1. Promoting Sustainability in Healthcare – How to Stay Positive
27th April 2018
Identifying Sustainable Development Opportunities in Community Healthcare
Claire Jordan, Darzi Fellow
Care Without Carbon
Sussex Community NHS Foundation Trust

2. Darzi Fellowship 1 Year Project Clinical Leadership
Leadership in Health Post Grad Cert - LSBU
Head space/time – wicked/complex problems
Pharmacist – Counsellor – Psychological Therapist – Clinical Sustainability - ?

3. Darzi Project Outline
To identify and develop opportunities to integrate sustainable development into the Trust's clinical care model as well as improve engagement with frontline community staff on key sustainability issues.

4. NHS – Direction of Travel
Five year Forward View
Sustainability & Transformation Partnerships
Place Based Care
Integrated working
Prevention – All Our Health
Making every contact count
GIRFT
Carter review
Model Hospital
Shared decision making
What Matters to you
CQC – use of resources
One Public Estate

5. Sustainability Work in Health
Sustainable Development Unit
- South regional network
Centre for Sustainable Healthcare
UK Health Alliance on Climate Change
Health Care Without Harm Europe
Global Green and Healthy Hospitals
Lancet Countdown
Sustainable Health & Care Week/Awards
Chief Medical Officer Report 2017 – Health Impacts of All Pollution – what do we know?
Royal College of Physicians, April 2018 Less Waste, More Health – A health professionals guide to reducing waste
The UK Health Alliance on Climate Change brings together doctors, nurses and other health professionals to advocate for responses to climate change that protect and promote public health. The Alliance was formed in March 2016 to coordinate action, provide leadership and help amplify the voices of doctors, nurses and other healthcare professionals across the UK
Professor Dame Sally Davies's ninth independent report as CMO discusses the threat to health posed by pollution to people living in England Published march 2018
Good waste management is critical to reducing the negative environmental impacts of an NHS organisation, and applying best practice in their field helps to reduce operational costs which can be reinvested back into critical front line patient care.
Clinical staff especially have a critical role to play in helping their NHS organisation better manage their waste and the practical solutions set out in this report should be adopted at scale across the system. Senior clinical leaders should work with their teams to start identifying the simple changes they can make today that will deliver efficiencies and better outcomes for our environment both now and in the future. Dr Kathy McLean Executive Medical Director and Chief Operating Officer NHS Improvement

6. What do people think? SDU NHS Staff study 6,200 responses:
98% think it is important for health and social care sector to support the environment
However….71% think their organisation actively supports environmental sustainability
Parliamentary survey, public:
Top issues that public want senior politicians to discuss more
18-24 year olds: Climate Change
18-40 year olds: Health, Climate Change
Blue Planet – plastic
Air pollution

7. National Strategy, Direction
Front line, individuals

8. 80 % clinical decision making

9. Care Without Carbon PEP Tool
How in SCFT can teams/services work out what to do to be more sustainable?
3 key areas of opportunities:
Prevention – actions taken now that prevent more resources being needed at a later time
Efficient use of Resources
Pathways – does information or a patient flow through a system in best way

11. PEP Tool 3 Themes – Prevention, Efficiency, Pathways
85 Questions, 35 non clinical, 50 clinical
Written for SCFT
Approx minutes to complete
Action Plan created
Some quick wins eg right bin
Areas for service /QI development
Pre QI ideas generator

12. Feedback Comments It made me think
Hadn’t realised how much we were already doing
Not realised that before
I get it now - sustainability is all about prevention
Shouldn’t we all be doing this

13. Staying Positive
Other people don’t think like you do – this may not be because they don’t care about the environment – they just haven’t thought about it.
Link in with other teams doing same work eg QI, Lean
A Marathon is run one step at a time
Information, sharing, encouragement

14. Language and Communication
Harness the power of social proof (website Bluetribe.co)
Experiment in San Marcos area , USA, 1 of 4 messages delivered once a week for a month, asking the residents to reduce their energy consumption.
the environment will benefit
it’s the socially responsible thing to do
it will save you significant money on your next power bill
most of your fellow community residents do try to conserve energy at home
1 of 4 messages delivered to homes in the San Marcos area, 1x week for month, asking the residents to reduce their energy consumption. 3 of the messages contained a frequently employed reason for conserving energy: the environment will benefit; or it’s the socially responsible thing to do; or it will save you significant money on your next power bill. The 4th message played the social-proof card, stating (honestly) that most of your fellow community residents do try to conserve energy at home
At end of the month, recorded how much energy was used - social-proof-based message had generated 3.5 times as much energy savings.
Surprised by the result – residents expected the social proof message to be the least effective.
Researchers surmised that the reason the social proof message was so effective was because of the high degree of uncertainty the residents felt in achieving energy savings. Benefits of energy efficiency are somewhere off in the future so not sure if you will in fact save any energy at all – the problem of uncertain achievability.
This problem exists in many areas of sustainability from energy efficiency to the benefits of reducing carbon emissions.
Here the principle of social proof was effective because the note stating that most of the residents neighbours do try to conserve energy had the effect of destroying the problem of uncertain achievability. Once the residents learned that others were saving energy then this removed any doubts about whether it was achievable and it became realistic and therefore implementable.

15. Staying Positive - making it normal
98% think it is important for health and social care sector to support the environment
Network
Connections
Joining dots for other people
Every little helps