The environmental impact of everyday things can come as some surprise. An iPod Nano, for example, weighs in at just 21g, and yet manufacturing each one releases 13kg of carbon dioxide into the atmosphere, according to estimates. Imagine, then, the impact of something as gargantuan as the NHS.
Thankfully, we don't have to imagine. The work of the NHS Sustainable Development Unit (SDU) has given us a good measure of the size and nature of the environmental footprint of the NHS. The bottom line is that Europe's biggest employer is also Europe's biggest public sector polluter, accounting for one quarter of all public sector carbon emissions in the UK – and this is before we add emissions related to other providers of health and social care.
So why should we care? There are several good reasons – legal, financial and ethical – why everyone working in health and social care should take environmental sustainability seriously. Government policy will make it increasingly difficult (and expensive) to ignore sustainability, and the health and social care sector is coming under growing pressure to reduce its environmental impact. The government's 'Carbon Reduction Commitment', launched in 2010, and other policy levers still in development such as carbon budgets, mean that poor environmental performance will have new costs attached. These costs will increase substantially as carbon prices rise.
Rather than waiting for government policy to force their hand, forward-thinking organisations are already seeing the opportunities that sustainability presents. Other business sectors have found that a focus on sustainability can act as a powerful driver for innovation and improved efficiency. Cost-benefit analyses indicate that many carbon-reducing interventions in health care, such as reducing drug wastage or installing combined heat and power units in hospitals, could deliver significant net savings to the NHS.
Ultimately, it is also in patients' interests that we pay attention to sustainability. The 2010 annual report by the Department of Health's Chief Medical Officer highlighted 'substantial and fortuitous overlaps' between sustainability and good quality care. For example, transforming care pathways or delivering care closer to patients' homes can reduce emissions while also improving the care received by patients.
However, there is much that remains unknown about how we can develop more sustainable health and social care. Over the next year The King's Fund will be conducting a scoping review to establish the priorities for future research in this area, with funding from the National Institute for Health Research and the Social Care Institute for Excellence. By clarifying the research needs, we hope to create a framework to co-ordinate future research on sustainability in health and social care. This will build on the 'route map for sustainable health' recently published by the SDU.
Over the next decade, environmental sustainability seems set to become an increasingly prominent concern within health and social care, as in other sectors. The long-term challenge goes well beyond changing light bulbs in hospitals – it will require a transformational change in terms of the kind of care we provide, and the way in which it is delivered. It is therefore an agenda for everyone working in the sector. Only by accepting a shared responsibility will we be able to develop a sustainable health and social care system that meets the needs of the future.