Applauding the NHS, and a word of warning

Yesterday I was at COP26 to hear NHS England announcing a number of good initiatives to improve sustainability.

Their CEO Amanda Pritchard spoke passionately about Greener NHS this week and on the first day of COP26, they unveiled the first zero-emissions ambulance, which has been designed to travel 300 miles. 

It is part of the NHS’s commitment to reduce carbon emissions. Their aim is to be the world’s first net-zero national health service.

They  have set two targets:

• For the emissions the NHS controls directly (the NHS Carbon Footprint), they have pledged to reach net-zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032;
• For the emissions they can influence (our NHS Carbon Footprint Plus), they will reach net zero by 2045, with an ambition to reach an 80% reduction by 2036 to 2039.

In the blue zone at COP26 yesterday, their chair, Lord Prior, talked about one of the key strands in their strategy to achieve this – through their partners.

For the NHS, the supply chain accounts for 60% of carbon emissions, so encouraging the likes of Microsoft and GSK to transform their businesses plays a key role.

Seated alongside Lord Prior at the UK Pavilion for the talk were Brad Smith, President and Vice Chair at Microsoft, Dame Emma Walmsley, CEO at GSK, and Gonzalo Munoz, high-level champion for climate actions since COP25, coming to the end of his tenure in the role.

All the speakers acknowledged the severity of the situation we face but were bullish about the work being done to reduce carbon emissions. Microsoft, for example, were committed to moving to renewable resources by 2025 and to being carbon negative by 2030. 

GSK’s CEO said they had a globally popular, life-saving inhaler which used a propellant that was responsible for 45% of their carbon footprint. Great efforts were being made to find a green alternative, she said, and she was overall optimistic that human ingenuity and creativity would lead to solutions.

So it was good to hear that the leaders of these big organisations and companies seemed to get the message that action was needed. And good to hear that so much thought was being focused on the climate emergency – at least in the sense of reducing carbon emissions.

A word of warning - remember the workforce

But we are also aware that the Green NHS plan was written and produced prior to the COVID pandemic and that we are therefore asking organisations such as the NHS, to explore and adapt to change at a time when many within the workforce feel exhausted and overwhelmed.

The coalface delivery of health care has been a profoundly challenging time - for practitioners and for patients, as well as their families - and the prospect of further top-down change might not be received well on the shop floor, and perhaps demonstrates why it is so essential that any plans and prospects of building back better need to be done in collaboration with all stakeholders, that isolated areas of driven leadership run the risk of polarising the workforce rather than inspiring all to come on board.

The presentation about the Greener NHS really did showcase why this is such a radical development within health care provision, and the NHS is once again demonstrating its capacity for being both radical and innovative in enabling a whole population access Greener Care.

But in this current recovery climate, there is a risk that the emphasis will be focused on areas where business is willing to invest - in pioneering approaches to health care, in developing new medications etc - which will undoubtedly  help us move towards the ambitious targets set out in the Greener NHS plan.

We must avoid mental health falling further behind

There are risks that we will see innovations in some areas, and other areas of care, particularly care within mental health settings, fall behind, further exacerbating the disparities between physical and mental health.

We are very much of the view that we need to ensure we address inequalities as an integral part of the Greener NHS plan.

That prevention and sustainable practice needs to be thought about in terms of the quality of the relationship between the health care professional and client / patient, and that we can't simply focus on an expectation and anticipation of innovation within the procurement pathways.

A Greener NHS is a holistic NHS, and one that thinks about its patients, its carers, is workforce and its communities.

We celebrate what the NHS has achieved, but we also recognise that we must never lose sight of one of its founding principles on prevention - as Aneurin Bevan said "preventative medicine .... is merely another way of saying health by collective action".

See all of our COP26 blog posts