Green Plan

Lancashire and South Cumbria Integrated Care Board's Green Plan was approved at its board meeting in March 2023.

We have a climate crisis and the NHS and regional partners have a significant role in reducing its impact and to build a strong coalition to reach net zero carbon.

Achieving net zero will require a growing and ongoing focus across all of our planning and healthcare delivery activities to ensure that our decisions make a positive contribution.

These decisions will not be straightforward and some of them will cost more in the short term which will be difficult at a time that the NHS is being challenged to become more efficient and cost-effective.

However, we have to act and act now at an NHS, organisational and personal level to reduce our contribution to the emissions that are changing our climate and increasing the risk of harm to our citizens. Some of these actions will be easier to achieve than others, such as choosing how, when, and even if we need to travel, while others will be more complex, like planning which services need to be delivered in hospitals, which can be achieved digitally, and which need to be delivered closer to where people live, in more local settings.

Our ICB Green Plan sets out clear priority areas for action. Our role as the NHS is to provide care and services to the population, and as an ICB to coordinate and lead the development of these services as they modernise. In doing so we recognise the inherent challenges we have across Lancashire and South Cumbria with an ageing estate sometimes in poor condition, the distances staff and patients currently have to travel to provide or receive services, and the challenges we have with areas of rurality and fragmented transport service. Resolution of much of this will require a joined-up approach with partners and regional and national colleagues.

What is the Green Plan about?

This diagram highlights the sources of carbon emissions by proportion of the NHS Carbon footprint plus.

It shows where we need to focus our efforts. Consequently, our Green Plan is divided into nine areas of focus, each with clear goals and actions and these are detailed below.

Ensure everyone understands their role in targeting net zero carbon. Improve health and wellbeing of our population including NHS staff and patients. Reduce inequalities.

Achievements

ICB exec level sustainability lead identified
ICB net zero project manager in post Feb23
Net zero surveys of GP practices collated and used to develop web page and training. Green champions identified in six PCNs.
Sustainability groups and champions established in Trusts with Green Plans published.

Goal

Develop comms and engagement plan(s) to raise awareness including training of the net zero agenda amongst ICB and provider staff.
Work as part of a wider system to embed sustainability in everything we do.

A consequence of sustainable/low impact models of care is emission reduction through reduced patient journeys and bed days. Health inequalities can be reduced by streamlining care pathways and focusing on preventative care.

Achievements

Initiatives established across our Trusts include virtual wards, virtual outpatient appointments (BTH), a same day emergency care programme (ELHT), hospital home care service (LTH).

Our Goal

Measure the carbon impact of Trust initiatives and share best practice.
Embed Public Health into clinical services programmes
Support the development of local Community Diagnostic Centres

Use technology to collate data and process information to reduce travel and paper, while also improving decision making processes. Build on the digital transformation that occurred during the pandemic.

Achievements

Digitisation of c1.75m primary care records now completed saving storage and admin costs associated with paper records and better patient care.
Majority of staff training and meetings undertaken on-line.
In Trusts, initiatives include SMS text reminders for patient appointments (ELHT), electronic discharge letters and virtual outpatient appointments.

Goal

Develop a common electronic patient record (EPR) to improve access and pathways to benefit patients and staff.
Letters to patients sent electronically.
Virtual appointments in Trusts to reach 25%

Staff and patient travel contribute to air pollution which accounts for 1:20 deaths in the UK and disproportionately affects our population living in poverty.

Achievements

Board approved healthy/active travel plans in some Trusts with facilities and schemes in place to encourage sustainable travel.
Electric vehicle charging is available on some hospital sites. The proportion of Trust owned electric vehicles has increased.

Our Goal

All Trusts to complete a staff travel and transport survey by end of March 2024. Staff to receive education re sustainable travel as part of staff induction by the end of March 2024.
ICB to work with regional stakeholders regarding sustainable travel planning/ funding streams.
Progress our plans for electric transport by 2027

A wide range of interventions need to be rolled out over the next 5 to 10 years to support net zero carbon involving waste reduction, energy efficiency, expansion of green space and sustainable capital projects.

Achievements

Decarbonisation review undertaken for all 17 hospital sites. High level plans will be completed end of March 2023 that demonstrate how net zero can be achieved.
All new builds and retrofits over £15m are compliant with the NHS England » NHS Net Zero Building Standard published 23rd February 2023.

Our Goal

Use high level plans to support bids to PSDS for grant monies (non-returnable, however, Trusts to contribute 12% from their capital programmes).
Reduce carbon emissions from building by 20% vs 2020 rates by 2025.
65% of relevant trusts in the region to operate walking aid refurbishment schemes, by March 2024.

Reduce the use of certain types of anaesthetic gases and inhalers that give off greenhouse gases 1000s of times worse for the environment than CO2

Achievements

Anaesthetic gas use below National target of 5% across all Trusts.
The Nitrous Oxide mitigation project run by ELHT significantly reduced waste and costs associated with this gas.

Our Goal

Utilise the national inhaler database to support areas with poor performance
Introduce an inhaler return scheme.
Implement NO2 reduction plan.
Anaesthetic gas, desflurane use to below 2%

Actions within this area will ensure providers have focus on sustainability from the initial procurement through to contract monitoring.

Achievements

Process now in place to ensure all relevant new NHS procurements include a minimum 10% net zero and social value weighting.

Our Goal

100% of new NHS procurements include a minimum 10% net zero and social value weighting. KPIs for each contract.
All new procurements over £5m/ annum to include Carbon Reduction Plan requirement (PPN 06/21). This applies to all procurements from April 24.
65% of Trusts (where relevant) to have walking aid refurbishment schemes by March 2024.

Promote healthier and sustainable food for staff and patients. Reduce emissions by sourcing food locally increasing the positive economic impact for our communities.

Achievements