In January this year HEJ conducted a survey on behalf of business utility and sustainability consultancy, Inenco. It sought to identify how far advanced NHS Trusts across England England were in developing and implementing a ‘Green Plan’
As part of the national drive for the NHS Carbon Footprint across England to be Net Zero carbon by 2040, and for the NHS Carbon Footprint Plus to achieve the same goal by 2045. Here, with input from Inenco Senior Account manager, Beth Goodwin, we report on the responses.
In March’s HEJ, we reported on an informative webinar held in conjunction with the magazine late last year, during which Beth Goodwin of Inenco, and her colleague, Product and Insight manager, David Oliver, explained to the audience the background to, and rationale behind, Green Plans. The Inenco speakers also set out the key steps in creating an effective such plan, and suggested some of the best ways to encourage staff employed in a wide range of NHS roles to play their part in achieving the targets set. The aim of the follow-up survey undertaken via HEJ on Inenco’s behalf this January was to gauge how far NHS Trusts across England had actually already progressed in developing and implementing their Green Plans, and, equally, to find out more about how they propose to play their part in the NHS’s publicly stated goal of becoming the world’s first Net Zero Carbon national health service. In this article we list the questions posed, and the responses obtained.
1: Does your Trust currently have a plan in place to achieve the Net Zero Carbon targets of 2040 and 2045 outlined by NHS England?
In October 2020 NHS England published Delivering a ‘Net Zero’ National Health Service, which outlined the goals NHS England has set in the quest to become the world’s first Net Zero carbon national health service. Two deadlines were set – for the NHS Carbon Footprint to be ‘Net Zero’ by 2040, and the NHS Carbon Footprint Plus to achieve the same goal by 2045 (see the article in the March 2021 HEJ for fuller details). “Encouragingly,” said Beth Goodwin, “the majority (56%) of Trusts surveyed are already working towards a sustainable future. However, 44% surveyed have not currently got a plan in place to achieve net zero, which indicates that many still have work to do to begin to address one of NHS England’s key priorities going forward.
Over 50% of respondents did indicate in a later question however, that COVID-19 has understandably slowed down their progress.”
2: Do you know what your Trust’s carbon footprint is currently?
This question suggested about 47% of the survey respondents do not know their Trust’s current carbon footprint. Beth Goodwin said: “At Inenco, one of our core principles is ‘What gets measured, gets managed’. The success of any sustainability strategy will depend on being able to measure against an accurate baseline, and therefore we would argue that determining the current carbon footprint should be a key starting point for all Trusts
“Service Condition (SC)18 of the new NHS Standard Contract states that all Trusts must make efforts to reduce their impact on the environment, particularly in relation to greenhouse gases and air pollution, and that the goals set must be in accordance with the guidance published in October. Data collection and analysis are therefore crucial to not only knowing what your Trust’s carbon footprint is, but also to be able to set realistic goals, and measure against those goals in accordance with the updated contract.”
3: What is your Trust’s main driver internally for reducing its carbon footprint?
Perhaps unsurprisingly, 40.6% of respondents stated that regulatory compliance was the main driver for reducing their Trust’s carbon footprint. Encouragingly, another 40.6% indicated that it was ‘the right thing to do’, suggesting an acknowledgement that a net zero NHS will not only benefit the health service, but also the wider communities in which they operate. Beth Goodwin commented: “Just 6% said that pressure from key stakeholders was the main driver, suggesting that perhaps the sustainability agenda is still not being driven at Board level. Our experience suggests that while sustainability is an initiative placed at the door of Estates Departments, in order to achieve the ambitious targets set by NHS England last October, all areas of Trusts will need to make changes to drive change.”
4: Do you currently have a Green Plan (formerly a Sustainable Development Management Plan) in place?
Last year’s NHS Standard Contract introduced the necessity for all Trusts to develop a Green Plan to outline how they were going to reduce their carbon emissions. However, 38% still do not have a plan in place. Beth Goodwin said: “The 2021/22 NHS Standard Contract now also states that each Trust must nominate a Net Zero lead, and notify the Coordinating Commissioner of who that lead is, further highlighting that a Green Plan is no longer merely ‘an option’, but rather something that should be developed by all NHS Trusts
“In the words of the saying, ‘Failure to plan is planning to fail’. Even those Trusts with Green Plans in place will need to ensure that the targets set are in line with the targets published in the Delivering a ‘Net Zero’ National Health Service document.”
5: Do you currently measure your performance against the sustainability goals set in your Green Plan, annually?
Those respondents who answered ‘yes’ to Question 4 were asked this question, and 86.6% said that they do measure against the Green Plan they have developed. Of the 13% that answered ‘no’, the majority said in in question 6 that they use their Sustainable Development Assessment tool (SDAT), or have ‘another action plan’ in place
6: How are you currently measuring the performance of your sustainability goals?
(No set answers to select from for this question were listed in the survey, giving respondents the opportunity to respond in their own words.) Answers included:
- “Not sure.”
- “Not presently measured, but we have plans to measure performance against our carbon baseline.”
- “Using the SDAT and NHS Carbon Footprint.”
- “Annual carbon emissions (absolute and efficiency KPIs), SDAT performance score, and ‘other’.”
- “Non-carbon sustainability metrics.”
- “We have an annual action plan each year which we review.”
- “We have a group that is constantly monitoring our performance.”
- “Using the NHS SDU SDAT.”
7: Do you have the data you need to measure your progress against your sustainability strategy?
In response to this question, 46% of respondents said they do not have the data to measure their progress. “As indicated earlier,” said Beth Goodwin, “we believe it is of paramount importance to have a baseline in place for Trusts to be able to set realistic and measurable goals in their Green Plan, and to have this in place as soon as possible. A Trust’s Green Plan should also look back to 1990, and estimate its reduction against the 80% ‘stretch goal’ to enable it to set meaningful targets.
8: How do you update key stakeholders on performance?
Sixty-nine per cent of respondents stated that they use their Trust’s Annual Report to update key stakeholders, with only 15% using the Green Plan. “However,” noted Beth Goodwin, “a Trust’s Green Plan often featured within its Annual Report, so there may be some overlap here.”
9: Which function is responsible for driving sustainability within your Trust?
In the survey, 70% of respondents stated that their Trust’s Estates Department is responsible for driving sustainability within and across the organisation. Beth Goodwin said: “While this wasn’t a surprise, decarbonising the NHS estate is not going to be easy, and every department will have a key role to play; Estates departments will not be able to do this on their own
“It was interesting to note that 30% of Trusts did say that a special team had been created to drive sustainability. This is really encouraging, and we would recommend this approach to tackle decarbonisation. The team should comprise personnel from across a range of departments and different disciplines within the Trust.
“Of concern was that not a single respondent said that the ‘key stakeholders’ within their organisation were driving sustainability in their Trust.”
10: What do you believe are the main barriers currently in place to achieving net zero carbon within NHS Trusts?
“Unsurprisingly,” commented Beth Goodwin, “85% of respondents to this survey question stated that funding was the main barrier. We know that 59% of buildings across the NHS estate were built pre-1994, and will require investment either to reshape them, or to develop new buildings. The decarbonisation of heat will be one of the biggest (and most expensive) challenges for Trusts, which is why having a heat decarbonisation plan in place is of great importance. Fifty-four per cent of respondents stated that COVID-19 had been one of the barriers, which, again, is unsurprising and understandable given the extreme pressures the NHS has faced over the past 12 months during the pandemic. A ‘lack of key stakeholder buy-in’ was cited by 46%. As previously stated, we cannot emphasise enough the need for Boardlevel support for Green Plans and all major sustainability initiatives to succeed; getting to a position where all departments are working in alignment on the sustainability agenda is far more likely if the message is coming from the top.”
11: Which of the below best describes your job function?
The survey results revealed that the vast majority of respondents work in either a Trust Estates Department (38.46%) or in a ‘sustainability’ role (30.77%).
12: Which of the below best describes your role?
Here the highest number of respondents – at 61.54% – were personnel employed in managerial roles, with Director-level staff (23.08%) the next largest category.
Pandemic’s impact felt
Beth Goodwin said of the overall results: “The survey would suggest that – as laudable as the 2040 objective is – its announcement at the height of the pandemic, with the NHS under unprecedented pressures, has almost inevitably resulted in a slow start to implementing meaningful action in many Trusts. The responses received suggest that nearly half do not yet have an overarching plan to achieve the 2040 target, or even the mandated, more shortterm, Green Plan in place. Many Trusts also appear to lack the baseline data to understand their current carbon footprint, and are thus inevitably falling victim to the old adage of ‘You cannot manage what you can’t measure’
“Although the distractions of the last year are understandable,” she continued, “the clock is already ticking towards 2040 – and the lack of Board engagement on the sustainability agenda within many NHS Trusts demonstrated by the survey results, plus the issues highlighted as regards attracting the necessary funding, should perhaps act as a timely wake-up call about the need to refocus efforts as the systemic strain associated with the pandemic starts to abate.”
