– Messages from the Chief Executive

– Insite Magazine

Other communications

– Information stalls (Atrium & staff restaurant)

– Message of the day

– Staff Bulletin

Communications


http://www.nbt.nhs.uk/sustainablehealthcare

Southmead New Super Hospital May 2014

• Sustainable design aims: – Conserve water resources (water efficient appliances)– Enhance water quality– Water sensitive design– Minimise vulnerability to flooding – Maximise access to green space and biodiversity onsite.

• BREEAM Healthcare Excellent (water efficiency measures, metering, leak detection and water recycling for irrigation purposes).

• SUDs to reduce surface water run off by 20%

– 2 large therapy gardens and 6 landscaped courtyards.– 1000 new trees & shrubs– 6 sedum/green/brown roofs – Swales– 4900m3 of attenuation ponds– Roof Rainwater Harvesting System

Water Award: Winner

Water Efficiency & Sustainable Urban Drainage

Environmental Impacts

• Water consumption (25% reduction)

• Flood prevention (est. 40% surface water run off reduction)

• Improved biodiversity (1000 new trees)

• Climate change adaptation

• Carbon reduction (31 tonnes Carbon p/a)

Health Impacts

• Access to green space (staff & patients)

Financial Impacts

• Water savings (£130,000 p/a)

• Indirect savings from flood prevention, reduced energy costs from reduced heating / cooling from local shading, staff and patient wellbeing.

Water Award: Winner

Water Efficiency & Sustainable Urban Drainage

Collaborative working

• University Hospitals Bristol NHS Foundation Trust

• North Bristol NHS Hospital Trust

• Successful expansion of Green Impact citywide across the two major acute Trusts

• Shared opportunities (and challenges!)

• Working together to support, encourage, share best practice, resources, experiences, ideas, solutions and skillsets

• Strong working relationships have enabled us to challenge others, deliver consistency across multi-site working, and strengthen both organisations reputations to improve both patient care and public health.

• Collective influence to a combined workforce of over 20,000 members of staff (some shared staff)

Highlights

• Healthy Cities Week launch (October 2015)

• UHB Big Green Scheme event

• NBT NHS Sustainability Fair

• Joint Green Impact award ceremony

Community Award: Highly Commended

Community: Working together

Outcomes

• 859 sustainable actions completed

• 1000 staff across both Trusts

• £42,000 estimated savings (Carbon Trust Empower calculator)

• There is a potential for this figure to increase by 35 times if all staff were engaged across both hospitals. In this case cost savings could reach around £1.5 million.

• Estimated carbon emission reduction from both hospitals - 145,684 kg CO2 per year per Trust.

Community: Working together

Community Award: Highly Commended

Sustainable Development Unit North Bristol NHS Trust

Southmead Hospital Somerset House Southmead Road

Bristol BS10 5NB

E: [email protected] T: 0117 4148523/4145422

Travel Transformation – and measuring impact

Susie Vernon, Head of Environment18th October 2016

1. Setting the scene – sustainability at Sussex Community

2. Travel transformation

3. Measuring our impact – carbon, cost and wellbeing

4. What’s next?

Today

Three key challenges facing the NHS

1. £30 million funding gap with increasing demands on services

2. Largest public sector carbon footprint in UK, with target to reduce this by 34% by 2020

3. A workforce of 1.5 million people, whose wellbeing the Lord Carter Review highlights as a priority

“Our strategy focuses on actionsthat simultaneously support and reinforce financial sustainability,

carbon management and health and wellbeing (both of our staff

and our patients). A stronger, greener healthcare system means

better outcomes for our patients.”

Sue SjuveChair of the Board

Sussex Community NHS Foundation Trust

>Since 2010, reduced travel footprint by 18.8% - on track for 2020

>Reduced grey fleet mileage to 4.2 million miles per year (17% reduction)

>Currently include Trust vehicles, lease cars and grey fleet; aim to include commuting and patient travel.

Tackling travel in a community trust - 74 sites, 1100 sq miles.>Travel Bureau – one-stop-shop for staff travel advice:

>Introduced low-emission vehicle fleet: 2 electric bikes, two zero emission electric vehicles (pool car & courier van), 15 low emission (hybrid) pool cars

>Lease car scheme – capping vehicle emissions (g CO2/km)>Route planning & quarterly mileage reports to directors & heads of service >Booking public transport, providing info on safe walk & cycle routes>Plus: eco-driving courses, interest free season ticket loans, promote external campaigns

>Annual Travel Survey - e.g. led to new showers and cycle storage at several sites

>Estates Strategy: move to agile working

THE RESULT: in one year nearly 1 million miles cut, saving clinical and operational services £500,000

>Speech & Language Therapy Team

>Using electric bicycle for business travel (help up those hills…)

>Since 2014, over 3000km travelled – still going strong

“I just love the headspace I get from not being in the car all the time. I have time to think more, and it is less stressful than driving – as well as being great exercise.”

Key success factors?>introducing initiatives that enable services to make savings, whilst maintaining

full operational and clinical activity

>tailoring recommendations for each area by engaging with staff at all levels & with their specialist local knowledge

>supporting colleagues, not enforcing change

Significant carbon and cost savings – what about the wellbeing benefits?

Engaging our staff – do you Dare to Care?

CWC is about doing new things that will make you feel good AND create a healthier, happier and more sustainable NHS

The campaign reflects that – not just about financial and environmental impacts of actions, but critically also the health and wellbeing impact (individually and collectively)

Inspire and support staff and teams to come with their own initiatives

Dare to Care

Posters

Dare in numbers

1. Staff focus groups & interviews

2. Dare mapping

3. Staff survey

4. Analysis

Dare – what impact have we had?

Survey responses from 352 staff (of which nearly 200 were not darers) showed the impact over the last 18 months:

1. Cost savings of £14,634

2. 438 tonnes CO2e cut

3. Wellbeing improved by 12%

Dare – what impact have we had?

Survey considered eight aspects of wellbeing based on NEF’s National Accounts of Wellbeing methodology:1. Physical health2. Team bonding3. Meaning and purpose4. Job satisfaction5. Concentration and focus6. Day to day happiness7. Stress8. Pride working for the Trust

Each converted onto 0-10 scale with national average (not NHS specific) of 5.

% increase

Pride 11.68

Reduced stress 11.42

Day to day happiness 5.69

Concentration/focus 15.14

Satisfaction with job 8.15

Meaning and purpose 22.88

Team bonding 16.07

Physical health 7.14

>Continue to develop our Travel Transformation Programme – focus on business travel, pool car expansion and IT infrastructure.

>Team challenges to engage staff – Step Up & Sugar Smart Challenge

>Re-run impact survey in summer 2017

>Working with other NHS Trusts – sustainability programmes, STP, staff engagement & wellbeing metric

What’s next?

Looking to

the future

if everyone dared to care…

Susie VernonHead of Environment

[email protected]

07900 160513

www.carewithoutcarbon.org


http://www.carewithoutcarbon.org/

Our journey to a greener NHS

Sid Siddiqui Environmental Manager

Derbyshire Community Health

Services Trust

One of the largest community healthcare provider in the country

4300+ staff Annual turn-over £180 million

133 sites including 12 Community Hospitals

Background - Aim

Statutory Compliance

NHS emission reduction targets

Good Corporate Citizenship (GCC)

Sustainable Development

Management Plan (SDMP)

Cost Improvement Pressures (CIPs)

Business As Usual (BAU) was not an

option

Report

Behaviour

Capital investment

Innovation

Stakeholders Engagement

Programme Implementation

Board’s full backing and approval

Capital Investment

Lighting

Insulation BMS

PV

Travel

Speed Ctrl

Boilers

Thermal Imaging

Heat escape improvements

Boiler replacement programme

249

Lighting replacement programme

250

Photovoltaic panels installed at 3 sites total generation 160kW

251

Low emission pool cars

252

Innovation

Technology

Print redSpace utl

Estates EfficiencyTravel red

Agile wrk

Innovation

• Technology - new technologies, IM&T

• Agile & remote working, hot desk, teleconferencing

• Reduced travel costs and emissions

• Reduced estate, efficient space utilisation, lower energy

• Reduced administration, electronic records, printing

• Improved Estates functions, hand held devices, quality and environmental standards

• Overall efficiencies and increased productivities

Awareness and behavioural CHANGE

Measure, analyse and report

Directly Measurable

Water

Results and Impacts of Innovation and Best Working Practices

Mileage

Procurement

Space Utilisation

Behavioural Change

IM&T & Agile Working

Waste

Energy

75%

21%

4%

EMISSIONS

Energy

Travel

Water & Waste

31%

59%

10%

COST

Energy

Travel

Water & Waste

Carbon emission reductions

0

2000

4000

6000

8000

10000

12000

14000

16000

Water, waste, traveltCO2e

Elect. tCO2e

Gas tCO2e

Cost reductions

0

1000

2000

3000

4000

5000

6000

7000

8000

Travel £(000)

Waste & Water £(000)

Energy £(000)

Scores

Carbon emissions

BAU scenario 4340 tCO2e (33%) Saved 3946 tCO2e (30%)

compared with baseline of 2007/08

Cost

Saved £1.9m (28%) BAU scenario £2.9m (35%)

What’s next?

• Short term

• To achieve 34% carbon emission target by 2020

• Continue to reduce costs

• Medium to long term

• Implement sustainable procurement

• Be part of local economy

• Low to zero carbon buildings and transport

• Increased use of renewable energy

• Waste minimisation and zero landfill

Lessons learnt!

Scope & Aim

Project Team

Good Data

Specify Tasks

Adhere to Timelines

WidelyCommunicate

Thank you

Closing comments

#Dayforaction

Sustainability Day Birmingham 2016

Healthcare

Transcript of Sustainability Day Birmingham 2016