10 Resources for your NHS Wales Decarbonisation Action Plan
Croeso/Welcome! In 2019, Welsh Government declared a climate emergency to trigger more action to meet the climate change challenge, the first government in the world to declare such an emergency.
In March 2021, the NHS Wales Decarbonisation Strategic Delivery Plan was published, which details 46 initiatives and targets for the decarbonisation of NHS Wales. These initiatives and targets will be assessed and reviewed in 2025 and 2030.
To support this strategy, Health Boards, Trusts, and NHS Wales Shared Services Partnership (NWSSP) must develop Decarbonisation Action Plans at the local level. To ensure that this work is aligned with each organisation's strategic direction, Decarbonisation Action Plan commitments will form part of their Integrated Medium-Term Plan by March 2022.
Since 2008, the Centre for Sustainable Healthcare (CSH) has worked with healthcare providers, health boards and trusts to create more sustainable healthcare systems. We provide a variety of resources, tools, networks and training programmes to assist organisations in developing and implementing their Decarbonisation Action Plans, measuring impact using 'triple bottom line' (environmental, social, and financial) metrics and collaborating with external partners across the wider integrated care system.
For healthcare organisations in England, please view our Green Plan resources here. Healthcare organisations outside of NHS England and NHS Wales looking to develop their sustainability plans may also find the below resources useful. Please get in touch with us if you would like to discuss this further.
Table 1. Decarbonisation Action Plan sections matched to CSH resources
1. Free elearning modules
CSH has partnered with Health Education England's elearning for healthcare platform to provide free elearning modules to all staff groups. These modules are also applicable to the Welsh context and take approximately 30 minutes to complete. They include certificates that can be downloaded.
- ‘Building a Net Zero NHS' raises awareness about the demands and opportunities of a sustainable healthcare system. It presents a short animated film about a healthcare worker discovering the existing work on preventing climate change in the health system. It includes interactive activities that reinforce key information and case studies of successful projects
- ‘Environmental Sustainability in Quality Improvement' empowers staff to integrate financial, social, and environmental measures into their QI projects
- 'Sustainable Dentistry’ (due June 2022) describes the relationship between climate change and health and the application of sustainability principles in the dental setting
The modules can be accessed here.
2. Short courses
The Centre for Sustainable Healthcare offers a series of training courses that equip participants with the skills and motivation to initiate and deliver innovative low-carbon healthcare. Designed for health staff at all levels, they consist of:
- Four hours of engaging and interactive self-study materials
- A live online workshop led by national experts to help participants apply theory to practice and design sustainable healthcare projects
- A follow-up café session to share project findings and receive further advice
“The courses provide a fantastic opportunity to network with other like-minded health care professionals”
“A knowledgeable faculty provide real-life examples of how sustainability projects can improve the NHS for patients and the environment”
3. Green Ward Competition
This award-winning leadership and engagement programme mentors six teams from a health board or trust to identify carbon hotspots in their service and then develop, implement and evaluate a sustainable quality improvement project. A cash prize is awarded to the team whose project has the biggest positive impact or potential to do so and the highest quality projects are recommended for spread throughout the organisation.
In 2020, the Green Ward Competition at Frimley NHS Foundation Trust was won by the paediatric respiratory team. Their project reduced the environmental impact of metered-dose (‘puffer’) inhalers used in the paediatric service. The forecast annual savings for all teams was £12,417 & 424.3 tonnes CO2e. The Recovery Team were the winners of the University Hospital Dorset Green Ward Competition. They replaced single-use ethyl chloride spray for spinal/epidural block testing with a reusable metal ‘cold stick’. The forecast annual savings for all teams was £37,042 & 16,399kg CO2e respectively.
Benefits of the Green Ward Competition include:
- Training clinical staff in the skills required to run sustainable quality improvement projects and to teach others
- Engaging senior leadership in sustainable healthcare through inviting them to judge projects
- Forging good working relationships between all those required to deliver sustainable healthcare, especially helping sustainability managers work with clinicians and quality improvement teams – a real morale booster
4. Sustainability in Quality Improvement
The recent net zero targets for the NHS acknowledge that significant change needs to occur to make healthcare more sustainable. But how? The mechanism for change in the NHS is quality improvement (QI); integrating sustainability into your QI framework will help to ensure that sustainability is included in every QI and transformation project carried out in your organisation. This will help to embed sustainability into operations and governance, create sustainable improvements and change culture.
The SusQI framework is an innovative approach to holistically improve healthcare by assessing quality through environmental, social and financial impacts – these three factors combine to form the ‘triple bottom line’. By applying CSH’s four principles of sustainable healthcare, health professionals can respond to both environmental challenges and social inequalities, while also saving money. There are many examples of how the framework has been used in different organisations to achieve sustainable transformation; visit our Green Ward pages and Green Surgery Challenge pages to find more examples. CSH offers a 3-part Sustainable Quality Improvement course and open access project resources.
Contact Dr Frances Mortimer if you would like to discuss integrating sustainability into quality improvement in your organisation.
5. Sustainability Fellows and Scholars
CSH partners with the NHS and medical specialties to train clinicians to move Decarbonisation Action Plans forward strategically through full-time Fellow and part-time Scholar roles. Fellows and Scholars are mentored by CSH experts and supported by in-house resources including training courses, web-based networking tools, online case libraries and the sustainability in quality improvement (SusQI) toolkit.
A CSH Sustainability Fellow is seconded or employed to work half- to full-time on sustainable healthcare for 1-3 years. Fellowships often include a research element supported by a university partner; they may focus on a clinical specialty or on a cross-cutting theme such as education, quality improvement or a specific topic (e.g. single-use plastics). A CSH Sustainability Scholar is allocated 1-2 days per week to work on a decarbonisation related project over the course of a year and is based in a host organisation – often a health board or trust.
Current examples include:
- National Fellow in Sustainable Anaesthesia, in partnership with Newcastle University Hospitals NHS Foundation Trust and the Association of Anaesthetists
- Welsh Clinical Leadership Fellow in partnership with Cardiff and Vale University Health Board
- Eye Scholar at Barts Health NHS Trust
Currently, NWSSP are trialling a Group Scholar Programme (for 10 members of staff using ½ a day a week to deliver a sustainable procurement intervention) in Cardiff and Vale UHB. Guidance on how to set up a fellowship or scholar position and how to gain funding can be accessed here.
6. Board Level Training
For executive-level staff we offer two interactive 90-minute workshops. We outline the expectations of the NHS Decarbonisation Strategic Delivery Plan, highlight what is unique about leadership for sustainability and explore how to inspire people to lead and measure change.
For more information, please email Stefi Barna.
7. Carbon Literacy and Footprinting
Identifying your carbon hotspots puts you in the best position to set your Decarbonisation Action Plan priorities and to develop decarbonisation initiatives with the highest impact. CSH offers a variety of free carbon footprinting tools and resources, as well as a short course, Carbon Footprinting for Healthcare. In-house experts can help estimate and analyse your carbon footprint at an organisational, departmental or clinical pathway level. Current examples include modelling the carbon footprint of dental procedures and analysing the triple bottom line of eye motility services at Moorfields Eye Hospital and its satellites.
For more information, please email Ingeborg Steinbach.
8. The NHS Forest
Your site can be literally greener, drawing holistically on the therapeutic potential of nature. NHS guidance tasks health boards and trusts to prioritise interventions that simultaneously improve patient care and community wellbeing while tackling climate change and broader sustainability issues. Green space initiatives can do this.
The NHS Forest is a national alliance of over 200 UK health sites working to transform their green space and to realise its potential for health, wellbeing and biodiversity. This can mean beautiful gardens for rest and recovery; woodland, orchards, and meadows that help to lock up carbon and growing space for fruit and vegetables to supply hospital kitchens. This good practice network captures learning from the best NHS green space initiatives, both at health sites and in the community, and works with individual health facilities on innovative projects. The potential for health boards and NHS Trusts to work with the NHS Forest is highlighted in the NHS Wales Decarbonisation Strategic Delivery Plan:
"Health Boards and Trusts may wish to work with organisations such as NHS Forest to develop green spaces, encourage biodiversity, develop localised carbon sinks and provide a space where the health and wellbeing of patients, staff and communities can be enhanced. These areas can also be used to aid recovery and social prescribing."
The NHS Forest runs an annual conference and awards scheme, and provides help and guidance on all aspects of the use of green space in healthcare, from tree planting advice to research and evidence. Each year during tree planting season, we give away trees to NHS sites that can help plant the NHS Forest. Please email us if you would like to request trees, and to register your site with the NHS Forest network, click here.
We also work in partnership with NHS organisations to employ Nature Recovery Rangers at health sites with a remit to engage patients, staff, and local residents in activities that connect people to nature, support biodiversity, and enhance green space for wellbeing. Learn more about the Nature Recovery Ranger programme here, and if you are interested in partnering with us to host a ranger at your site, please email us for more information.
Our course on Green Space and Health provides evidence, inspiration, and support for health staff developing green space projects.
Our specialty networks are set up around communities of practice, the evidence-based way to support change happening and spreading across Wales and internationally. All staff can join free and start straight away by asking questions and contributing ideas. With over 3,000 people now on over 25 networks, clinical and non-clinical staff can facilitate resource sharing, discussion and peer support. Join the networks here.
Additionally, Green Health Wales is a network of healthcare professionals across Wales who recognise that the climate emergency is a health emergency. You can connect to green groups based on your location or specialty in order to benefit from their collection of resources and be inspired by others working in healthcare across Wales.
10. Development of Decarbonisation Action Plans
The Centre for Sustainable Healthcare can co-develop your organisation’s Decarbonisation Action Plan. Together with relevant stakeholders, we will help you create a vision, approach and initiatives to reduce your carbon emissions while improving patient care. Your plan will address your local priorities while following the national Welsh trajectory for a net zero Public Sector by 2030.
For more information please email Ingeborg Steinbach.