Can We Make Healthcare Sustainable?

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  • Patient care is the key to unlocking sustainability in the health and care sector.
  • The NHS is responsible for 40% of public sector carbon emissions in the UK.
  • NHS England Health Check 2017 report published

Demand exceeds supply

Health and care systems across the world are under pressure from rising demand for products and services due to a growing and ageing population, the epidemics of obesity and Alzheimer’s, and increasing numbers of people living with chronic  diseases such as diabetes – both in developed and developing countries.

“Sustainability is the ability to continue a defined behaviour indefinitely.”

The supply of resources – trained staff, facilities and funding – is not keeping up. Both health and social care in the UK face a significant funding gap over the next 15 years as the cost of delivering services continues to increase. From the British media one might believe that only the NHS has such problems but countries across Europe are struggling with finite resources and waiting lists. Our current health and care systems are not sustainable long term.

 Sustainability is a health issue  

The health and care system is the largest public sector emitter of carbon emissions in the UK, responsible for 40% of public sector emissions. At the same time that it is under great financial pressure, it needs to transform itself to meet various environmental sustainability goals. The first is the hugely ambitious goal – for the UK to cut its carbon emissions by 80% by 2050[1]; a goal enshrined in law in the Climate Change Act (2008). The sector is also one of the largest consumers of natural resources and generates a substantial volume of waste.

in January 2014, NHS England launched the Sustainable Development Strategy for the NHS, Public Health and Social Care System. Describing the vision for a sustainable health and care system, it is composed of three goals:

  1. Creating a healthier environment by reducing carbon emissions, protecting natural resources, and minimising pollution and waste,
  2. Preparing communities for changing climate and extreme weather events, and
  3. Helping people be well and reducing their care needs by promoting healthy lifestyles and nurturing community strengths and assets.

Putting people and patients at the centre

The overarching challenge is: how to improve health and well-being and deliver high quality care now and in the future with available financial, social and environmental resources?

Nurses, doctors, consultants and cleaners have barely enough time to complete the basic requirements of their jobs without adding extra tasks like managing carbon emissions! Yet as the largest employer in the UK, the NHS has a unique resource. With 1.7 million employees[2], tapping into that resource successfully can have a huge impact on health and sustainibility.

How? Changing the conversation can be transformational. Instead of talking about goals and targets to reduce carbon emissions, what if we looked to improve patient well-being and quality of care?

That’s what was done at Barts Health Trust with Operation TLC – an energy improvement programme with a difference. It’s all about creating healing environments[3]. Operation TLC starts by delivering improved patient experience, as well as better environments for staff, and cost efficiencies for NHS Trusts. Three simple actions that provide a more pleasant patient environment, whilst also cutting energy usage.

  • Turn off equipment (often noisy)
  • Lights out (more daylight, better sleep)
  • Control temperatures (wasted heat, uncomfortably warm)

And then there is the dictum “to do no harm”. Air pollution is contributing to about 40,000 early deaths a year in the UK[4]. Yet 5% of all road travel in the UK is attributed to “NHS-related travel” – that includes patients travelling to and from hospital or doctors or pharmacy. So healthy transport plans that re-design how health and care services are delivered in the community can reduce air pollution whilst also improving access to care and reducing costs.

Making healthcare sustainable is possible  – but an 80% reduction is carbon emissions is not going to happen with minor tweaks and incremental adjustments. Only if we are open to transformational change will we hit that goal – and to do that we need to have patients and people at the centre of sustainability.

Health Check 2017 Report

This report, launched on 13th February 2017, is the first in a series of annual publications from the NHS Sustainable Development Unit looking at progress of sustainable development across the health and care system.


[1]  The interim target is to reduce our carbon footprint by 34% by 2020; the baseline for these targets is 1990.

[2] 5% of the UK’s workforce

[3]  In two studies that have shown the benefits of increasing the use of natural daylight, one demonstrated that it reduced the use of painkillers by 22% after scheduled surgery (Joseph, 2006) and in the other increasing natural daylight shortened the length of hospital stays by 3.7 days in a mental health unit (AHRQ, 2005).

[4] Report published by the Royal College of Physicians and the Royal College of Paediatrics and Child Health, assessing the impact of air pollution on public health in the UK.


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