Understanding NHS emissions to reach net zero

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Dr Atanu Chaudhuri, Associate Professor in Technology & Operations Management at Durham University Business School, discusses the need for digitalisation and a supply chain strategy to reduce NHS emissions

In 2019, research conducted by environmental NGO Care Without Harm in partnership with consultancy firm Arup, and covered by the Guardian, stated that global healthcare accounted for as much as 4.4% of the world’s net Co2 emissions. Though a small number, it’s no doubt a significant amount – the Guardian pointed out this would be akin to being the fifth largest emitter on the planet if “healthcare” was a country.

On a local scale, in the UK, the NHS has a significant challenge on its hands. The same report found NHS emissions were responsible for 5.4% of the UK’s output. And it’s not hard to see why.

NHS emissions from hospitals to transport

The NHS has a massive footprint across the country. Not only is there the running of physical buildings to consider; hospitals, clinics, GP surgeries and dentists, but also the NHS’ extensive transport infrastructure, the energy required to run a 24/7 service of response in person, online and over the phone, and a global supply chain for medicines, machinery and consumables. Therefore, like any large organisation, it has a vital role in reaching net zero targets for the UK.

In helping to make such ambitions a reality, the NHS has not been shy in making a commitment, becoming the first health system to embed net zero into legislation, through the Health and Care Act 2022.

The UK has developed a comprehensive strategy for reducing NHS emissions to net zero through planned interventions at every level of its operations, from the day-to-day care provision, medicines and supply chain, transport and travel to the implementation of digital transformation-led innovations, upgrading hospital infrastructure, including heating, lighting and long-term climate sensitive efforts. Baselining concerning 1990 has already been conducted – several scenarios were modelled, and an extended set of interventions and carbon reductions were identified.

Net zero within regional NHS trusts

Furthermore, efforts are being made by Academic Health Science Networks in England to initiate work to reduce NHS emissions with regional trusts. I believe there should be synergies between existing NHS Transformation Programmes such as NHS Lean, which emphasises waste minimisation and NHS Digital Transformation, which should support net zero goals.

A broader societal challenge must be overcome if the NHS has any hope of reaching its targets. Reducing patient admissions and patient visits are considered as overarching goals, not only in avoiding capacity bottlenecks and reducing waiting lists but also emissions, as every patient admission is associated with transportation and consumption of medicines and medical consumables, energy, etc.

There are multiple ways to avoid admissions and re-admissions – the fundamental one being building awareness of healthy lifestyles and healthy food habits in children, teenagers and young adults so they do not need as much healthcare. Obviously, it is easier said than done, but a more concerted effort must be made.

Advances in the NHS, including digitalisation

Advances such as the digitalisation of patient services, using AI to predict conditions before they advance, robotic surgeries and the use of 3D printing for both planning surgeries and producing custom-designed surgical tools and implants have all been shown to not only have better clinical outcomes and reduced re-admissions, but also reduce treatment time, thereby improving cost efficiency and indirectly reducing NHS emissions and its carbon footprint.

On the transportation and logistics front, as electric vehicles become more reliable and battery production becomes more environmentally friendly, the NHS might also consider moving beyond petrol and diesel vehicles and consider more novel mobility solutions.

Change is needed to achieve NHS net zero goals

However, despite a willing attitude to create such change, achieving any – if all – of the above will require a significant commitment of time and focus over the next 20-30 years, something which may be in short supply, given that the NHS remains overburdened and underfunded. A vast reduction of NHS emissions is not possible without investment – which poses a significant hurdle at a time when the service is in crisis and making cuts across the board.

Any funding cuts on net zero initiatives will undoubtedly harm progress made so far, halting a more significant challenge emerging. Climate change brings with it health implications, which put further strain on already limited resources. The NHS cannot afford to let up or deviate from its net zero goals, and we cannot afford to sit by whilst it fights fire on both sides.

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