Are we doing the best we can for our local communities? | Sonia Roschnik

Sonia Roschnik

The NHS is often the largest procurer, employer and polluter in a local area. So how can health and care leaders ensure their organisation is doing the best it can for their local community? Sonia Roschnik explains.

If I asked you “are you green?”, what would you say? Do you recycle, have a reusable cup for coffee or bottle for water?

You might buy energy from renewable sources, drive a hybrid or electric car. Increasingly, people will be saying “yes” to a lot of those.

Environmental issues have risen rapidly up the news agenda and in the minds of the public. Efforts to reduce single-use plastics or cut air pollution are becoming common, and recent publications from the UN and Intergovernmental Panel on Climate Change have detailed stark warnings about the impacts of global warming on the planet.

While we struggle to find our place in the world, and Europe (I won’t mention the B word!), two things we can take great pride in are the NHS and our action to combat climate change (on which the NHS is a leading authority among health systems).

The UK’s Climate Change Act (ten years old this November!) is a globally unique piece of legislation that marks our national commitment to reduce carbon emissions and help combat climate change. The Act sets out a number of target points on a journey to reach zero emissions by 2080.

The NHS and care sector as a whole is aiming to reach those ambitious targets and, at last count, has reduced its carbon emissions by 18.5 per cent compared with the 2007 baseline. While we’re slightly behind the curve, that is a mightily impressive achievement given the rising demand in services.

You might ask, “why should the NHS care about this?”. It’s because climate change and human health are intricately related. There is no single way to describe the relationship, but let’s give it a go.

Delivering health and care contributes to climate change and global warming. The vehicles used to transport patients, staff and goods, the energy used 24/7 in hospitals and other health organisations, and the millions of products bought every year in the NHS’ global supply chain all produce greenhouse gases and use finite natural resources.

However, the key detail here is that climate change will have wide-ranging and potentially devastating impacts on human health. Climate-related migration, seasonal changes and more frequent extreme weather events are just three consequences of climate change that we will be seeing more of over the next few decades.

All of these will contribute to changing needs of health and care, as populations are exposed to rare or previously unseen parasites, illnesses and disease; as insects change their timings or geographical spread and thus pollination of plants; and as the NHS faces summer, in addition to winter, pressures due to more extreme temperatures.

None of this is new information. We have known about climate change for decades, but taking action is often proving difficult. There are several reasons, but one of the most important is that often people simply don’t know where to start. Climate change and global warming are big, complex, ‘wicked’ problems. The more you find out about them, the more you realise there is to learn.

The health and care system is in a unique position to act and in the process become a national and international leader. The good news is that often behaviours that are more environmentally friendly are also better for health, such as reducing car use and increasing use of public transport or active travel (walking or cycling).

Very simply, any behaviour that prevents illness is likely to contribute to decreased avoidable pressure on the system, reducing its activity and thus greenhouse gas emissions and air pollution.

This is an important start to being ‘green’, although admittedly a rather simplistic version of the argument.

But the system can go even further, by not only reducing harm it may inadvertently cause, but also actively improving the influence it has every time it touches a life. The NHS is often the largest procurer, employer and polluter in a local area. So, in addition to reducing the pollution caused by an NHS organisation, we also need to ensure that every pound spent through procurement and employment is spent as well as possible, providing positive impacts through the supply chain and on the local area.

Concepts such as social value are key, where suppliers include positive work such as widening opportunities for job seekers or improving the local environment in their contracts. The Sustainable

Development Unit (SDU) has recently created the Social Value Calculator to help procurers and commissioners estimate the financial value of this work.

Those in management roles in health and care have a particular responsibility to ensure that their work is doing the best it can for their local community. The SDU has teamed up with the NHS Confederation to co-run a workshop for non-executive directors, discussing the concepts of sustainable development, social value and local growth, and how hospitals can play a key role.

Many NHS organisations are already doing fantastic work – just look at the shortlisted organisations for the Sustainable Health and Care Awards, or join us at the Forum on 21st November, to see the proof. Now we want to help those in power influence this change, by looking at the changing context of policy, governance and place-based working, and the new perspective it is giving to statutory responsibilities.

Sonia Roschnik is director of the Sustainable Development Unit. Follow the organisation on Twitter @sduhealth

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