Rachel Stancliffe Centre for Sustainable Healthcare Healthy Planet conference 2 nd March 2014 Sustainable Specialties New models of healthcare delivery

“ Health and social care services must be planned, financed and delivered in ways that allow them to meet the needs both of today’s population and of future generations.” Naylor & Appleby. Environmentally sustainable health and social care: Scoping review. NIHR (2012)

Financial sustainability Environmental sustainability Social sustainability Triple Bottom Line “Sustainable healthcare delivers the highest possible value to patients from a radically reduced resource input.” Green Nephrology Summit 2012 – position statement

Results of Public Opinion Survey: Source: Ipsos MORI ns/Ipsos_MORI_Survey.pdf

CENTRE for SUSTAINABLE HEALTHCARE Savings Potential savings from moderate replication of Green Nephrology case studies in UK renal units are estimated at £7 million, 11,000 tonnes CO2e and 470 million litres water per year BMJ 2013;346:f588 doi: /bmj.f588 (Published 28 January 2013) Mortimer F, Connor A, Stott A. Cumulative savings from green nephrology innovations [abstract presented as poster at joint Renal Association and British Transplantation Society 2013 annual congress].

NHS England CO 2 e footprint with Climate Change Act targets

CENTRE for SUSTAINABLE HEALTHCARE Carbon footprint – NHS England Supply chain (pharmaceuticals, equipment, everything else) Transport Energy use

Models of care Reduce carbon without reducing health Reduce activityPreventionSelf careLean pathways Reduce carbon intensity Low carbon alternatives Sustainable estates Mortimer-F. The Sustainable Physician Clinical Medicine 2010, Vol 10, No 2: 110–11 Outcome needed Secondary drivers Primary driver CENTRE for SUSTAINABLE HEALTHCARE

Models of care Reduce carbon without reducing health Reduce activityPreventionPatient-centredLean pathways Reduce carbon intensity Low carbon alternatives Sustainable estates Mortimer-F. The Sustainable Physician Clinical Medicine 2010, Vol 10, No 2: 110–11 Outcome needed Secondary drivers Primary driver CENTRE for SUSTAINABLE HEALTHCARE

Models of care Reduce carbon without reducing health Reduce activityPreventionPatient-centredLean pathways Reduce carbon intensity Low carbon alternatives Sustainable estates Mortimer-F. The Sustainable Physician Clinical Medicine 2010, Vol 10, No 2: 110–11 Sustainable clinical practice Outcome needed Secondary drivers Primary driver Infrastructure & process CENTRE for SUSTAINABLE HEALTHCARE

CENTRE for SUSTAINABLE HEALTHCARE How we work 1.Fellowship Programmes - focusing mainly on clinical specialties (green nephrology, respiratory, OT, operating theatres and mental health) and this year, via the AHSN Diabetes, Dementia, Medicines Optimisation 2.Sustainable Healthcare Education Network Priority learning outcomes for GMC 3.Research on sustainability metrics and methodologies Service line footprinting, Triple Bottom Line

CENTRE for SUSTAINABLE HEALTHCARE CSH Sustainable Specialities Fellowships 1.Network Local champions Case studies Summit & Awards 2.Research or demonstration project

CENTRE for SUSTAINABLE HEALTHCARE “Thanks to Green Nephrology, sustainability is now the seventh dimension of Quality. The work over the past couple of years has caught the imagination of the whole kidney community and has launched a social movement to provide better, greener and leaner kidney care.” Dr Donal O'Donoghue, National Clinical Director for Kidney Care

CENTRE for SUSTAINABLE HEALTHCARE Fellowship Programmes 1.Network (action learning + legacy) Local champions Case studies Summit & Awards Blogs and podcasts 2.Research/demonstration project (MD) 3.Policy papers at national level 4.Education including curriculum change 5.Leadership skills

CENTRE for SUSTAINABLE HEALTHCARE Fellowship Programmes- outputs Innovations and new models of care. Case studies and publications. Sustainability evaluation tools for service improvements, for use by commissioners and clinical management. Quantification of environmental, financial and social impacts (i.e. ‘Triple Bottom Line’ analysis) of at least one clinical service unit within the specialty. A sustainability agenda for the specialty. A trained and experienced Fellow.

CENTRE for SUSTAINABLE HEALTHCARE Fellowship Programmes- outcomes Carbon reductions and cash savings in clinical service units that use the innovations and new models of care. Improved patient outcomes in those units. Increased awareness of and changed attitudes towards sustainability across the specialty. Network participation. Use of case studies and sustainability evaluation tools.

CENTRE for SUSTAINABLE HEALTHCARE How can we help? Running Fellowship Programmes Training/teaching sustainable healthcare Mentoring sustainability scholars Create specialty-specific materials Map assets and opportunities in each area Advise on embedding sustainability metrics into projects and reporting structures Working with commissioning Write joint proposals for research Come and talk to us and we will work with you

Watch the video – 6 mins nephrology/podcasts/2013/09/sustainable-specialties-greening- nephrologyttp://sustainablehealthcare.org.uk/green- nephrology/podcasts/2013/09/sustainable-specialties-greening- nephrology