The winner of the HEFMA-sponsored Public Engagement award category as part of the 2020 NHS Sustainability Day was Newcastle upon Tyne Hospitals NHS Foundation Trust. The award was made in recognition of the Trust’s pioneering position on climate change, as part of which it became the first NHS Trust to publicly declare a Climate Emergency in June 2019. It was later established that the Trust was the first healthcare organisation in the world to declare a Climate Emergency, although local authorities and educational institutions had already made similar declarations.
The declaration was part of a proposal prepared by James Dixon, Head of Sustainability, which was accepted by the Board. The proposal also stated that the Trust should pledge to become carbon neutral by 2040* and should work collaboratively with civic partners in Newcastle to agree individual and collective actions to deliver on this goal.
The proposal highlighted the link between climate change and public health. According to the Lancet (2009), climate change is the greatest threat to global health. Global temperatures have already increased by 1C (degrees centigrade) from pre-industrial levels and are projected to continue beyond the 1.5C safe limit cited in the Paris Agreement.
Accepting the proposal sent a clear message that the Trust recognises and gives weight to the threat that climate breakdown poses to public health. It required the Board to be brave and make a public commitment to becoming a net zero carbon organisation before developing clear action plans of how this would be achieved. With a moral obligation to ‘first do no harm’, the team at Newcastle upon Tyne Hospitals NHS FT knew it was imperative to reduce the harmful effects of carbon emissions from its activities.
James and the Sustainability Team at Newcastle Hospitals (Cara Tabaku, Jason Mitchell, Amy Johnston, Laura Middlemass, Thomas Wright and James Duffy) laid the foundations and buy-in for climate action was improved by fostering relationships with the Executive Team. Key allies included the Director of Estates, Rob Smith, Director of Communications & Engagement, Caroline Docking, and Chief Executive Officer, Dame Jackie Daniel.
Since the declaration the following citywide groups have formed to take action:
• Climate Change Committee
• Net Zero Taskforce
• Climate Change Assembly
The existing Newcastle Sustainability Network has incorporated net zero targets into the energy & carbon subgroup.
Dame Jackie Daniel leads the climate action group within the Integrated Care System. A Shelford Group of Sustainability Leads has also been established to co-ordinate work nationally. She is also on the NHS Net Zero Expert Panel that has been established to advise on the development of the NHS Net Zero Plan.
The Sustainable Healthcare in Newcastle (Shine) work has attracted a high level of interest from other healthcare organisations, with professionals from Trusts around the UK contacting the team to find out how they gained support for this declaration and how they plan to achieve net zero carbon. The Trust’s initiative has inspired many other healthcare organisations to take action on climate change.
As well as this citywide and regional action, the Trust has established its own Executive Oversight Group for Climate Emergency Action, which has task groups focusing on priority action. Climate Emergency, carbon reduction and energy efficiency have also been embedded in the Trust Strategy for 2019-24.
Climate change and public health
Left unabated, climate change will define the health profile of current and future generations and will challenge already overwhelmed health systems.
Any increase in global temperature is projected to affect human health, with predicted impacts including heatwaves and increases in vector-borne diseases like malaria and dengue fever. Poverty is also expected to increase for many populations, which is known to exacerbate health inequalities.
A child born today will experience a world that is more than four degrees warmer than the pre-industrial average. Across the world, children are among the worst affected by climate change, being most at risk from undernutrition (related to food security) and diarrhoeal disease.
Throughout life air-pollution damages the heart, lungs and other vital organs and people aged over 65 are particularly vulnerable to extremes of heat.
Financial benefits
There are predicted financial savings associated with becoming carbon neutral. About 25% of the Trust total carbon footprint is attributed to building energy use. Current spending on utilities is £16 million a year and it is projected that demand reduction initiatives, along with an increase in energy provided by on-site renewable technologies will reduce that spend significantly.
Any investments in energy saving technologies would be recouped. For example, typical demand reduction initiatives with a 3-5 year payback period include upgrading heating controls, upgrading lighting to LED and lighting controls, insulation and upgrading controls for systems like air handling units. Whilst installation of renewable technologies such as solar PV has a typical payback of 5–10 years.
However, the financial savings are actually far greater when the increasing cost of energy from fossil fuels is considered.
Sustainability principles are therefore neatly aligned with resource efficiency and reducing waste, all of which offer financial savings as well.
Collaboration
The commitment to work collaboratively with other civic anchor institutions to agree individual and collective actions is an innovative way of working, which will see the city and wider region as a whole become a cleaner, healthier and more pleasant place to work and live.
Work is currently taking place on a city and regional basis to establish the carbon footprint and profile. A science-based plan to reduce this is being developed, meaning that the whole city region will become carbon neutral over a similar timescale.
Partnership working with other anchor institutions in the city of Newcastle, particularly sustainability colleagues in Newcastle City Council and Newcastle University, has helped create a civic partnership that resulted in Newcastle-upon-Tyne being the first UK city to have all three anchor institutions declare a climate emergency and commit to collaborative action on achieving carbon neutrality by 2030* - ten years ahead of the Trust’s original institutional commitment!
