05.06.24 Climate

Climate Action Programme Case Study: NHS in Bristol

In this Climate Action case study, Sam Willitts, Head of Sustainability Integrated Care System NHS Bristol, North Somerset and South Gloucestershire reflects on how framing climate action as a health issue can drive staff engagement, and why carbon budgets are fundamental to making climate action part of business as usual.

Staff-led climate action

We’re in a good position here in the NHS in Bristol, because we have pushed ahead at a greater pace thanks to our 2030 target, which aligns with the city’s. The near-term target has helped us develop a clear focus and simplify our decision-making. For example, if an intervention or initiative is unlikely to deliver the change we need by 2030, it won’t be considered. With this focus, we have been able to make big changes over the last few years, for example, we’ve de-steamed both our Bristol hospitals, resulting in a 2,122 tCO2e carbon reduction in the city centre. That being said, the real wins are where you see staff making changes themselves, going above and beyond to make climate action part of their work.

Our Green Operating Day, devised by Southmead’s Neurosurgery team, is a fantastic example of how impactful staff-led action can be. Inspired by one of the surgery’s suppliers looking to reduce their emissions, the team went on to make much bigger carbon savings when they organised a net zero operating day. Staff implemented a range of operational and behavioural changes to reduce waste and energy use across the department, including staff travel and diet choices. By the end of the day, the team had reduced emissions relating to operations by 77%. This case study is now inspiring other departments to look at what they can change to make a lasting impact on their carbon footprint, for example, our Anaesthetics team have removed the highest GHG gases from all of their operations.

What we have found throughout our efforts to engage our staff is that the culture around climate action is changing. There is an increasing recognition that this is a health issue, and if we frame climate action as such, they are more likely to engage, as fundamentally patient care is their top priority. As we look ahead, we’re looking to show how climate action is about sustainable healthcare and look at how we can integrate our work on socio-economic development with our green plan. If we can keep our patients healthy, we can keep them out of carbon-intensive hospitals.

Carbon-conscious decision making

Whilst we have made significant progress in Scopes 1 and 2, Scope 3 remains a challenge, with 70% of our carbon footprint sitting within our supply chain. Although this is one of the most complex areas to tackle, it presents a huge opportunity for us to make a significant impact, as it equates to approximately £2bn of spend each year. We recognise that if we are to achieve our climate goals, every department needs to understand its carbon impact and be equipped to make the right decisions. We have begun to make progress in this area by implementing a new way of working: our sustainability impact assessment with carbon pricing.

Our sustainability impact assessment gives each department a simple tool to assess the carbon impact of purchases and projects, and the assessment must be included within every business case. We have tried to make it as easy as possible for our teams to make the right decision and embed carbon reduction into business as usual. Some of the areas the assessment covers are the carbon impacts of changes in models of care such as reducing numbers of emergency admissions, number of bed days, outpatient appointments, staff and patient travel. The assessment also covers impacts on nature giving a financial value for the loss of a tree or greenspace.

Our carbon pricing is probably where we are most progressive. We have assigned a carbon price to goods, services and activities such as pharmaceuticals, an outpatient appointment or a patient bed day. This has helped to translate climate action into something tangible. We have used the government’s Treasury Green Book guidance to establish our carbon pricing, where the carbon abatement cost is the rate used in Bristol council’s (draft) new local plan. The goal is for every business case to be net zero, and if not, then the department needs to factor in carbon offsetting to manage it. This is to be applied through a process of insetting where funds are invested internally into carbon reduction initiatives. Although we’re not charging for carbon yet, we’re finding that this new approach is helping to stimulate questions from different departments, helping them to understand where they need to reduce emissions.

Top tips

  • Make it easy for your staff to make the right decision – build carbon impact into your frameworks and processes
  • Make climate action part of your core business – connect it to the purpose of your organisation
  • Be in the room with your decision-makers – help them understand why decision-making needs to incorporate climate action

NHS Bristol is a member of our Climate Leaders Group

Through our Climate Action Programme collaboration with the City Centre and Redcliffe & Temple Business Improvement Districts, we’re keen to showcase climate progress and create more opportunities for businesses to learn from one another.

If you have an initiative or project we can shout about, please do get in touch with bex@bristolclimatenature.org.

Find out more about the Climate Action Programme

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Green Operating Day Team Picture