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Net Zero NHS – We can not afford to miss the opportunity

26th Aug, 2021

The Government published its Hydrogen Strategy last week, setting out specific policies that will be put in place to support the UK’s plans to create a world-leading hydrogen economy. Described by Business Energy Secretary Kwasi Kwarteng as the ‘start of the UK’s hydrogen revolution,’ it certainly makes for an interesting read, and my colleagues in Gemserv’s Low Carbon Business Unit were quick to comment. 

The sense I have is that it could have been more ambitious but – in the words of my colleague Clare Jackson – it fires the starting gun.

This prompted me to go back and review the NHS Net Zero Plan published last October, which set out a roadmap for the NHS to become the first net zero national health service. Despite some ground-breaking ambition there is a danger that many people missed this important document due to it being published mid-pandemic.

The plan represents a crucial step in recognising not just the public health impacts of climate change and environmental degradation, but also the NHS’s own contribution through its operations.

Amid growing evidence of the health impacts of climate change and air pollution, the case for action within the Strategy is made abundantly clear, coupled with targets and credible milestones to reach them. It is ambitious – and it needs to be. The NHS is responsible for ~5% of all UK environmental emissions, if they are to play their part in achieving their percentage of overall targets, the actions must be sustained and decisive. This isn’t a tick-box exercise after all; failing to achieve these targets will impact all our lives.

Upon Reflection

The plan is clearly a comprehensive document – with detailed modelling, analytics and interventions required to achieve the ambition. Indeed, external reviewers have stated it to be the most advanced review of its kind (Lancet Countdown). It sets an agenda for several areas critical to carbon reduction and splits these up into different scopes; those in the direct control of the NHS and those it can influence indirectly including its supply chain.

On refection, I question the split between internal and external scope. The report places greater emphasis on the indirect scope with, I fear, the potential of responsibility being passed to those in the supply chain. But my fundamental concern is what the report does not cover – the opportunities that have not been identified and examined.

Here are three key areas of missed opportunities

Opportunity one: Change our lens

Net zero strategies and interventions must be embedded into service redesign today. I do not believe we can achieve a sustainable Health and Social Care service unless we look at the sustainability ecosystem holistically and understand the impact of every net zero strategy on service delivery and, therefore, patients. The lens in which service redesign is looked at should be changed into an ‘e4’ lens to ensure they are – effective, efficient, economic, and environmentally sustainable. Let us take the example of anticoagulation and the move from Wafarin to NOACs. I recall my father had regular visits to the clinic for testing. The change of medication not only improved his quality of life, but it also reduced 20 car journeys a year. Multiply this by 1.25m, we have a meaningful example of changing the lens.

Opportunity two: Invest in people before products and processes

A net zero strategy is a holistic change that really requires all stakeholders to be on-board and have a voice in delivering long term sustainable change. My experience of successfully delivering change underlines this point – we cannot impose change on people and must heavily invest in shifting mindsets and cultures by creating visible short term benefits in addition to the wider climate contribution to achieve buy-in and sustain change.

Opportunity three: Create a regulated market

Our direct experience from the Energy market shows the successful transformation of markets have key attributes – they ensure quality, safety and common objectives and promote innovation, ease of market entry, transparency, and overall cost reduction. There is an opportunity to go beyond signing up to a common set of aspirations – to create a market that works for all stakeholders. One in which suppliers to the NHS have reduced cost of entry, common and mutually accepted standards, and a shared vision for net zero. This can really enable the NHS to adopt innovation quickly and reduce both the cost of supply and lower the carbon footprint of this key area.

Right place at the right time

We, at Gemserv, are at the heart of these issues and missed opportunities. Our core values ensure an unrelenting focus on the biggest issues facing society today – longer healthier lives and climate change. Our unique combination of perspective from on-the-ground health care expertise to net zero implementation in the supply chain coupled with our experience and methodology will help us make a material difference.

 

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Authors

David Newell

Director of Health

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