Lancet Commission on climate change

Climate change poses such a threat to public health it risks undoing the gains of the last 50 years according to the Lancet Commission. The study on climate change and health has found the threat continues to be underestimated, but that tackling it could be a huge opportunity to improve global health.

You can read the specifics of the report on the Lancet website.

SDU response to the Lancet commission Report

The SDU welcomes this important publication that will help set the tone for health sector involvement in climate change negotiations and policy makers around the world. It is particularly timely as part of the preparations to influence COP 21 in Paris (the United Nations Climate Change Conference taking place in November and December). We also welcome the countdown approach to make sure that we reflect on progress made every couple of years.

This is a very important message of hope for the health of the planet. It is also an opportunity for us all to take forward more sustainable services, making sure that we reduce our impact on the environment in a way that helps address inequalities and reduce the burden of disease. We must  also build on the inherent strengths within communities and the natural environment so that we can enhance health and wellbeing.

Successes across the health sector The health sector can play a real role in making sure that its activities promote lower carbon and a more resilient infrastructure. This holds true in relation to every part of the sector including travel and transport systems, in relation to building infrastructure and through the procurement of products and services.

Energy

There are some excellent examples of health sector action in ways that can make us all feel proud. For instance between 2007/08 and 2013/14 the NHS carbon footprint in relation to building energy use dropped by 3.5% despite increases in activity of 13%. The decrease represents around £50m of energy costs for the NHS in England in 2013/14. The 2013 NHS Energy Efficiency Fund forecasts, for its ring fenced projects, savings of £70m over five years and up to £115m over 10 years. This is a saving of over 100,000  tonnes of CO2e per year.   

Travel

NHS Derbyshire Community Health Services saved more than 3,000 hours of staff travel time, 20 tonnes of carbon, and over £100,000 by using teleconferencing services. Replicated across the NHS this could contribute to significantly reduced environment impact and much needed financial savings.

Food

Nottingham University Hospitals NHS Trust shows how part of the health system can lead sustainable food systems.  It serves fresh, healthy meals made with local, seasonal and organic ingredients.  77% of the food spend is now on local ingredients creating locally resilient and economically sustainable system.  Switching to local suppliers has been cost neutral and allowed the hospital to invest £2m per year in local sustainable businesses.  The cost increases of using organic milk have been offset by a new system to reduce food waste.  The hospital operates below the national average for patient day costs.

Areas specific to health


The health sector has control over numerous processes and products where it can take leadership to make a real difference as demonstrated above. In addition there are areas that are specific to the health sector which will only be solved with leadership from within our sector because others are unlikely to do so on our behalf. Some of these opportunities are described below:

Gases and medicines

The use of anaesthetic gases represents 5% of acute hospital CO2e emissions. These could be reduced with lower flow rates or substituted for instance moving away from nitrous oxide
Inhalers which represent 4.3% of the English health and care sector’s footprint could be replaced by a pulverised form as in Scandinavian countries. While more effective technology could mean better recovery so one third is not wasted when the devices are disposed of .  New meter dose inhalers without high environmental impact propellants could save nearly 7 million tCO2e over five years.
Medicines are often a cornerstone of our health response be this through immunisations, diagnostics or therapeutic drugs. It is however sometimes more effective to prescribe physical activity, dietary changes or talking therapies.  The pharmaceutical industry is similarly keen to help reduce environmental impacts involved in the production, use and disposal of medicines so are already important partners in this journey. More information about this work is available on the CSPM pages.

Contaminated waste

The health sector produces waste in vast quantities, some of which is contaminated and needs to be separated and disposed of effectively. We hold the key to doing this effectively and   and safely as well as reducing environmental impacts). Reducing waste simply through theatre kit efficiencies saves time and money, for example, just improving knee replacement kits nationally saves 3 ktCO2e over five years. This could be replicated across all kits and have a significantly greater effect.

Medical devices

The use of multi-use or single use items, balancing the ethical sourcing and material use with decontamination and/or recycling approaches needs to be fully understood and effectively implemented to minimise both visible and hidden costs and environmental impacts.   The health system in every country has a huge potential to influence all its supply chains to ensure health is protected and promoted globally.

Models of care

The very nature of our business which is now considered unsustainable economically, environmentally and socially means that we need to focus on improving health and reduce our reliance on acute settings. The NHS Five Year Forward View is addressing some of these through the development of Vanguard sites and it would be exemplary to be able to demonstrate the benefits in environmental and social terms too.

There are no doubt other examples that are conundrums specific to the health care sector. Please do contact the unit if you have good examples to add. We can then ensure that our sector is aware and able to maximise its contribution to the transformation towards sustainable, healthy and resilient healthy people, places and systems. We can  demonstrate that the health sector is serious about achieving sustainability and climate change and is highlighting the warning and the opportunities to get this right.





The video below from the Lancet shows the link between climate change and health - the threats to human health and the opportunities.