Transcript SAP workshop 1 slides - Sustainable Action Planning

SUSTAINABLE ACTION PLANNING
Workshop 1: Where to Start
[Team name & date]
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A programme of Knowledge into Action | Registered charity No. 1123566. Summertown Pavilion, Middle Way, Oxford OX2 7LG
NHS sustainable
development
Why should the NHS take action?
“We’ll do it better tomorrow, and better
still the day after”
• Improved patient care & experience
• Nicer place to work
• Reduced carbon in everything we do and use
• Resilience
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Before the programme
You should have received this information:
• Introduction to Sustainable Action Planning (SAP)
o Why, what, how, who
• Pre-questionnaire
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Workshop One
Goal
Team agreement on 1-2 issues to tackle first
Agenda
1. Introduction to environment and health
•
•
Environment and health
Climate change
2. NHS sustainable development
•
•
Actions for whole Trusts
Actions taken by other teams
3. Discussion: priorities for your team
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Part 1
Environment and health
Climate change
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Environment and Health
• A healthy environment is
essential to health
• People need clean air
and water
• Our food and all our
material possessions are
derived from the world’s
natural resources
• Green spaces are
important to physical and
mental health
Climate change
• One of the biggest threats
to a healthy environment
today is climate change
• Warming of the world’s
climate system is creating
more extreme weather:
floods, storms and droughts
• Health researchers have
called it the “biggest global
health threat of the 21st
century
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Climate change can affect health
directly…
1. Malnutrition
2. Deaths and injuries caused by storms and floods.
(Flooding can also be followed by outbreaks of diseases, such as
cholera)
3. Water scarcity / contamination (droughts and sudden
floods) – increased burden of diarrhoeal disease.
4. Heatwaves – direct increases in morbidity and mortality;
indirect effects via increases in ground-level ozone, contributing to
asthma attacks.
5. Vector-borne disease – malaria and dengue.
…but climate change also brings
much greater health risks from
• Drought
• Crop failure
• Economic collapse
• Mass migration
• Civil unrest
• Societal collapse
Health impacts are worse
for the poorest in the world
Cumulative emissions of
greenhouse gases, to
2002
WHO estimates of per
capita mortality from
climate change, 2000
Map projections from Patz et al, Ecohealth 2007.
WHO Comparative Risk Assessment estimated that by 2000,
climate change that had occurred since the 1970s was
causing over 150,000 additional deaths per year (WHO, 2002,
McMichael et al 2004)
Protecting health from
climate change
• Adaptation: “managing the unavoidable”
= preparing for change
• Mitigation: “avoiding the unmanageable”
= tackling the causes of climate change
we need to understand the causes for this…
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Mitigation: tackling the
causes of climate change…
350 million years-worth of carbon locked
away in fossil fuels – now being released
150 years
100 years
First Oil
Well
Domestic
light bulb
4142 cars,
10 miles
concrete
road in US
50 years
First
commercial
jet ticket
NOW
240,000,000 home PCs
650,000,000 cars
4,800,000,000
passenger flights
4,000,000,000 bulbs pa
EU+USA alone (that’s 126
a second)
Mitigation: tackling the
causes of climate change...(2)
Livestock farming accounts for > 18% global emissions
Health “co-benefits” of mitigation
• Many actions to reduce greenhouse gas
emissions which cause climate change are good
for health!
o Active travel
o Eating less meat and dairy
o Clean energy
o Family planning
Leading doctors worldwide
have called for governments
to act decisively on climate
change
“Politicians must heed health effects of climate
change.” BMJ 2009;339:b3672
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Part 2a
NHS Sustainable Development
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What is sustainable
development?
Development that meets the needs of the present
without compromising the ability of future generations
to meet their own needs.
Social
Environmental
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Economic
Sustainable development
meeting environmental needs
• Climate change /
carbon
Social
• Resource depletion
o Water
o Fossil fuels
(plastic etc)
• Biodiversity
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Environmental
Economic
NHS sustainable
development
Why should the NHS take action?
• Andy Williamson, Chair – GSTT Kidney Patients’
Association: Your answers?
“As a kidney patient, I’m acutely aware of my own
vulnerability to climate events, and my dependence on
drugs and dialysis equipment which rely on cheap oil for
their availability.”
June 2009
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NHS sustainable
development
Why should the NHS take action?
“We’ll do it better tomorrow, and better
still the day after”
• Improved patient care & experience
• Nicer place to work
• Reduced carbon in everything we do and use
• Resilience
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Climate change / carbon
the NHS England carbon footprint
18 million tonnes
CO2 in 2004
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NHS carbon footprint
Procurement
“things in lorries”
www.sdu.nhs.uk
NHS sustainable
development
What should NHS Trusts be doing?
• Energy & carbon
• Procurement & food
• Travel
• Water
What can’t
be done at
Trust level?
• Waste
• Designing built environment
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NHS Carbon Reduction Strategy
NHS sustainable
development
What can specialties and clinical teams do?
• Clinical practice
o prevention, supporting patient self care
o preparation for health effects of climate change
• Local systems
o energy, travel, water, waste
o medical supplies
(drugs & equipment)
o non-medical supplies
(e.g. food, laundry, paper)
o improvements in the way we do things
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procurement /
consumption
What could our team do?
Clinical Practice
Disease prevention
Supporting patient selfcare
Preparing for health
effects of climate
change
Opportunities?
What could our team do?
Local systems
Energy
Travel (staff, patients)
Medical supplies
Non-medical supplies
Water
Waste
Opportunities?
A different way of seeing
things
Part 2b
Actions taken by clinical teams
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What kind of actions can
we take?
Current waste
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-
estimated loss (£)
Reducing waste to
yellow bags
£250,000
Return drugs process
£300,000
Mis-labelled path lab
tests
£100,000
Action: energy
• Switch off campaign to reduce unnecessary
lighting
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Action: transport
• Improve communication
with ambulance service
– reduce aborted
journeys
• Cost of aborted journeys
2009
£
June
£1500
July
£690
Aug
£400
Sept
-
Oct
-
Nov
-
Action: water
• Recovery of waste water
from purification unit
• Capital investment
£14,000
• Annual saving £7-8,000
• 38% reduction in mains
water use
• Carbon reduction
• 177g/m3 water
• 322g/m3 sewerage
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Action: medical supplies
• Significant reduction in
packaging
• Reduced deliveries 50%
(mileage)
• More concentrated
solutions: smaller
volumes needed
• Reduced costs by £11,000
a year
• Changed suppliers for
greener products
Action: food
• Discussion with catering
staff, paper menus
• Food waste reduced from
35% to 15%
• Cash saving: approx.
£4,000/y (£2 per sandwich)
• Carbon savings from:
•
•
•
•
Growing
Cooking, preparing, packaging
Transport
Waste disposal
• Happier patients!
Part 3
Your priorities
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Which of these matter to you?
building
design
staff
commuting
visitor
travel
medicines
food
laundry
paper
dialysis
products
patient
transport
number of
appointments
recycling
waste
segregation
climate risk
heating
lighting
equipment
air conditioning
water
green
spaces
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preventative
care
Where are you today?

What are you most
concerned about personally?

What are the other priorities
for the team?

What are your team’s biggest
environmental impacts likely
to be?

What can you influence?
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Decision
• 1 – 2 areas to tackle first (in Workshop 2)
• Keep a list of other areas (to tackle later)
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Next time – Workshop 2
Goals
A sustainable action plan!
Plan for ongoing improvement
Agenda
1. Exploring your chosen areas:
•
•
Describing how the process works today
Brainstorming problems and ideas
2. Actions
3. Ongoing improvement
•
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Managing implementation and monitoring