A Proposal by Enviros Limited : December 2003

working with

• developing an achievable and challenging plan to reduce the organisation’s carbon emissions;
• embed a process of engagement and culture change so that carbon management becomes part of the routine management of the Trust.

South Tees Hospitals NHS Foundation Trust

Carbon Management Plan (CMP)

Date: 17/03/11

Version number:Draft (3)

Owner: Ian Roberts

Approval route: Board

Approval status:

1

South Tees Hospitals NHS Foundation Trust

Carbon Management Plan

CONTENTS PAGE

FOREWARD FROM CHIEF EXECUTIVE4

FOREWORD FROM CARBON TRUST5

EXECUTIVE SUMMARY6

1INTRODUCTION10

2SUSTAINABLE DEVELOPMENT AND CARBON MANAGEMENT - THE

CASE FOR ACTION12

2.1 Context and Drivers12

2.2 Our Low Carbon Vision13

2.3 Strategic Themes14

2.4 Targets and Objectives14

3EMISSIONS BASELINE AND PROJECTIONS16

3.1 Scope16

3.2 Baseline16

3.3 Extended Baseline18

3.4 Projections and Value at Stake18

4CARBON MANAGEMENT PROJECTS20

4.1 Existing Projects20

4.2 Planned/Funded Projects21

4.3 Near Term Projects22

4.4 Medium to Long Term Projects22

4.5 Projected Achievement towards Targets23

5CARBON MANAGEMENT PLAN FINANCING24

5.1 Assumptions24

5.2 Benefits/Savings - quantified and unquantified24

5.3Additional Resources25

5.4 Financial Costs and Sources of Funding25

6ACTIONS TO EMBED CARBON MANAGEMENT IN THE PCT26

6.1 Corporate Strategy - embedding CO2 saving across the PCT26

6.2 Responsibility - being clear that saving CO2 is everyone’s job26

6.3 Data Management - measuring the difference, measuring the benefit27

6.4 Communication and Training - ensuring everyone is aware27

6.5 Policy Alignment28

3

7PROGRAMME MANAGEMENT OF THE SUSTAINABLE DEVELOPMENT

AND CARBON MANAGEMENT PLAN29

7.1 Strategic Ownership and Oversight29

7.2 The Carbon Management Implementation Team - delivering theProjects29

7.3 Succession Planning for Key Roles30

7.4 Ongoing Stakeholder Management31

7.5 Annual Progress Review31

APPENDICES

Appendix ACarbon Management Matrix – Existing

Appendix B Carbon Management Matrix – Target

Appendix C Staff Engagement Activities for Carbon Reduction

Appendix D Major Project Definitions

Foreword from Chief Executive

Carbon management is an increasingly important issue for all organisations and taking sustainability and carbon reduction seriously is an integral part of a high quality health service. The NHS in England is responsible for the production of more than 18 million tonnes CO2 each year from heating, cooling and lighting buildings, powering equipment, procuring goods and commissioning services, sending waste to landfill, and patient, staff and visitor travel.

The NHS has a responsibility to reduce carbon emissions. Not only is it a good thing for a sustainable future, but there is a link between health – our core business – and reducing carbon. There are also sound financial reasons for reducing carbon emissions.

This plan sets out how we at South Tees Hospitals NHS Foundation Trust plan to reduce our emissions, and it also outlines how we can influence others to reduce their emissions too. Our Board of Directors supports the development of this plan, and is keen to see real changes over the next five years so that we can achieve a 25% reduction in our baseline emissions.

This Carbon Management Plan reminds us that respect for the environment is at the heart of our business strategy. Carbon reduction is not something extra to do on top of all the other things we do – it should be part of our core business because it is good for the environment, good for our local area, good for our staff, and most importantly, it is good for our patients.

Simon Pleydell

Chief Executive South Tees Hospitals NHS Foundation Trust

Foreword from Carbon Trust

Cutting carbon emissions as part of the fight against climate change should be a key priority for NHS Trusts - it's all about getting your own house in order and leading by example. The UK government has identified the NHS sector as key to delivering carbon reduction across the UK in line with the Climate Change Act targets, and the NHS Carbon Management programme is designed in response to this. It assists NHS Trusts in saving money on energy and putting it to good use in patient care, whilst making a positive contribution to the environment by lowering carbon emissions.

South Tees Hospitals NHS Foundation Trust partnered with the Carbon Trust on this ambitious programme in 2010 in order to realise substantial carbon and cost savings. This Carbon Management Plan commits the NHS Trust to a target of reducing CO2 by 25% by 2015 and underpins potential financial savings to the organisation of around £2.5 million by that date.

There are those that can and those that do. NHS Trusts can contribute significantly to reducing CO2 emissions. The Carbon Trust is very proud to support South Tees Hospitals NHS Foundation Trust in their ongoing implementation of carbon management.

Richard Rugg

Head of Public Sector, Carbon Trust

Executive Summary

During 2010 South Tees Hospitals NHS Foundation Trust participated in Phase 5 of the Carbon Trust’sNHS Carbon Management Programme. The purpose of the programme is to understand and develop a plan to reduce the organisation’s carbon emissions.

This Carbon Management Plan sets out the Trusts approach towards climate change and has the following primary objectives:

• Ensure the delivery of an achievable and challenging carbon management plan;

• Embed a process of engagement and culture change so that carbon management becomes part of the routine management of the Trust at a strategic and operational level.

Our vision is that South Tees Hospitals NHS Foundation Trust will:

“Become a leader in carbon management in the local community working with our staff, patients, suppliers and key local stakeholders to achieve and exceed the targets set by the NHS.”

We have set ourselves a target toreduce CO2 emissions from our operations by 25%, which equates to 7285 tonnes CO2, by 2014/15 from 2008/09 levels and to work with our partners in the wider health economy to reduce carbon emissions in the community. The Trust has identified 4 key themes for action on carbon reduction:

• Improvements to the Built Environment – Investment in improvements to the built environment (engineering and building) to improve energy efficiency. This theme underpins the majority of carbon reduction projects identified in the plan and it is anticipated that this theme will deliver the largest percentage reduction in carbon;

• Behavioural Change – Raising awareness and changing behaviours and attitudes among staff towards carbon reduction. This theme will include a targeted reduction in carbon as a result of business related travel;

• Policy Alignment – Reviewing existing policies and procedures to ensure carbon management is embedded in the routine management of the Trust at a strategic and operational level;

• Community Engagement -As the Trust prepares to manage a range of community services in the Middlesbrough and Hambleton & Richmondshire localities real opportunities will be presented for the Trust to work more closely with partnersto reduce carbon emissions in the community and to ensure that the commissioning of health servicestakes carbon reduction into consideration

Our baseline emissions for 2008/09 are 29,141 tonnes of CO2 which can be broken down into the following areas:

The current cost of these emissions is estimated at £5.26M which, if no action is taken to reduce emissions growth would increase, allowing for inflation to £7.89M. If the recommended target reduction in emissions is achieved the cost would be £5.42M, a Value at Stake of £2.47M. This saving is presented in terms of costs that can be avoided.

High level estimates of carbon and financial savings together with indicative investment requirements required to support delivery of the plan are shown below:

A significant amount of work has already been undertaken since the baseline year of 2008/09 to reduce the organisations carbon footprint. However, there is still a lot to be done and number of future projects have been identified which will help the Trust achieve its 25% target reduction in emissions over a five year period.

These includeCombined Heat and Power installations at the JamesCookUniversity and FriarageHospitals, heat recovery equipment at JCUH laundry, provision of energy efficient lighting and a communications strategy that will support the implementation of a carbon awareness culture with across the organisation. Investment requirements and savings associated with a number of major carbon reduction projects identified in the plan are shown in the following table:

Costs and associated savings identifiedare estimatedbased on guidance from the Carbon Trust and will be subject to detailed review during the development of individual business cases required to support investment decisions as part of the Trusts annual business planning cycle.

Investment decisions for individual projects will be made against a number of criteria including carbon saved (tonnes), investment required and payback period. Confidence within the project team remains high that the identified projects will proceed. Although internal finance available for investment in projects will be at a premium, all opportunities for securing external finance will be explored and the team are optimistic that with sufficiently robust business cases Trust Board will remain supportive of investment.

This plan outlines how sustainable development and carbon management will become embedded across the organisation with more robust andmetrics used to measure our carbon footprint year on year in a consistent manner that will allow progress against the reduction target to be measured.

Progress against the savings targets identified in the plan will be reportedannually through the performance and governance structures within the Trust to Board level.

The approved Carbon Management Plan will be the first step towards a comprehensive Sustainable Development Management Plan (SDMP). It is proposed that the Carbon Management Plan forms the core of a SDMP to be presented to the board during 2011.

1.0 Introduction

The UK Government introduced the Climate Change Act 2008 with a target to cut carbon emissions by at least 80% by 2050, with a minimum reduction of 26% by 2020 across the UK. The NHS has a carbon footprint of 18 million tonnes CO₂ per year, an increase of 40% since 1990. In 2004, the NHS carbon footprint represented 25% of England public sector emissions. The breakdown of those NHS emissions was:

60% procurement,

22% building energy use

18% travel.

In January 2009 the NHS Carbon Reduction Strategy for England, Saving Carbon, Improving Health, was launched. This strategy was developed in response to the need to take action on climate change and in consultation with the NHS and other organisations. It establishes that the NHS should have a target of reducing its 2007 carbon footprint by 10% by 2015 become the leading Public Sector Organisation on Climate Change Mitigation.

This is the fifth year the Carbon Trust has run the NHS Carbon Management Programme (NHSCMP). The NHSCMP supports the delivery of a Carbon Management Plan (CMP) at each NHSTrust involved. This plan highlights risks and opportunities posed by climate change and will provide astrategy to reduce carbon emissions and create cost savings over a set period of time.

This document represents South Tees Hospitals NHS Foundation Trusts response to the challenge of carbon reduction implementation. The NHSCMP takes organisations through the following five stage process:

In developing this plan, a range of staff from different departments and directorates across the Trust have been involved in a number of workshops and individual discussions run in conjunction with the Carbon Trust.

These workshops included:

• mobilising the organisation;
• stakeholder identification;
• opportunities identification;

The results of these work streams together with the outputs from the five steps outlined above have been translated into this Carbon Management Plan. The plan establishes a framework and action plan to deliver carbon saving and embedding carbon management into the Trusts day-to-day operations. In identifying schemes to reduce carbon, the Trust has been as ambitious as possible and has considered a broad range of actions including enabling and direct emissions reductionprojects. The project has involved a range of clinical and non-clinical directorates including, Anaesthesia & Theatres,Finance, Information Technologyand Estates.

This Carbon Management Plan describes how South Tees Hospitals NHS Foundation Trust will reduce its carbon emissions, and identifies the wider role the Trust can adopt with respect to the sustainable development agenda within the wider health economy.

1. Sustainable Development and Carbon management – the case for action
2. Context and drivers

The drivers for reducing climate are both clear and compelling with extensive scientific research establishing a causative link between man-made CO2 and other greenhouse gas emissions with an increase in global temperatures. While scepticism remains in some quarters the evidence is very strong and the preventative principle has persuaded successive governments to commit to reducing emissions by 80% by 2050 as the UK’s contribution to minimising the impact of climate change this century.

A key driver is that the government is committed by legislation to reduce carbon emissions and sees the NHS as being in the vanguard. It is also good practice for the Trust to contribute to reducing carbon emissions as part of its overall response to the ever developing sustainability agenda. Levels ofcarbon emissions are directly related to energy consumption and with continuing price increases failure to act to reduce emissions presents a significant risk of funds for frontline services being diverted into ever-increasing energy bills.

The case for carbon reduction is strengthened by the financial constraints facing the NHS. With little real growth in NHS expenditure and increased demand for services there is a significant incentive to reduce both energy use and carbon emissions and therefore release cash for frontline services. A recovering world economy, limitations on energy supply and a more challenging regime in terms of carbon taxation will drive energy prices above general inflation for the foreseeable future. The reduction in carbon should not just apply to the Trusts direct energy consumption but also to the supply chain of our suppliers of goods and services if we are to achieve significant cost efficiencies.

Climate Change if left unchecked is expected to have significant impacts on public health (e.g. increasing frequency of heat waves) and it should be recognised that opportunities to reduce carbon emissions can also have positive health impacts e.g. walking/cycling versus cars. In the UK[1], increases in deaths, disability and injury as a result of climate change can be linked to:

• extremes of heat and cold;
• floods and storms, including health hazards from chemical and sewage pollution;
• food poisoning;
• respiratory problems from the damaging effects of surface ozone during the summer and mould growth in housing;
• skin cancer and cataracts;
• Insect-borne disease from increases in flies and fleas.

The global impact of climate change will indirectly affect the UK[2] with:

• crop failures causing food insecurity through rising prices and possible shortages;
• conflict over water, land and food supplies, and major flooding, leading to mass migration, creating potentially huge numbers of displaced people.

The national strategy on reducing carbon within the NHS (‘Saving Carbon, Improving Health’) was launched by the NHS Sustainable Development Unit in January 2009. It presents the case for the NHS taking a lead in carbon reduction on the basis that it is the biggest employer in Europe, that there are real threats to health from climate change and that reducing carbon emissions saves the NHS money and is cost-effective. It requires every NHS organisation to have a carbon reduction board approved policy and establishes a 10% reduction target in the total NHS carbon footprint on 2007 levels by 2015.