The activities of an organisation as large as the NHS inevitably have consequences for the environment. Carbon dioxide emissions attributable to the NHS in England alone are greater than the total admissions from all passenger aircraft departing from Heathrow Airport. As financial challenges for the health and social care sector increase, so too does the need for services to be delivered in ways that are environmentally sustainable.
Sustainable Health and Social Care: connecting environmental and financial performance is based on a literature review and stakeholder consultation carried out by The King's Fund on behalf of the National Institute for Health Research and the Social Care Institute for Excellence. The report provides an overview of current knowledge about the environmental impacts of health and social care and examines the evidence for a connection between sustainability, productivity and other system objectives.
The authors consider how health and social care needs to change to become more environmentally sustainable. A key finding is that improving efficiency at the operational level is unlikely to be sufficient. A more fundamental transformation in service models will be needed, with a greater emphasis on prevention, shifting care upstream, better integration and co-ordination of care, and an ongoing focus on maximising value for patients.
Priorities for health and social care organisations include:
developing a more detailed local understanding of the problem through systematic measurement of environmental impacts
exploiting the synergies between environmental sustainability and other organisational objectives
investing in preventive approaches to reduce demand for formal care
exploring the opportunities presented by new technologies such as telehealth and telecare
improving medicines management and prescribing practice to reduce inefficient or wasteful use of pharmaceuticals.
The report also urges policy-makers to remove barriers that discourage organisations from developing more sustainable approaches and to explore the policy changes needed to create a more enabling environment.
A more detailed version of this report focusing specifically on the question of what research is needed to support the development of environmentally sustainable health and social care is available from the National Institute for Health Research.