Sustainable Health, Low Carbon

SUSTAINABLE DEVELOPMENT MANAGEMENT PLAN March 2010

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Foreword

I very much welcome this Sustainable Development Management Plan and encourage you to read it and give us feedback as it is a means of making Great Ormond Street Hospital for Children a more sustainable and environmentally friendly place to work and visit.

As a Trust we are committed to our Sustainability agenda and are aware of our Corporate Social Responsibility and have developed this plan in response to the NHS Carbon Reduction Strategy (January 2009) which will build on the work already carried out in our Carbon Management Strategy and Implementation Plan 2008, which was produced in partnership with the Carbon Trust.

We recognise the impact that Great Ormond Street Hospital for Children NHS Trust’s operations has on the environment as well as the strong link between sustainability and the health of the public.

We are committed to demonstrating leadership in sustainability and this comprehensive Management Plan represents a route map for us to deliver significant improvements, with the help of all our staff, key partners and other stakeholders.

The Trust Management board delivered support for the formation of the Sustainable Development committee in December 2009 and Bill McGill, Director of Redevelopment and Estates, chairs this board.

Also the board gave its support to the Joint Environmental Committee (JEC) which is a TUC initiative that allows all staff, patients and careers to join the committee, and work in partnership with the TUC, and get involved in environmental projects around the Trust.

I look forward to hearing, reading and reporting on the achievements of, and the future plans of, the Sustainable Development committee. I also welcome the commitment from all staff who get involved in the Joint Environmental Committee that helping to make the Trust a greener place.

Jane Collins

Chief Executive

 

 

 

 

 

 

 

 

 

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Contents

Executive Summary - NHS Carbon Reduction Strategy - 4

Carbon Trust 5

EU Emissions 5

Carbon Reduction Commitment 5

Redevelopment Energy balance 5  Sustainability Strategy 7 Energy Strategy 8

Corporate social responsibility 9 Good Corporate Citizen 9 Good Corporate Citizen (Baseline Assessment) 10 Appendix 1(Review against Key Actions) 11

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Executive Summary – NHS Carbon Reduction & The GOSH Sustainable Development Management Plan

The NHS Sustainable Development Unit has produced an NHS Carbon Reduction Strategy for England. This Strategy delivers a framework for all Trusts to work to and provides support in various forms to ensure success. Great Ormond Street welcomes this Strategy and will take this opportunity to expand on our previous carbon reduction success as detailed in this plan. The NHS has a carbon footprint of 18 million tones CO2 per year. This is composed of energy (22%), travel (18%) and Procurement (60%). Despite an increase in efficiency, the NHS has increased its carbon footprint by 40% since 1990. This means that meeting the climate change act, targets of 26% reduction by 2020 and 80% reduction by 2050 will be a huge challenge. The Carbon reduction Strategy for England, establishes that we should have a target of reduction equaling 10% by 2015. The urgent need for organisations to reduce carbon emissions and incorporate sustainability in their operations is particularly important in the NHS given its significant contribution to England’s overall emissions. As well as reinforcing the link between sustainability and public health, a clear focus on sustainable development will enable Great Ormond Street Hospital for Children NHS Trust to capture a range of financial and non-financial benefits as well as a reduced carbon footprint.

We have assessed and are assessing the Trust against the Key actions from the NHS Sustainable Development Unit. (See appendix 1)

This focuses on key priorities, being environmental legislation, governance, organisational and workforce development, partnerships, finance, energy and carbon management, water and waste management, travel and transport and design and operation of buildings.

The development of the Management Plan demonstrates the Trust’s commitment to carbon reduction through a range of practical but ambitious measures, sharing of good practice and active engagement and support of its staff.

The Action Plans which support the Management Plan include the following:

To produce a comprehensive carbon baseline (footprint) to measure progress towards objectives, identify milestones, and guide action.

• The incorporation of sustainability within the Trust’s policies and procedures and reinforcement of Board level commitment and responsibility

• Enhanced data management relating to energy, waste and water and the robust measurement of our carbon footprint

• The development of a communication strategy to ensure the effective implementation of the Plan throughout the Trust • The development and establishment of Partnerships with key stakeholders, through

local strategic partnerships and others • The development of a sustainable procurement strategy, incorporating Supply Chain

activity, with the Trust’s Head of Procurement and Supply Chain Manager. • Identification of opportunities to reduce the Trust’s carbon emissions in particular

through the active management of energy, transport and procurement • We will produce clear targets following the final assessment of the Trusts Carbon

Baseline (footprint) • Action plans will be assessed annually • The Trust is commited to the Good Corporate Citizenship Model

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Carbon Trust On the 24th April 2007 Dr. Jane Collins (Trust Chief Executive) signed the partnership pledge confirming the Trusts intension to enter into partnership with The Carbon Trusts NHS Carbon Management programme. In March 2008 the Trust board approved the Trusts Carbon Management Strategy and Implementation Plan (CMIP) which contained the first measured carbon base line of the Trust. (Pre enabling works 2005-2006) A base line figure of 14160.32 tonne was calculated based on Energy and utilities, Waste, Trust Transport and Total Staff Commuting and a target reduction of 15%, 2124 tonne, was agreed. EU Emissions Trading Scheme The Trust has had a number of sessions with the external verifier and and the Environment Agency we have agreed our information and calculations. Our ETS 7 form was duly submitted to the Environment Agency. We have therefore placed on the Environment Agency’s EU Emissions Database our emissions for the year 2009 and these have been verified on the database by the verifier. Following this the Trust has on line surrendered that many allowances for the year 2009 and our account is in balance. As part of the our Monitoring and Reporting plan we now report to the Board our position for the calendar year 2009 under the EU Emissions Trading Scheme. This is a legal requirement. The Combustion Emissions of tonnes of CO2 for the calendar year 2009 was 4,354. This is against a total allowances for 2009 of 4,834. The main reason why we are below our allowances is because we have shifted items such as humidification, sterilisation to electric so are not burning gas and the reduction of areas heated (Barrie wing Nurses Home). We have also had boilers off e.g. steam or at reduced output following the October incident.

Carbon Reduction Commitment (CRC)

Each year, the CRC will require participating organisations to purchase and submit sufficient allowances to meet their annual emissions covered by the scheme. The scheme will start with a reporting year from April 2010, with the first sales of allowances held in April 2011. During the introductory phase, all carbon emission allowances will be sold at a fixed price of £12 per tonne of carbon dioxide. From April 2013, allowances will be auctioned by the government, with fewer available each year. Redevelopment Energy Strategy

The energy target of the redevelopment Phase 2 is 53 GJ/100m3, Emissions of carbon dioxide and other climate change gases is expected to be approximately 50% less than the existing buildings, with full implementation of the biofuel options the carbon emission reduction is estimated at over 70% of present levels.

The redevelopment Energy Strategy has set a target of 120% carbon reduction and 60% renewable contribution from its new developments and over 70% carbon reduction and 25% renewable contribution site wide.

The programme has been independently assessed by BREAM using the NEAT model in the excellent category.

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The stated objectives from the strategy are as follows:

• Achieving the lowest energy use for the new hospital buildings whilst meeting staff comfort issues, clinical needs and best value.

• Delivering a cost effective heating and power strategy for the site. • Provide an integrated, overarching site strategy with buy in from all parties. • Delivering a development to inspire future projects.

GOSH is committed to developing the site in line with best practice including;

• Economic • Environmental • Social

But at the same time focusing down on its carbon footprint using the key drivers of;

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• Efficiency of energy use • Supplying energy efficiently • Renewable energy sources

This will form a major part of the Trust’s Sustainable Development Management Plan

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Corporate social responsibility Corporate social responsibility is about being aware of the impact our work has on people and the environment we work in and taking steps to reduce any negative effects. Great Ormond Street Hospital as a Provider at the forefront of healthcare for children has a clear responsibility for the impact of our activities on or Community. That includes our patients, the public, our partners and stakeholders, as well as the environment.

Our responsibility

Great Ormond Street has a corporate social responsibility to address social, economic and environmental challenges and encourage other organisations to do the same.

• We need to be aware of the impact of our buildings and ensure that we manage them effectively to avoid any detrimental environmental impact.

• To maximise the benefits of being a large employer and the significant social and economic impact that has on our local community including our own workforce

• To understand the impact our suppliers have and consider how we can engage and involve them in order to benefit local communities.

• To work in Partnership on many different levels to enable the most effective use of resource but also to share best practice.

• To engage our stakeholders to work with us to deliver our Sustainable Development Management Plan

How we will monitor this?

Through signing up to the Good Corporate Citizenship Model the Trust will:

• Annually assess its practices • Set action plans and targets for improvement • Benchmark against other NHS Organisations

Good Corporate Citizen.

Since 2008 Great Ormond Street Hospital has carried out assessments of it’s practices based on the Good Corporate Citizen Assessment Model. The NHS is the largest employer in the UK. Good corporate citizenship can help NHS organisations to promote health, sustainable development, improve recruitment and retention and reduce inequalities in health. In practical terms, CSR involves

• working with social partners such as local communities, • Nurturing relationships with employees and patients and their families as well as • responsibilities such as protecting the environment, ensuring good labour standards

and • sound environmental and OCH practices in house and in suppliers.

The latest assessment against the Trusts current Practices are below (fig 1)

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FIG 1

Baseline assessment results – Good Corporate Citizenship Model

Score 0 to 3 = Getting Started, 4 to 6 = Getting there, 7 to 9 = Excellent

Domain Component Assessment Mar 2010Policies and Performance 5 Area planning 7

Service delivery and estate design 7 Active travel 5 Business travel 1

Travel

Traffic management 2 Policies and Performance 5 Procurement skills 1 Procurement process 3 Engaging suppliers 3 Minimising waste 5

Procurement

Ethical procurement 3 Policies and Performance 4 Energy use and carbon 2 Waste 2 Water 2 Hazardous substances 2

Facilities management

Green space 2 Policies and Performance 6 Diversity and Inclusion 6 Valuing workforce 4 Healthy workplace 5 Childcare and carer support 5

Workforce

Learning and development 5 Policies and Performance 4 Local partnership and planning 5 Community participation 1 Healthy and sustainable food choices 5

Community Engagement

Assets and resources 2 Communication 2

Policies and Performance 8 Planning 8 Design 8 Sustainable procurement 8 Energy and Carbon 7

Buildings

Green Space 5

Appendix 1

Gosh Review of Progress on Key Actions – March 2010

1. Energy and Carbon Management

Key actions Status/Action Date

How Measured

/Monitored

Lead

1. Regular Board level reviews of performance in energy efficiency and carbon reduction should be reported annually to staff, the public and other stakeholders.

Complete

SDMP

Bill McGill

2. Carbon measurements should replace energy measurements as the target for reduction.

Complete

SDMP

Bill McGill

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3. All NHS organisations should create a strategic plan to develop resilient and

more renewable energy sources to ensure a guaranteed energy supply, whilst managing their overall carbon footprint.

Complete

SDMP

Bill McGill

4. All NHS capital developments should be assessed to ensure options are

evaluated on a whole life cost basis. Low carbon options may include renewable energy, passive cooling, ultra-efficient lighting, sustainable transport and natural environment.

Complete

NEAT Assessment

Bill McGill

5. Every NHS staff member should be able and encourage to take responsibility for

energy consumption and carbon reduction.

Complete

Joint Environment Commitee

Sarah Lewis

2. Procurement and Food

Key actions

1. The NHS should take every opportunity to manage its operations and procurement efficiently, thereby minimising wastage and carbon from the outset.

Ongoing

Trust Procurement

Strategy

Jay Gunawardene

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2. The NHS should work in partnership with suppliers to improve sustainable and

low carbon procurement.

A roadmap to support organisations in this process will be published by NHS PASA, DH, the SDC and the SDU.

Ongoing

Trust Procurement

Strategy

Jay Gunawardene

3. Local procurement, whole lifecycle costs and the environmental impact of

financial decisions should be considered by all NHS organisations, in

preparation for the use of carbon as a currency.

Ongoing

Trust Procurement

Strategy

Jay Gunawardene

4. Further research will be undertaken into the carbon footprint of pharmaceuticals

within the NHS to better understand this and to inform actions to produce

significant reductions.

Ongoing

Trust Procurement

Strategy

Jude Cope

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5. The promotion of sustainable food and nutrition throughout the NHS should

become the norm.

Ongoing

Food at Gosh Group

Anna Cornish

3. Low Carbon Travel, Transport, and Access

Key actions

1. All Trusts should have a Board approved active travel plan as part of their

sustainable development management plan.

Complete SDMP Robert Wilkins

2. The NHS should consider introducing a flat rate for business mileage regardless

of engine size or even modal option (car, train, bus, cycle and foot).

July 2010

Review of Travel Plan

Robert Wilkins

3. NHS organisations should establish consistent monitoring arrangements so

reductions in emissions from road vehicles used for NHS business can be

measured.

July 2010

Review of Travel Plan

Robert Wilkins

4. Mechanisms to routinely and systemically review the need for staff, patients and

visitors to travel need to be established in all NHS organisations.

July 2010

Review of Travel Plan

Robert Wilkins

5. Healthcare delivery must continue to move closer to the home. Ongoing

4. Water

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Key actions

1. Efficient use of water should be integrated into building developments at the

design stage.

Complete

SDMP

Bill McGill

2. Water costs and consumption should be measured, monitored and reported

annually by all NHS organisations as part of their Annual Report to staff, patients

and the public.

Complete

SDMP

Bill McGill

3. Leaks in NHS infrastructure should be identified and fixed immediately.

Ongoing

Estates Strategy

Bill McGill

4. Water efficiency technology should be adopted as standard across the NHS

estate.

Ongoing

Estates Strategy

Bill McGill

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5. Routine purchasing of bottled water should be avoided. Complete Carbon Trust Strategy

Graham Mills

5. Waste

Key actions

1. Management of domestic, clinical and hazardous waste should be reported at

Board level by all NHS organisations as a key part of their sustainability

reporting.

Jul 2010 Annual Waste Report

Anna Cornish

2. Boards should undertake a balanced risk assessment of all waste, and its

associated costs and carbon including those related to single issue, use and

disposal policies in contrast to sterilisation and re-use policies.

Jul 2010 Annual Waste Report

Anna Cornish

3. All Trusts should ensure they have the necessary skills to manage waste legally,

efficiently and cost effectively.

Jul 2010 Annual Waste Report

Anna Cornish

4. All Trusts should monitor the quantity and cost of all waste streams and set

trajectories to monitor, manage and reduce them over time.

Jul 2010 Annual Waste Report

Anna Cornish

5. The DH and the NHS SDU will consider appropriate targets to:

• Reduce waste from clinical areas / hazardous waste

• Reduce domestic waste to landfill

• Increase recycling.

N/A N/A N/A

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6. Designing the built environment

Key actions

1. All new buildings and major refurbishments should be designed to withstand

significant climate change and weather extremes.

Ongoing

Estates Strategy

Bill McGill

2. All new healthcare buildings should aim to achieve a target of being low carbon

by 2015.

Ongoing

Estates Strategy

Bill McGill

3. A Low Carbon Design Taskforce of public and private sector expertise should be

established to develop a blueprint for the optimum low carbon healthcare

building, accompanied by best practice guidance.

Ongoing

Estates Strategy

Bill McGill

4. All decisions about design and build of healthcare facilities must be explicit

about how they encourage a broader approach to sustainability including

transport, delivery of service and community engagement.

Ongoing

Estates Strategy

Bill McGill

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5. All NHS buildings need to move quickly to have a significantly lower carbon

impact, not only in their construction but also in their lifetime use and in their

decommissioning. NHS buildings must be designed to promote sustainable

behaviours in staff, patients and visitors, and they must be adaptable to support

change towards low carbon patient pathways.

Ongoing

Estates Strategy

Bill McGill

7. Organisational and workforce development

Key actions

1. Future leadership development should take account of the competencies

required to deliver carbon reduction.

Dec 2010 Workforce Action Plan

Ray Conely

2. NHS organisations and SHAs should work in partnership with Higher Education

Institutions to ensure that sustainability and carbon reduction concepts are

included in under graduate curricula.

Ongoing Workforce Action Plan

Ray Conely

3. NHS organisations should consider including sustainability and carbon

governance as a responsibility on all job descriptions for Chief Executives and

Director level posts and on all job descriptions for NHS staff.

Dec 2010 Workforce Action Plan

Ray Conely

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4. NHS organisations must ensure their staff have information about, and

opportunities to use, low carbon travel options (see travel).

Complete SDMP Robert Wilkins

5. Audio, video and web conferencing technology must be made available by NHS

organisations and staff must be trained in these technologies to support a

cultural shift away from routine care and other high carbon travel and to

encourage more home working.

Ongoing ICT Action Plan Mark Large

8. Role of partnerships and networks

Key actions

1. The NHS should use its leverage within local frameworks in relation to carbon

reduction.

Ongoing UCL Partners Chief Executive

2. Every NHS organisation should actively pursue climate change action in their

Local Strategic Partnership (LSP).

Ongoing Trust Annual Plan

Chief Operating Officer

3. NHS/DH regional sustainable development networks need further support to

ensure wide representation across organisations and functions.

N/A N/A N/A

4. Each SHA Board should receive, at least annually, a report about progress in

meeting the requirements of this strategy in their region.

N/A N/A N/A

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5. The NHS should take a lead on sustainable development and carbon reduction

and be an exemplar to other sectors and to other health systems.

N/A N/A N/A

9. Governance

Key actions

1. Every NHS organisation should sign up to the NHS Good Corporate Citizenship

Assessment Model1 and produce a Board approved Sustainable Development

Management Plan which sets out clear measurable milestones to measure,

monitor and reduce direct carbon emissions.

Complete SDMP Bill McGill/Peter Wollaston

2. The NHS should set itself targets and trajectories to at least meet the provisions

of the Climate Change Act. In the first instance this should be 10% of the 2007

levels by 2015, as a minimum.

N/A N/A N/A

3. Carbon reduction and sustainable development are corporate responsibilities for

all organisations and should be an inherent part of each organisation’s

performance and governance mechanisms.

Ongoing SDMP Bill McGill/Peter Wollaston

4. Healthcare regulators should consider making sustainability and the

environmental impact of services an integral part of quality standards.

N/A N/A N/A

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5. SHAs (through PCTs) and Regional Government Offices should ensure:

1 See The Sustainable Development Commission , Good Corporate Citizenship Assessment Model

[Online] Available at: www.corporatecitizen.nhs.uk [Accessed 07 January 2009]

o The NHS delivers carbon reduction through its commissioning

frameworks

o The NHS delivers on its sustainability commitments within Local Area

Agreements (LAAs)

o Sustainable Development Regional Networks in the NHS are developed

further and given more prominence to ensure broad corporate

representation across organisations and directorates.

10. Finance

Key actions

1. NHS organisation should develop carbon literacy and embed carbon reduction in

their financial mechanisms.

TBC Finance Action Plan

Claire Newton

2. NHS organisations should take advantage of schemes which support investment

in energy efficiency initiatives.

Jul 2010 SDMP Bill McGill

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3. The DH and NHS SDU will provide practical guidance for Trusts on the Carbon

Reduction commitment following the consultation process in 2009.

N/A N/A N/A

4. NHS organisations should be involved in local strategic partnership

arrangements and regional economic forums in order to play their part in

developing a sustainable and resilient health economy.

Ongoing UCL Partners Trust Board

5. The DH and the NHS SDU will work in collaboration to encourage the

development of further incentives to support carbon reduction in the NHS.

N/A N/A N/A

Looking ahead – the next steps

Key actions

1. The NHS SDU, SDC and DH will continue to develop the most appropriate

metrics to measure and monitor direct and indirect carbon footprints across the

NHS and translate them into trajectories and milestones for the NHS to meet

legally binding Government targets.

TBC TBC TBC

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2. Societal and NHS scenarios set in a low carbon world will be developed by the

NHS SDU to better understand the ways healthcare delivery should be shaped

in the medium to longer term low carbon future. This will involve integrating

societal approaches to a low carbon future into the core values and mechanisms

of the NHS over the next 40 years.

TBC TBC TBC

3. Models of care and how they may be affected in a low carbon society, should be

considered by the NHS in order to develop low carbon pathways and maximise

the co-benefits to health and health systems.

TBC TBC TBC

4. The NHS should be exemplar users and investors in low carbon technology to

enable to the delivery of sustainable healthcare.

TBC TBC TBC

5. Current and future NHS leaders should be developed to understand and

manage future risks and opportunities of sustainability and climate change.

TBC TBC TBC

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