Why We Need A Green NHS

"The NHS finds itself in an interesting dichotomy where it produces large amounts of emissions but also treats patients suffering from the effects of these emissions."

A recent UN report on climate change warned that we are at “Code Red”. Here, Caitlin examines how the NHS is lacking when it comes to reducing emissions, and how it could become ‘Greener’.

Topics covered in this article

Introduction

Code Red For Humanity

Net Zero By 2050?

Six Trusts Have Now Declared Climate Emergencies

Lots Of Medical Waste Isn’t Recycled

An Interesting Dichotomy

Introduction

For the past year and a half in which I have worked for the NHS, I have learnt a lot both about myself and about patients.

Yet one of the more significant and extremely visual is the level of plastic waste produced by the NHS, even on a 12 hour shift it is staggeringly obvious.

In fact a peruse on google indicates 133,000 tonnes of plastic is disposed of each year by the NHS, 5% is recovered.

The average British army tank weighs 62.5 tonnes, a quick calculation indicates the NHS throws away 2128 army tanks worth of plastic a year, which greatly contribute to greenhouse emissions.

This figure is from early 2020 and so probably did not capture the impact of the pandemic and PPE on this figure. You can also read about the main cause of sick days for NHS workers.

Code Red For Humanity

Whilst these figures seem a little jovial the situation is less so, more recently the UN issued a report seen as a code red for humanity, indicating that unless emissions are cut we will be unable to change the course of climate change.

This means that our weather will continue to be unstable, that people will continue to die from heat waves or droughts or flooding.

Even in the best case scenario some of the changes are irreversible such as rising sea levels.

Reports investigating the impact of healthcare on emissions show us that if healthcare was a country it would be the fifth greatest largest emitter on earth second to Russia, the largest country on earth.

The NHS has a higher emission production than the global average, emitting the same amount of waste as 11 coal fired power stations.

Whilst damning there is hope as it seems that the NHS could have a huge impact on joining the effort to change the course of humanity.

Net Zero By 2050?

Especially as the NHS in Scotland and England is the largest employer in the UK, with a huge workforce who are used to innovation in the face of challenge.

The NHS has set itself a target to be net zero by 2050.

When looking at the NHS there are three major drivers of emissions.

Firstly is medicine, which contributes to 25% of emissions, the use of anesthetic gases and nitric oxide and inhalers contribute 5% of NHS emissions reducing the waste of these medicines and ensuring medications are used correctly and not wasted may be helpful.

It would also be beneficial to analyse supply chains and ensure partner supply chains are committed to reducing their carbon emissions and have strategies to reduce these effects, which could be part of the criteria for an NHS supply contract.

Our estates contribute to 15% of the total carbon emissions profile, and so this may mean intervening with making new buildings net zero carbon emissions and making older buildings less wasteful.A trust in London found that turning off printers, computers and other equipment overnight and managing heat loss each staff member was able to reduce CO2 emissions by an average of 70kg a year.

This could be a pretty small stage intervention with great returns.

The third and greatest contributor of emissions is supply chains.

The non-medical supply chains contribute 42% of carbon emissions.

This includes food, office and business goods, my trust has trialed paperless offices and this seems to be effective but the NHS as an organisation is taking bolder steps, stating that by 2030 the NHS will no longer purchase from suppliers that do not meet or exceed our commitment to net zero.

This could develop into an interesting wave of influence for supply chains who focus on the NHS.

Six Trusts Have Now Declared Climate Emergencies

It is also interesting to look at the trusts that have declared climate emergencies: there are six and the majority of them are in Manchester, Nottingham, Gloucestershire, Newcastle and Bristol.

Most recently Great Ormond Street has declared a climate emergency and it would be interesting to see if other NHS trusts declare emergencies in the near future.

Interestingly Newcastle upon Tyne was the first trust in the world to declare a climate emergency, all the trust sources of electricity come from renewable sources, it has sent zero waste to landfill since 2011 and recycles more than 40% of non-clinical waste.

The trust has an electric visitor bus reducing visitors driving themselves and ensuring that driven visits are green.

The trust also has a green renal unit where dialysis produces a lot less waste than other trusts recycling packaging and dialysis fluid canisters and generally uses less polluting anaesthetic gases.

There is a real push to use sustainable and reusable clinical items and hopefully this trust inspires others to follow foot.

Lots Of Medical Waste Isn’t Recycled

Lastly in operating theatres about 40% of waste in operating theatres is a high-quality product that could be recycled.

Unfortunately, most waste ends up being labelled as “infectious clinical waste”, he says, and gets incinerated at a high financial and environmental cost.

Disposing of infectious waste is a tricky one but perhaps there are alternatives.

Instead of incinerating waste there are methods such as hydroclave which uses hot steam to sterilise medical items with low water usage and low-cost emissions.

An Interesting Dichotomy

The NHS finds itself in an interesting dichotomy where it produces large amounts of emissions but also treats patients suffering from the effects of these emissions.

Air pollution is linked to 700 avoidable deaths per week and on days of high pollution a trust in London found 673 out of hospital cardiac arrests.

The NHS has both the means and the motivation to improve its carbon emissions and it is encouraging that it is starting to put these processes into place.

Yet it's one of the biggest producers of emissions so does have a lot to do.

Particularly there is a wasteful culture in healthcare often due to single use plastics and this needs to change.

It is an interesting time to be in the NHS and I look forward to the changes the NHS will make.

We are leaders in the vaccine push and we will be leaders in the push against climate change.