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Nurse managers urged to be active in promoting environmental sustainability

The RCN is lobbying healthcare providers to adopt strategies on environmental sustainability

The RCN is lobbying healthcare providers to adopt strategies on environmental sustainability

A model globe held by a pair of hands with the UK marked in red. The RCN wants nurses to lobby healthcare providers for strategies on environmental sustainability and raise awareness of climate change.
Picture: Alamy

  • The NHS is the largest public-sector contributor to climate change in Europe
  • A resolution passed by RCN congress requires the college to lobby healthcare providers
  • Healthcare providers are urged to develop sustainable policies and raise awareness of climate change

Nursing managers need to be aware of sustainability and think about what it may mean in their workplaces, the RCN says as it addresses climate change.

Gwen Vardigans speaking at RCN Congress. The RCN wants nurses to lobby healthcare providers for strategies on environmental sustainability and raise awareness of climate change.
Gwen Vardigans at RCN congress
Picture: John Houlihan

The college is taking action following a debate at its annual congress, in May, in which nurses spoke passionately about the need for it to lead on climate change.

Members passed a resolution putting the issue on the organisation’s agenda for future action.

The congress resolution requires the college to lobby healthcare providers to develop environmentally sustainable policies and strategies, and to raise awareness of climate change.

During the debate Gwen Vardigans, from North Yorkshire, cited environmental protests by schoolchildren inspired by Swedish teenager Greta Thunberg, protests in London by the Extinction Rebellion movement and extreme weather events, as well as warnings from scientists and the World Health Organization.

She said action was critical and suggested that RCN representatives could become involved in their organisations, encouraging people to reduce waste, recycle and help reduce their carbon footprint.

‘Climate change is the biggest threat of our lives,’ Ms Vardigans told fellow nurses.

‘Sustainability is going to be with us for many years to come, and nurses are going to be at the centre of managing and supporting it’

Rose Gallagher, RCN sustainability lead

590,000 tonnes

of waste was generated by the NHS in 2016-17, of which 15% went directly to landfill and 23% was recycled

(Source: NHS Long Term Plan)

RCN sustainability lead Rose Gallagher says that despite the many kinds of healthcare setting and nurses in the UK, there are several things that all nursing managers can do on climate change.

Nurses urged to learn about the sustainable development

She says: ‘The most important thing for managers is to be aware of the increasing priority of sustainability and think about what that might mean in your workplace.’

Ms Gallagher says work on sustainability has been growing for several years and urges nurses to familiarise themselves with the Sustainable Development Unit, which is funded by and accountable to NHS England and Public Health England.

Its job is to ensure that the health and care system fulfils its potential as a leading sustainable and low-carbon service. 

‘Sustainability is going to be with us for many years to come, and nurses are going to be at the centre of managing and supporting it, and bringing the public with us,’ says Ms Gallagher.

Going green: what some care providers are doing

Barts Health NHS Trust, London

  • Staff are encouraged to turn off equipment, switch off lights and close doors
  • The programme has resulted in carbon savings of 1,900 tonnes a year and energy consumption reductions equating to around 3% (£428,000) of trust consumption
  • Patients have reported fewer privacy intrusions and sleep disruptions, and overall patient experience rates have improved

Northern Devon Healthcare NHS Trust

  • The trust has used £2.8 million in government-backed interest-free loans to help fund a £4.6 million modernisation programme to improve energy efficiency
  • Lifetime savings of £9.2 million are projected from trust projects, with annual savings of 2,500 tonnes of carbon dioxide equivalent
  • Overall annual savings were estimated at £600,000, giving a five-year return on investment, although more recent estimates suggest savings of closer to £710,000 a year

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Dorset

  • All conventional catering packaging, including hot cups and lids, cold cups for drinks and desserts, napkins, cutlery, takeaway boxes and sandwich bags, have been replaced with compostable disposables
  • The catering waste stream costs 70% less than its general waste stream, in addition to saving 8.8 tonnes of carbon and diverting 13 tonnes of used packaging from landfill

 

Each year the NHS emits 21 million tonnes of carbon dioxide equivalent.

The NHS standard contract mandates that all care providers in England produce a sustainable development management plan, and clinical commissioning groups are ‘strongly recommended’ to have one.

‘If a trust has not undertaken a sustainability assessment and put a management plan in place to reduce carbon output, that needs to be challenged’

Rose Gallagher, RCN sustainability lead

Sustainable development management plans address areas such as air pollution, energy, waste and water efficiency, green space and carbon emissions. They also encourage staff engagement in social and environmental activity.

RCN sustainability lead Rose Gallagher. The RCN wants nurses to lobby healthcare providers for strategies on environmental sustainability and raise awareness of climate change.
Rose Gallagher Picture: David Gee

The Sustainable Development Unit offers an online assessment tool for providers to use, and Ms Gallagher wants nurse managers to encourage boards to undertake an assessment, if they have not already done so.

Having a plan to cut carbon output in place

‘For executive nurses, if a trust has not undertaken a sustainability assessment and put a management plan in place to reduce carbon output, that needs to be challenged at board level,’ says Ms Gallagher.

She says managers should work with nurses in their organisations to understand what the priorities are and ensure there is scope to make required changes.

‘The best thing nurses could do is get involved with the procurement process and encourage their staff to engage with procurement teams to help define clinical criteria for products.’

She says nurses working at patient level are a valuable resource to avoid waste and reduce unnecessary items and packaging.

‘Plastics recycling comes up again and again, but many organisations don’t have dedicated waste managers to do the right thing.’

21%

reduction in water consumption by the health and care sector between 2010 and 2017

(Source: NHS Long Term Plan)

She says greater action is needed to ensure trusts allow staff to increase plastic recycling and improve management of waste, but also highlights the importance of having someone to listen to ideas and turn them into action.

Simple changes can have a big effect

‘There is nothing worse than engaging staff around the issue of sustainability and then find there is absolutely nothing you can do to improve it.

‘People will come with you if you make it simple and allow them to do the right thing.’

Ms Gallagher says seemingly simple changes can have a big effect and cites the RCN glove awareness campaign as an example.

‘Look at RCN resources and plan local activity’

‘There are not only implications for the prevention of infection if gloves are inappropriately used, but also there is a waste that occurs through manufacturing and transporting items.

‘If nursing managers have not already done so, they should look at the RCN resources and plan local activity.

‘One thing we learnt from the glove awareness campaign is that, when people discuss their local issues and have the autonomy to target what they feel needs improving, they are much more inventive and committed to doing that work.’

The Green Nurse Network, which is part of the Centre for Sustainable Healthcare charity, is also working to help the NHS reduce its carbon footprint.

A Centre for Sustainable Healthcare spokesperson says there are already more than 150 nurses on the free online network, which includes access to forum discussions, resources and toolkits.

19%

reduction in the carbon footprint of health and social care since 2007, despite a 27% increase in activity

(Source: NHS Long Term Plan)

England’s chief nursing officer Ruth May says the NHS Long Term Plan, with its proposals to improve healthcare and services for the next ten years, will help drive further changes.

Improvements needed throughout NHS supply chain

‘The long-term plan makes bold commitments to ensure the NHS continues to lead by example in sustainable development and reducing our use of natural resources,’ says Dr May.

‘Across the NHS, nurses already provide great leadership in this area and continue to champion positive action to promote sustainability where they work.’

The plan states that progress in reducing waste will be delivered ‘by ensuring all trusts adhere to best practice efficiency standards and adoption of new innovations.’

‘By 2020, we aim to reduce the NHS’s carbon footprint by a third from 2007 levels’

NHS Long Term Plan

It states: ‘Key to this will be delivering improvements, including reductions in single-use plastics, throughout the NHS supply chain.

‘By 2020, we aim to reduce the NHS’s carbon footprint by a third from 2007 levels, including by improving energy efficiency through widespread implementation of LED lighting and smart energy management.

‘We will also improve the way we manage our estate and modernise and standardise our ambulance fleet to help to reduce emissions and to improve air quality.’

Why action is happening now

  • Media coverage of climate change protests and global campaigning by children and adults alike have thrust the issue of a climate change emergency into the spotlight
  • In March, following the lead of Swedish teenager Greta Thunberg, 1.4 million pupils from more than 2,000 cities worldwide took part in school strikes urging adults to take stronger action on climate change
  • Campaigners for the Extinction Rebellion movement, whose tactics include civil disobedience, have staged high-profile protests in London and in other cities across the world
  • In June, the UK government committed to cutting greenhouse gas emissions to zero by 2050, acknowledging it would benefit public health and cut NHS costs
  • A report last October by the United Nations Intergovernmental Panel on Climate Change states that limiting the increase in global temperatures to 1.5 ºC above pre-industrial levels could help slow a rise in sea levels and allow more time to adapt in low-lying coastal areas. The report says: ‘Climate-related risks to health, livelihoods, food security, water supply, human security, and economic growth are projected to increase with global warming of 1.5°C and increase further with 2°C’

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