1. Material Health Report launch 21 st April 2004 St Thomas’ Hospital London Best Foot Forward bringing sustainability down to earth

2. Andrea White Chair Material Health Advisory Group

3. Peter Jones Director Biffa Waste Services Ltd peter.jones@biffa.co.uk www.biffa.co.uk

4. Nicky Chambers Director Best Foot Forward Ltd Best Foot Forward bringing sustainability down to earth

5. Material Health - The project First of its kind England and Wales High level of cooperation and support from NHS Estates and PASA High level of interest from within and outwith NHS Just a starting point

6. Surprising facts – a sample Gas dependency – NHS consumed 7,809 GWh of gas. This is 1.2% of UK consumption Over 1.3 million tonnes of products were purchased by the NHS in 2001 and 0.3 million tonnes came out again as waste. NHS produced 120,000 tonnes of clinical waste. Patients, staff and visitors travelled 25 billion passenger km. 70% of this was by visitors. Water heating efficiency is about 12%, i.e. 88% is ‘wasted’.

7. Resource flows in the NHS

8. Relevance to policy makers What is sustainable consumption? How big is the impact of healthcare services? What effect does best practice have? Is service delivery getting more resource efficient or less?

9. What is sustainable consumption?

10. Scale of sectoral consumption The ecological footprint of a region in South East England, by component The NHS’ environmental impact contribution to the UK per capita ecological footprint, in 2001

11. The effect of best practice The total ecological footprints of the 2001 base case and scenarios for staff travel Note: Ecological footprint contributions for walking and cycling was zero for all four cases

12. Service efficiency ‘the delivery of competitively priced goods and services that satisfy human need and bring quality of life, while progressively reducing ecological impacts and resource intensity throughout the lifecycle, to a level at least in line with the earth’s estimated carrying capacity.’ WBCSD 4,964,825 57,668,300 = 0.09 gha/patient episode

13. Why are these relevant to - Managers: What are our ‘big hitters’? What impacts can I realistically and most effectively reduce? What are our most ‘unproductive’ impacts? How can everyone make a difference? How have we made a difference?

14. Big hitters? The ecological footprint of the NHS in England and Wales, by component, in 2001

15. Big hitters? The products & waste ecological footprint compared to tonnages consumed, by the NHS in England and Wales, in 2001

16. Reducing impact and wastage The ecological footprints of the NHS in England and Wales’ domestic waste base case and scenarios 1, 2 and 3 The ecological footprints of the NHS in England and Wales’ energy use for heating water and scenarios 1, 2 and 3

17. Facts and Figures to engage staff to engage facilities managers to assist decision making

18. Have we made a difference ?

19. Where to next? Headline indicator for the sector? Use of concept at Trust and/or hospital level? Improvement of data sources/availability? Infrastructure construction?

20. Footprint tool for trusts

21. Policy Director Sustain Vicki Hird

22. Dr Gina Radford Regional Director of Public Health Department of Health: East of England

23. NHS One of the largest organisations in the world Employs over 1 million people Annual budget of £60 billion £11 billion spent on public services and goods

24. NHS Estates - 2002 New Environmental Strategy for the NHS Sustainable Development in the NHS NHS Environmental Assessment Tool (NEAT)

25. Impact of the NHS Ecological Footprint is 1.8% of the total Eco-efficiency is 72% with 28% wastage compared to UK’s eco-efficiency of 52% retained and 48% wasted

26. Still room for improvement Transport – 17% Trusts implement green travel plans Waste –Domestic waste – 98% landfilled or incinerated –Food waste – 10% meals wasted –Medicines – 480 tonnes = £100m = 10-12% all prescribed

27. Picture slides removed to save space

28. Dr David Moon Procurement Manager The Waste & Resources Action Programme “Resource efficiency through procurement”

29. Why paper? Good practice 43% 2% Current practice Paper and cardboard Recycling rate

30. Why construction? 10 Mtonnes consumed Current practice 2.5 Mtonnes waste 1 Mtonnes recycled Mtonnes

31. Why procurement? You are not recycling unless you are buying recycled. Cost-competitive options are available. A top-down mandate is needed.

32. Paper - the good news In 2003, 85% of NHS PASA sales of tissue products included recovered fibre.

33. In 2003, NHS PASA and Guilbert supplied 18.5 ktonnes of paper, averaging 3.5% recycled content. Paper - the not so good news

34. Construction case studies – share of recycled content by value “Current practice” (%) “Good practice” (%) House12.114.6 Office 9.6 12.2 School12.214.9 Road8.226.7 Bridge18.332.7

35. Quick Wins in construction

36. OGC-DEFRA Joint Note on Environmental Issues in Purchasing Requirement specification Supplier selection Tender evaluation Contract management Key stage to implement environmental policy objectives Best value for money applies to contract award stage Identifying need

37. Setting requirements in contracts Proposed target for the Government Estate: at least 10% of the materials value of a major construction project to derive from recycled content

38. http://www.wrap.org.uk david.moon@wrap.org.uk

39. Q & A panel Andrea WhiteChair, Project Advisory Group Peter JonesDirector, Biffa Waste Services Nicky ChambersDirector, Best Foot Forward Vicki HirdPolicy Director, Sustain Dr Gina RadfordRegional Director of Public Health, Department of Health Dr David MoonProgramme Procurement Manager, WRAP Research Dr John BarrettStockholm Environment Institute (York University) George VergoulasResearcher, Best Foot Forward

40. Thanks … Funders Environment body Advisory group Research Best Foot Forward bringing sustainability down to earth