Sustainability was on the menu once again as the Road show cycled it’s way to the North-West and arrived in Liverpool to a warm welcome. Delegates from across the city and throughout the North-West were on hand to participate in an inspiring day of presentations, knowledge sharing and motivation.
Sarah Dewar and Professor Maureen Williams, Deputy Chair NHS Liverpool CCG were on hand to deliver inspirational sessions focusing on debate, action and good practice. Delegates entering the event were asked to jot down what they wanted to take away from the day via post it notes which were then displayed on the entrance to the venue. Postcards were also handed out with delegates tasked with writing down what they will do on NHS Sustainability Day.
The morning session kick-started with Fiona Daly, Environmental Manager at Barts Health, discussing Sustainability Day on March 27th 2014. Fiona was followed by Professor Sir Ian Gilmore, University of Liverpool who spoke passionately on the city and the important role sustainability can play in improving healthcare and supporting the people of Liverpool. The morning session also saw presentations from Dr Tim Ballard, Vice-Chair of the RCGP who was on hand to address the role sustainability can play in general practice and supporting commissioning of health services.
The mid-morning session saw best-practice examples on a wide range of areas including waste and water. Royal Liverpool and Broadgreen University Hospitals Trust were on hand to discuss their work with Carillion around the new development in the city.
The afternoon discussions saw delegates interacting with each other to identify solutions to the challenges they face around sustainable development. The day concluded with delegates outlining their promises via the postcards distributed earlier in the day.
It is these promises which will ensure NHS Sustainability Day 2014 is a success and the weight of expectation amongst the Liverpool delegates was high. Many of them leaving the venue inspired, motivated and enthused. It is through this motivation that the NHS has a chance to deliver huge change in the next few years via sustainable practice and with inspiration such as that seen in Liverpool we think the future is looking bright!
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NHS Sustainability Day Liverpool CCG Road Show
1. Welcome to the Liverpool CCG NHS
Sustainability Day Road Show
#Dayforaction
2. Care for the Future
Liverpool 4th December 2014
Professor Maureen Williams
Deputy Chair
NHS Liverpool Clinical Commissioning
Group
3. Aims and objectives of event
• Promote dialogue about sustainability in NHS and how
integrate with sustainability in social care and PH to make
system wide
• Broaden agenda from estates based measures to models of
care…increase understanding of what this means
• Share good practice
• Promote activity for NHS sustainability day
• Galvanise momentum for action and build network of
protagonists
4. Liverpool CCG Long Term
Need to Achieve?
More emphasis on prevention
More emphasis on early identification of illness
More emphasis on self care
More targeted support when not well
Easier navigation of services
5. Social Value and
Sustainable Development
• Public Services (Social Value) Act 2012
• Strategic Opportunity
• Increasing the social, economic and
environmental wellbeing of the people we
serve
• Clear link to Sustainable Development agenda
6. Social Value Aims
Building Social Value
to Improve health
Outcomes by…
• maximizing impact of clinical services
• supporting non-medical solutions
• positively influencing social determinants
of health
Place Social Value at the centre of
our thinking and
policy, commissioning and
practice.
Ensure the way LCCG invests and acts
achieves maximum benefit to the
population we serve now and in the
future.
7. LCCG Developing
Approach
•
•
•
•
Strategic approach to social value
Supports CCG Vision and Values
Supports system planning – Healthy Liverpool
Takes into account input from third sector, LCC inc
public health, NHS providers and partners
• Economic, Social and Environmental measures
• Aiming for collaboration across NHS in Liverpool,
with LCC and city wide
8.
9. Liverpool Food Alliance
The Liverpool Food Alliance is a network of food
growers, composters, buyers, cooks and
eaters, passionate about a positive healthy food culture
for
Liverpool
LFA aims to make enjoying good food easy and
affordable for everyone and to grow a local,
eco-friendly food economy for the future.
10. Sustainable Development Strategy for
NHS, Social Care and Public Health System
Overarching strategy in line with draft..plus..
• Released in January
– Carbon hotspots
– Engagement and leadership
– Strong and resilient
communities
– Commissioning and
procurement
– Clinical models of care
• To be developed
during 2014…
– Social
capital/value
– Research &
Development &
innovation
– Metrics
11. Over today’s meeting want to consider..
– What top three things should commissioning and
procurement do differently to achieve better prevention
and self-care?
– What are the top three opportunities to deliver the mutual
benefit on environment, strong communities and health
priorities?
– How do we engage clinicians in creating sustainable
models of care?
– What are the top three remaining big carbon challenges?
– What will I do after today to bring about change?
12. • Launch of strategy London
29th January
• Sustainable
development
conference
• NHS Sustainability Day
14. NHS Sustainability Day
A call to action for the NHS
• A platform for whole system thinking on sustainable actions
• Showcase for innovation, excellence and best practise
• Opportunity to learn, share, collaborate
• Engage - staff/patients/visitors/supply chain
• Help develop an NHS that is fit for the future
• Do one thing differently
• We hope you will be inspired to take part in 2014
15. NHS Sustainability Day
Motivating Success
•
•
•
•
•
•
•
•
•
•
Day of action and engagement across
NHS
100 organisation participated 2013
300 participating in 2014
Key endorsements
Royal Colleges, associations and Institutes
Sharing knowledge, experience and best
practice
Creating a legacy
National Road Shows
Awards
Internationally showcasing NHS
16. NHS SD Road-shows
Coming to a venue near you
3rd October – Hull
17th October – Official Launch (London)
4th December – Liverpool
29th January – Nottingham
6th February – Royal Bournemouth
27th March – NHS Sustainability Day
19. 14:14
Planting the seeds of change
• Getting the NHS to grow their own
• Reducing the carbon footprint of
patient meals
• Delivering a sustainable legacy for
local grown produce
• Engaging communities to support
their NHS
• Lambeth Food Co-operative case
study
• #dayforaction
• #14:14
20. Celebrating success
Category
Clinical Engagement Initiative
Biodiversity Initiative
Sustainable Food Initiative
Carbon Reduction Initiative
Energy Reduction Initiative
Sustainable Travel Initiative
Waste & Recycling Initiative
Community Engagement Initiative
Best Overall Project Initiative
Description
Winner
Educate all students in the benefits of
effectively controlling anaesthetic gas
scavenging systems and the energy and
carbon efficiencies that can be gained
University of Southampton
Planting 120 Trees to create a mini forest
at the hospital with NHS Forest
Set up Lambeth Food Cooperative to
support sustainable food and local
businesses
Carbon Reduction in energy, travel and
behaviours
Big Easter Switch off and Eco Rhyme
Cycle train around Warwick
Increased recycling and introduction of
new waste recycling streams
Grow your own' project & 200 trees
planted
Carbon Reduction in energy, travel and
behaviours
St Helens and Knowsley NHS
Trust
Lambeth Clinical Commissioning Group
Barking, Havering and
Redbridge University Hospital NHS Trust
Southend
South Warwickshire NHS Foundation
Trust
Isle of Wight
Lancashire Care NHS
Trust
Barking, Havering and
Redbridge
21. #dayforaction
If the NHS can deliver a sustainable focus collectively on
one day, why can't we do it every day - think what a
difference it would make
24. Care for the Future – 4 December 2013
Judith Greensmith, Chair, Royal Liverpool & Broadgreen
University Hospitals NHS Trust
and
David Kennedy, Director,
Carillion
KEEP UP TO DATE WITH
SUSTAINABILITY
Get involved at
www.stnlive.info
Making tomorrow a better place
through our 2020 sustainability strategy
25. RLUH – ‘Sustainable Communities’
We want Carillion to be recognised as a leading sustainable business and
the leading sustainable support services company
Our six positive outcomes for the basis of our 2020 Sustainability Strategy and
encompass Carillion’s economic, environmental, and social contributions and
Impacts.
RLUH Project Vision
Our vision and objective is to leave a social and economic regeneration legacy
for the Liverpool community by:
• Supporting local economic development
• Maximising local training, employment and skills
KEEP UP TO DATE WITH
SUSTAINABILITY
Get involved at
www.stnlive.info
Making tomorrow a better place
through our 2020 sustainability strategy
26. RLUH – ‘Sustainable Communities’
Social & Economic Impact through Local Jobs & Enterprise
Apprentice & Training Opportunities for local people
Local workforce (Merseyside / City Region)
Targeted Recruitment & Up-skilling of people from Priority Wards
Unwaged work placements
Support Student Employability and Learning & Careers Information
KEEP UP TO DATE WITH
SUSTAINABILITY
Get involved at
www.stnlive.info
Making tomorrow a better place
through our 2020 sustainability strategy
27. RLUH – ‘Sustainable Communities’
Social & Economic Impact through Inward Investment
Local construction spend with local Supply Chain partners
Regular Meet the Buyer & SME Development Workshops
Regular ‘Liverpool Third Sector Forums’
Carillion Liverpool Regeneration Fund of £100,000
KEEP UP TO DATE WITH
SUSTAINABILITY
Get involved at
www.stnlive.info
Making tomorrow a better place
through our 2020 sustainability strategy
28. RLUH – ‘Sustainable Communities’
Social & Economic Impact - How we will create our legacy
Committed to establishing RLUH as a CITB National Skills Academy for
Construction (NSAfC) accredited project
Jobs & Training Forum
Work in partnership with local colleges across the City & Liverpool Futures
Support BITC’s BAoH & Business Class Programme
Invest in local charities & support sustainable outcomes
Collaborative working with Liverpool in Work & Local Agencies
KEEP UP TO DATE WITH
SUSTAINABILITY
Get involved at
www.stnlive.info
Making tomorrow a better place
through our 2020 sustainability strategy
32. Food in context
• Chocolate 1kg – over 17,000 litres
• Beef 1kg – 15415 litres
• Butter 1kg – 5,553 litres
* The average person consumes 3,400 litres per day
35. Water Cost & CO2
• Global energy demand
• Cost of water
• Maximum demand
• CO2
36. Water & the NHS
• Total Spend: £79,900,000
• 35 billion litres of water
• 14,240,000 kg of carbon
• Better water management
• A comprehensive approach
39. Automatic Meter Reader (AMR)
• Total visibility on water use at site
• Accurate profiling of your building water use
• Fast reaction to leaks
• Accurate water balance assessment
• Prepares for deregulation of the water market
41. What can be saved?
• 20 – 30% saving
• NHS cost for water: £78,900,000
• 30% saving is 23,700,000
• 10,700,000m3 of water
• A shower everyday for 1 year
42. What help is there?
• East of England Procurement Hub
• AquaFund Grant
• Typical Grant: £300,000 - £600,000
45. Our Partnership with
• Helping those most deprived of
water, out of poverty
• Current project – Nepal
• 6 month Sustainability update
• Positive addition to CSR
* We track your contribution to a dedicated project
48. Blue Green
A Natural Health Service
Gideon Ben-Tovim OBE
Chair Liverpool City Region
Local Nature Partnership
49. • “I climbed a tree and swung off the
branches, it felt amazing”
50. People who live furthest from
public parks 27% more likely
to be overweight or obese.
Children able to play in natural
green space gained 2.5 kg
less per year than children
who did not have such
opportunities.
1,300 extra deaths each year in
UK among lower income
groups in where the provision
of green space is poor.
Natural
England
51. What Can GI Do?
Increase physical activity
Improve air quality
Opportunities for
growing food locally
Improve mental health
Social cohesion
Adaptation to climate
change
Reduce symptoms
ADHD…
52. Evidence
• 80% of LCR LNP is
green/ blue space –
more than any city
outside London.
• £100bn asset
• 8000 LCR jobs in
sector
• GI generating £8 for
every pound
invested
53. Marmot Review
• Health inequalities
• Physical & mental health
• Public think…
– 95% very or fairly important to have
green space near homes
– 90% parks & open spaces improve their
quality of life
– 74% important to physical & mental
wellbeing
• Reconnect to healthy food
• Communities stronger and more cohesive
with good quality green infrastructure
54. Other Health
evidence
• Roadside trees can trap up to 90 per cent
of traffic-related air-borne dust particles
• Reduce risk of flooding
• Climate change
• NICE Guidance for
physical activity
55. “Stretching from our
famous coastline to
our estuaries,
our urban parks and
green
spaces, including our
rural hinterland, the
richness and diversity
of the
Liverpool City
Region’s natural
environment is
unique”
57. LCR GI
Framework
• Health runs throughout strategy
• Wirral Waters, GI interventions of £2m = £29m of
net present value.
• Of these, health and wellbeing benefits being the
most significant @ 50%
65. 4th December 2013
NHS Sustainability Day
Liverpool
Resource efficiency through effective behaviour
change
Ann Durrant
Managing Director
66. A bit about me and M4C …
M4C:
• Sustainability specialists
• Strong focus on comms
• In business over 8 years
Who we’ve helped …
Ann:
• Chartered Engineer
• Ex British Rail and AstraZeneca
• Associate lecturer at Salford Uni
75. SABMiller
• KPIs
• Level assessments
0
1
2
3
Below
minimum
Minimum
standard
Progressing
Developing
leadership
• Areas of risk
• Good news stories
4
Best
practice
5
Leading
edge
82. Summary
•
•
•
•
•
•
•
•
•
•
•
Tell people what to do
Make it easy
Make it normal
Use intrigue
Make it fun
Use memory joggers
Provide feedback
Competitions
Set goals
Give rewards
Link to their values
In line with forthcoming strategy…these are the aims for today…expanding out thinking from carbon reduction to wider sustainability – to integrating sustainability thinking in all systems…Important time for this workNHS and Local Govt facing significant challenges…New solutions needed – paradigm shift – not hyperbole – in NHS lifetime massive changes have taken place….Communications – from state managed broadcast – to personal/mobileShopping – from local stores – to supermarkets – to internet... Travel – from walk, cycle, public transport…to cars & cheap flightsNew model of care for next generation – must address social, environmental and economic wellbeing – a resilient system supporting resilient communities.
LCCG undertaking review of whole health economy system in light of this contextHealthy Liverpool Programme…developing 5 year strategy for LCCG…looking at what we need to achieve More prevention – upstream action to avoid ill healthEarly Detection – how change culture of late presentation and poor knowledge of warning signs?Self-care – how support people, families and communities to know how to look after themselves and each other to stay healthy and to live better with long term health conditionsTargeted support when not well – when health and care services are needed, making sure the support is appropriate, effective and in the right place at the right timeEasier navigation – making it easy to find the right serviceAll these chime with sustainable models of care…and reflect the direction of travel we need to move in…
From this year new legislation for public bodies – opportunity to embed sustainable development through commissioning…At NHS Liverpool CCG, as commissioners – we see taking a strategic and committed view of social value as an opportunity and a framework to achieve sustainable development - bringing social, environmental and economic wellbeing in everything we do and commission. We are developing a social value strategy that will enable sustainable development to be at the heart of the CCG. Working with LCC social care and PH colleagues and others, can we build something across the city that means sustainable development is integral to how we conceive of services.
An example…In Liverpool we’ve been working together as a health economy to co-ordinate our efforts on carbon reduction through the Carbon Collective. All Trusts have accredited carbon management plans in place, we’re collaborated on renewable energy and sustainable transport projects and we developed a campaign across 10 Trusts to promote Simple Actions to save energy and waste. The campaign recently won a Gold and Silver award at the recent Chartered Institute of PR awards so congratulations to everyone for this – lots of people I room were involved. Want to take this forward, building on the messages and bringing NHS staff on the journey to a more sustainable health and care system…
National consultation on a new Sustainable Development Strategy took place this year – there was a hugely positive response…947 responses – NHS, LAs, royal colleges, CCGs…>90% support to expand NHS Carbon Reduction plan to create broader Sustainable Development strategy for whole health and care system.NHS Liverpool CCG welcomes new strategy for Sustainable Development across NHS, social care and public health. Launched January 29th 2014- new strategy will help direct us to new paradigm addressing the wider sustainable development concepts around fair economics and social equality as well as carbon reduction and promoting healthy environments.Above sets out the detailed areas the strategy will address supporting the overarching strategy.
In this afternoon’s session we will discuss these questions having heard from speakers. Encouragingly, there are many leaders to help guide all of us in this path and examples of good practice taking place now, demonstrating that we can find innovative and effective solutions to the issues we face now and for future generations.At today’s event – we are fortunate to share the experience of these leaders and use this time to consider how we build these ideas into improving Care for the Future.
Presentation will cover:-why green space is one of LCRs greatest health assetsWhat the local nature partnership is – and a sneak preview of our new identity Nature Connected..Examples of green space and healthSuggestions for harnessing this asset for health more
Being active outdoors is one of the best preventive health and healing activities available to us.It’s an instinctive reaction…we simply feel it.. But also ..compelling and extensive evidence base … improves mental and physical health and shown to reduce health inequalitiesThe Marmot Review 2009Public health outcomes indicators …NICE.…CABE….NHS HEATWAVE PLAN…PUBLIC HEALTH WHITE PAPER..
Green Infrastructure – all our green and blue spaces The image is the international good example of Landlife’s work in Kirkby using GI to transform an area and provide opportunities for local people.
Methodology for quantifying what natural environment contributes to us now well established….work led by The Mersey Forest – national leaders in this.Economic, social and environmental benefits… jobs, ecosystem services, environmental attractiveness for business investment, house prices…. That 80% of our area is GI presents a tremendous potential asset for health and wellbeing – It is the USP of the Liverpool City Region – more GI than any other UK cityWhat other city offers urban vitality right up to the beach? Where else in the UK do the forces of nature offer such potential energy solutions? What other city brings cruise liners and container shipping to 800 years of port city diversity? Where else does urban living include river and parkland, red squirrels and ferry rides?
But crucial to maximising this asset is making sure the spaces which are near to our poorest communities are of high quality and easily accessible.There is a significant international and national body of evidence supporting the role of green space in promoting health and wellbeing. And in reducing health inequalitiesOne of the most significant review of the evidence base for health - Marmot reivew..bringing health inequalities and green space agendas together through evidenceThe psycho-social effects of green space mean that even time spent looking at natural environment improve our wellbeingA view of green space improves recovery time for hospital patientsIts hard wired into our make-up to spend time in a natural worldWith >50% populations living in cities – we must adapt them to meet this need
Cimate change flooding risk reduced by tree planting and gi schemes such as sustainable urban drainageShade prvided by street trees will support vulnerable at risk from heatwaves10% increase in tree cover would cancel out the projected temperature rise from climate change in UKExercise in a green outdoor environment is more effective in improving health than exercise indoors…
Nature Connected will provide strategic leadership and direction to enhance, harness and celebrate our natural environmental assets, and with our partners mobilise resources to protect and manage them for their intrinsic value, and to support sustainable economic growth and improved quality of life.
Government set out LNPs in Natural En White PaperLiverpool City Regions LNP approved end 2012Requirement for LEP and H&WB Board and LNPs to collaborateDuty to co-operateLNP Board – members of LAs, Peel Holdings, MET= Merseyside Environmental Trust
LCR GI framework – evidence and strategy behind the LNPProduced by the Mersey ForestComprehensive evidence base setting out the GI of the LCR, what functions it currently serves and what it could achieve Example of GI investment supporting health and wellbeing..is Wirral Waters…Pie chart shows most benefit is to health and wellbeingAs the need to shift to community models of care, from intensive hospital and specialist treatment to more prevention and self care…GI has to be a big part of the solution…
In Liverpool the GI strategy produced jointly by LC and PCT provided the evidence to develop health and green space concept and test it outThis map shows areas where health and GI needs high and correlateThe Action Plan led to a health funded programme to explore how supporting communities to use and improve local spaces might contribute to improved health and wellbeing.Black dots are where the funded projects took place – meeting health need key criteria for selection
A grant programme was devised on principes ofBuilding community assets – communities devised programmes relevant for their areaStructured around 5 ways to wellbeingNatural Choices for health partnership - 38 programmes right across the cityCommunity leadGrowing food…making places accessible…brining communities together…rejeuvenating land…using existing land…Refugees connecting with local communities growing and cooking food, sensory gardens, community gardens, allotments… community cohesion, environment discussion – climate change on of functions of GI .. Experiencing the Five ways to wellbeing and greening spaces …
At the start of the programme 16.3% of participants who completed well-being cards had a ‘low’ well-being score, whilst 70% had an ‘average’ well-being score and 14% a ‘high’ well-being score.By the end of the programme 6% of participants still had a ‘low’ well-being, however fewer had an ‘average’ well-being score (60%) and more participants had a ‘high’ well-being score (34%).1
Significant outcomes and potential from programmeHalton also exploring a Natural Health Service approach
Potential for neighbourhood working to support green space activityNHS maximise value of estate for healthPartnerships – eg Alder Hey and Royal designing green space for health and match funding to EU programmeNext week – launch of Nature Connected – LCRs LNPKey partnership with healthMaximise value of assets part of H&WB Strategies..Place green space at heart of a city that enables and encourages health and wellbeing, prevention, self care and recovery.
Sustainability specialists, strong focus on comms and engagementNearly 8 yearsSome of our the people we’ve helped
Conditioning – Pavlov’s dog
Tell people what to doNudge
Improved quality of dataCompetitionFeedbackTelling people what to doMaking it normal
Appeal to their values – management, staff and studentsTell people what to doMake it easyMake it normalCompetitionTell people what to do - Fridge magnets
Make it intriguingMake it funMake it easyCompetitionReward – variable25 reasonable suggestions + a few others that were not so reasonable