The NHS is the first health service in the world to embed net zero into legislation, with a goal of reaching net zero by 2040. Here we look at the Green Plan of the Leeds Teaching Hospitals NHS Trust
Leeds Teaching Hospitals NHS Trust has a vision to be the best for specialist and integrated care and improve the health of patients through the provision of high-quality care. In order to provide the best quality care and improve quality of life for patients, the Trust recognises that it needs to reduce its impact on the environment.
Since Leeds City Council declared a climate emergency in 2019, organisations and individuals across the city have been working towards the goal of making Leeds a zero-carbon, nature-friendly and socially just place to live.
The Trust, which is one of the largest teaching hospital trusts in the UK, aims to become one of the greenest NHS hospital trusts in the UK and play a central role in reducing carbon emissions across the city.
The Trust said: “Reaching net zero is a key agenda at present, and the Trust has incorporated sustainability measures into the day-to-day running of our hospitals for several years. We know that to reach our target of becoming net zero by 2040 we will have to make some tough decisions and introduce radical changes. The key to our success will be our people and ensuring everyone understands the important role they can play both individually and within their CSUs.”
The Trust recognises the threat that climate change presents to the environment and the impacts that we are already seeing including increases in heatwaves, droughts, storms and floods. Of course, these changes also have an impact on population health, including areas such as heat-related mortality, infectious diseases and mental health, which in turn have an impact on hospital services.
The NHS has set two targets in an attempt to meet the goal of becoming the world’s first net-zero national health service, this means net zero for the emissions the NHS control directly (the NHS Carbon Footprint) by 2040 and net zero for the emissions they can influence (the NHS Carbon Footprint Plus) by 2045.
Achievements so far
Leeds Teaching Hospitals NHS Trust has 2013/14 as its baseline year and has already seen a 33 per cent reduction in its direct carbon footprint since then. In 2021/22, the Trust treated 1,321,593 patients (an increase of 23 per cent since 2013/14), but reduced the CO2e per patient by 45 per cent.
The Trust has already improved biodiversity by maintaining grass and wildflower areas and planting over 1,100 trees; introduced Attend Anywhere software for remote appointments; moved to a digital online patient record system and invested £20 million in energy saving projects.
They have reduced the carbon emissions of anaesthetic gas; won the Green Surgery Challenge for sustainable practice in laparoscopic appendectomy; signed the NHS plastic reduction pledge; become the first Carbon Literate NHS Teaching Hospital Trust and reduced processed and red meat options.
The Trust has also refurbished the combined heat and power units, used leak detection software to reduce downtime and costs; upgraded shuttle buses to low and ultra-low emission; consolidated deliveries to the Trust to a centralised site; and competed in the Green Ward competition to develop sustainable innovation in clinical areas.
The key elements of the Trust’s green plan are to ensure the Trust aligns with the wider NHS ambition to be the first healthcare system in the world to reach net zero carbon emissions; prioritise interventions that will enable the Trust to continue improving patient care whilst delivering carbon reductions and improving sustainability performance; and support increasing efficiency throughout the organisation.
“To deliver truly sustainable healthcare, we need to achieve environmental, social and economic sustainability, which link strongly to the Leeds Way Values.
“By recognising that climate change is a health emergency, we aim to be accountable for our environmental impact.
“We will create social value through sustainable, fair and patient centred decisions and take a holistic approach to sustainable and resilient models of care.
“We have taken a collaborative approach to improve sustainability within our organisation and the region. We will continue to engage with staff, our partner organisations and supply chain to empower people to deliver sustainable change.”
The Trust has a sustainability team with a dedicated head of sustainability and energy and waste managers tasked with progressing the sustainability agenda and holding the Trust accountable for taking action.
Mott MacDonald was commissioned to produce an Estates Decarbonisation Strategy, with a roadmap of initiatives designed to increase the number of connections to the Leeds Pipes district heating network and improve the fabric of the buildings, including windows, fascias, roofs and wall insulation. If the roadmap is followed, the Trust will reduce carbon emissions by 80 per cent by 2030 and by 92 per cent by 2040.
Between 2022 and 2025, several actions will be taken. This includes a transition to Leeds Pipes district heat network for St James’s University Hospital; the installation of air source heat pumps at Chapel Allerton Hospital; upgrades to lighting, glazing and building upgrades across the estate; and the inclusion of climate change in the Trust Risk Register. Over this period, all NHS procurements will include a minimum 10 per cent net zero and social value weighting and the trust will ensure that waste is managed and disposed of at the highest level of the waste hierarchy.
Between 2025 and 2032, there will be lighting, glazing and building fabric upgrades across the whole estate and a reduction in the operational emissions of the Hospitals of the Future (HoTF), with the aim of achieving BREEAM Excellent and Well Gold standards. There will be a large-scale roll-out of the electrification of heat initiatives and a review and upgrade of the electrical infrastructure capacity.
Between 2032 and 2040, there will be a major investment in energy centres, alongside the installation of heat pumps and a continued electrification of the Trust’s vehicle fleet.
On an ongoing basis, light fittings at the end of their life will be replaced with LEDs and glazing upgrades will continue. Climate change adaptation will be integrated into decision making and ventilation upgrades will be carried out, with the installation of heat recovery and energy efficiency interventions.
Sustainable action plan
The trust also has a sustainable action plan with interventions in workforce, leadership and partnerships; sustainable care models; medicines; estates and facilities; digital transformation; travel and transport; food and nutrition; supply chain and procurement; biodiversity and climate change adaptation.
In the realm of workforce, leadership and partnerships, this means supporting and engaging staff to improve sustainability at work and home; ensuring sustainability is embedded within decision making and working with partner organisations to achieve sustainability goals, as well as with the local community.
Sustainable care models means being mindful of the environmental impact of the care provided, promoting walking for health, welfare support and remote consultations and working collaboratively to provide holistically sustainable care models, including providing care closer to home.
On the subject of medicines, action will be taken to reduce the carbon impact of inhalers, and reviews will be carried out on the impact of nitrous oxide within the Trust and on the current procedures for prescribing medication.
In estates and facilities, the environmental impact of the estate will be reduced to ensure it is fit for the future and provides high-quality healthcare services. Energy efficient technologies will be embedded and the Trust will continue to reduce clinical and non-clinical waste.
In terms of the digital transformation, the Trust will continue to support remote working for staff, embrace new technologies and provide accessible digital patient care and drive efficiency and minimise resource consumption from paper, printing and postage.
Travel and transport includes working with local organisations to improve public transport, reducing the number of vehicles commuting to the sites and increasing the use of sustainable and active travel, as well as increasing the provision of cycle storage and showers across the Trust.
From a food and nutrition point of view, healthy food options, from sustainable sources will be provided and a digital ordering system to enable meals to be easily adapted to patients’ needs and reduce over ordering will be used. Alternative disposal options for food and packaging waste will also be explored.
Focussing on the supply chain and procurement, KPIs will be set for the carbon emissions of procurement and it will be ensured that staff are aware of sustainable procurement practices. Product lines will also be streamlined to reduce waste.
In terms of biodiversity, KPIs will be established to increase biodiversity and the impact of the supply chain on global biodiversity will be assessed.
Finally, a climate change adaptation plan will be developed and the potential impacts of climate change will be included in the Trust’s Risk Register. A climate change risk assessment will be developed and staff will be educated on the adaptation plan and its connection to the Green Plan and major incident plan.
In order to deliver the Green Plan, the Trust recognises that everyone needs to play their part. GRASP (be Green, Recycle, be Aware, be Sustainable for our Patients) champions will be recruited to embed and share sustainable practices across the Trust. GRASP rewards encourage staff to take positive environmental actions, with green points awarded for actions they log and those with the most points winning a £20 voucher. More than 550 people are now taking part with 55 tonnes of CO2e saved.
Chris Kelly, associate director for estates compliance and risk at Leeds Teaching Hospitals, said: “We now have a decarbonisation road map for each of our five hospital sites, which details the interventions and capital investment needed to decarbonise the Trust estate scope 1 and 2 emissions. The focus will be on reducing the use of harmful fossil fuels, improving energy efficiency and transitioning to low carbon energy sources. Works will include building fabric upgrades, LED lighting, integration of renewable technologies and expanding our connections to the local district heating network, Leeds Pipes.”
Craige Richardson, executive director of estates and facilities, Leeds Teaching Hospitals, said: “The Trust recognises that if we are to provide the best possible care to our patients and improve their quality of life, we need to reduce our environmental impact. Working with industry experts such as Mott MacDonald demonstrates our commitment to making radical changes and being at the forefront of creating a greener NHS. We will continue to embed sustainability into all our core activities so that it can become an integral part of our culture.”
With such a detailed Green Plan, and a long list of actions already taken and planned, Leeds Teaching Hospitals NHS is well on track to delivering net zero targets.