University College London Hospitals (UCLH) NHS Foundation Trust has released a new strategy entitled ‘Critical Care For Our Climate: UCLH’s Net Zero Strategy’, including a focus on digital and technology.
The strategy covers key areas including: clinical activity; procurement and supply chain activities; estates, facilities, technology and transport; education and engagement; and additional factors.
It begins by highlighting NHS England’s wider targets in this area. Emissions which can be controlled directly (the NHS Carbon Footprint) are to reach net zero by 2040, with an ambition to see a 80 percent reduction from 2028 to 2032. Emissions which can be influenced (known as the NHS Carbon Footprint Plus) are to reach net zero by 2045, and aim to be reduced by 80 percent between 2036 and 2039.
“At UCLH, we want to be leaders for the NHS in net zero and have set our own, even more ambitious targets,” the document reads. It states that UCL intends for directly controlled emissions to reach net zero by 2031 and influenced emissions to reach net zero by 2040.
Challenges and successes
To provide context, the strategy notes some of the key barriers to reaching net zero, including funding, cultural challenges, the scale of the work and leased estate complications. One key challenge is identified as innovation: “The world is in a race to invent new technologies that produce clean energy whilst being responsible for minimal levels of carbon emissions. We are likely to be reliant on this if our programme is to be successful. However, infant technology often comes at high expense.”
Early carbon reduction successes are included in the document to offset the challenges, with one such success focusing on the use of virtual clinics. The trust writes: “From April 2021 to March 2022, among NHS trusts in England, UCLH provided the highest percentage of outpatient appointments virtually (43 percent in some months). Video and telephone clinics have almost halved patient travel rates, saving more than 15 million miles of travel in 2021. This saved 4,200 tonnes of CO2 e emissions in 2021.”
The strategy shares an objective: “To reach our net zero targets, we must implement innovative, low carbon models of care in tandem with clinical teams, embrace green technology and research, and implement changes to reduce waste in pathways.”
An area of work here is to ensure that models of care are made sustainable, both environmentally and financially.
Part of this includes further implementation of virtual wards and remote monitoring, which will involve close work with the UCLH transformation team and the wider system, with the ICB to take main responsibility.
In addition, the strategy states: “We will continue to embrace artificial intelligence technologies. Such technology could assist our provision of high-quality care, including supporting with pathway mapping, triage, and diagnostics.”
Procurement and supply chains
On building net zero into NHS procurement, the strategy highlights how UCLH will review the carbon footprint of purchases, starting with their top 10 suppliers by spend. All products will be assessed to determine whether there are areas where the volume of goods used can be reduced, tying into an aim to minimise the amount procured and used per patient and staff member.
A key part of this is reducing paper consumption “by switching to digital alternatives in all areas, including for patients, wherever possible,” the strategy pledges. “A part of this is likely to be optimising how we send letters to patients, combining multiple letters in one envelope and exploring an opt in system for postal communication- ensuring our patients can go paperless if they wish.”
It adds: “We will assess areas with heavy printing requirements and support teams to reduce the content they print, switching to digital alternatives where possible.”
Estates, facilities, technology and transport
The strategy describes how “maximising our use of the available technology to support sustainable change will be crucial to reducing our direct emissions”.
In order to make this reduction, the trust notes that it is important to understand the changes required to increase energy efficiency, reduce energy consumption and reduce fossil fuel use.
“We will adopt more sustainable heating technologies than our existing gas boilers,” the strategy says. “This will be implemented across our estates to reduce our natural gas usage to as close to zero as possible. Given UCLH’s central London location, current technology dictates that this will likely be air source heat pumps for areas with suitable roof spaces and heat networks in other locations.”
On maximising use of technology to support net zero ambitions, the document states: “We will make our digital operations as efficient as possible, ensuring that the systems and networks we rely upon are sustainable. This will be outlined in more detail in our digital strategy.”
It adds that efficient buildings management technology such as localised smart meters will be implemented along with motion sensor lights, local heating controls and low carbon ventilation and cooling systems. Software will also be implemented to insure optimisation of space.
“We will assess the emissions associated with our electronic equipment and work to reduce the impact of this,” the document says. As an example, it notes that the embodied carbon in PCs is large and therefore “we will look to maximise the functional lifetime of such equipment by trying to reduce damage and keeping software requirements as light as possible for as long as possible.”
In order to reduce the trust’s digital carbon footprint, IT hardware policy is to be reviewed to ensure that they have the correct amount of hardware for business needs. Staff will be able to use their own device if they prefer or will have access to a trust-issued laptop as part of a wider device policy.
The strategy shares plans to integrate other technological innovations into care provision, including maintaining virtual appointments for up to 50 percent of activity; updating job planning processes to support staff to group virtual appointments with home admin sessions; increasing the offer of group clinics either by person or video; optimising and consolidating multiple appointments into one visit where possible; and maximising the capabilities of the MyCare patient portal.
On this, the document specifies: “Patients will be able to input more of their own data, gain access to their patient information and appointments digitally, be remotely monitored for certain conditions and be empowered to take greater ownership over their care.”
Education and engagement
In this area, the strategy highlights an aim to ensure that staff are kept informed of the trust’s net zero progress, receive education on sustainability, and know how they can get involved in the programme.
“We will design a comprehensive plan for staff engagement,” the document reads. “The contents of this strategy, our successes, areas for improvement, case studies and future plans will be shared widely and regularly across our organisation in various formats, both physical and digital.”
To read the strategy in full, please click here.