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NHS Sustainability Roadshow Cardiff


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The presentation from our brilliant day in Cardiff talking about sustainability.

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NHS Sustainability Roadshow Cardiff

  1. 1. #DAYFORACTION WELCOME #dayforaction
  2. 2. #DAYFORACTION Session 1: Value Based Procurement #dayforaction
  3. 3. Refill partnership with City to Sea
  4. 4. Deadline today! sustainability-campaign-partners-with-refill- company/ Chance to win a water station worth £2000 and installed!
  5. 5. Deadline today!! https://nhssustainabilityawards.c Ceremony May 16th- Leeds
  6. 6. NHS Sustainability Roadshow Sustainability Across NHS Wales Christopher Lewis Senior Environment & Facilities Management Advisor
  7. 7. Themes • NHS Wales Carbon Footprint 2016/17 • Policy & Legislation • Data Reporting • Sharing Good Practice (WHEF)
  8. 8. NHS Wales Carbon Footprint 2016/17 • Original exercise was undertaken in 2009 • In partnership with Carbon Trust Wales • Scope 1, 2 and 3 coverage • Response to Welsh Government policy ambitions (eg. Carbon Neutral Public Sector by 2030)
  9. 9. NHS Wales Carbon Footprint 2016/17
  10. 10. NHS Wales Carbon Footprint 2016/17 NHS Wales Carbon Footprint 2016/17 733,185 tCO2e
  11. 11. NHS Wales Carbon Footprint 2016/17
  12. 12. NHS Wales Carbon Footprint 2016/17
  13. 13. NHS Wales Carbon Footprint 2016/17 • Next Steps – Feeds into Welsh Government policy development (LCDP) – Periodic review and update – Improve data accuracy – Inform the development of future targets and NHS policy (All footprint graphics reproduced by kind permission of Carbon Trust Wales)
  14. 14. Policy & Legislation • BREEAM standards for new- build and refurb • ISO 14001 environmental management systems Current tools • Welsh Government Low Carbon Delivery Plan • Environment (Wales) Act 2016 • Well-being of Future Generations Act 2015 Future
  15. 15. Data Reporting / Benchmarking • EFPMS (Estates & Facilities Performance Management System) • Collates data from all HBs and Trusts in NHS Wales (except PHW) • Covers the whole estate and types of data gathered includes energy, waste, water and the range of FM services • Increasing focus on benchmarking means that we need to improve our data quality and how we utilise it
  16. 16. Sharing Good Practice • Welsh Health Environmental Forum (WHEF) • Originally formed in 2001 and still going strong • Representatives from all over NHS Wales with specific groups focussed on energy and waste management • All are welcome* * Must provide own lunch 
  17. 17. Thank you
  19. 19. VELINDRE CANCER CENTRE Reducing Single Use Plastic in partnership with Keep Wales Tidy
  20. 20. INSPIRED BY THE BLUE PLANET PROGRAMME This initiated a new European Strategy for Plastics, raising awareness in National/Local press and on Social Media
  21. 21. “REDUCTION OF SINGLE USE PLASTIC” THE START OF OUR JOURNEY  Internal audit of dining room to establish what plastic items were in use.  Quick wins implemented eg removing all plastic straws  “Great, we have done our bit. No more turtles in the ocean suffering from our straws”. However, it was quickly realised this was not enough.  Invited external companies, including Keep Wales Tidy to demonstrate what products could be used as an alternative to plastic.  KWT introduced us to Eco To Go and their reusable products  Internal evaluation work undertaken by our environmental teams and Operational Services on suitability and sustainability of the compostable products available (Vegware, Cornware).
  22. 22. Last year Velindre Cancer Centre used over 70,000 disposable hot drink cups, placing the cups end-to-end would be the equivalent of: INTERESTING FACTS 7.25 x the height of Pen y fan 5.75 X the height of Snowdon The equivalent distance from VCC to Cardiff Castle
  23. 23. IMPLEMENTATION  Start up costs for purchase of Eco cups and the display stand = £1,100  Offered promotional incentive to customers during the launch. 1 free hot beverage when purchasing an ECO to GO cup.  10p discount for drinks purchased in reusable cup  Adjustments to beverage machines to accommodate the 14oz drinks.  Re-introduced ceramic cups for customers sitting in  Eco to go cup product information was uploaded to the epos till database enabling us to capture the sales data (i.e. Eco Coffee, Eco Tea etc).
  24. 24. LAUNCH OF ECO TO GO CUPS  Launch date 13th November 2018.  Manned display stand in dining room of Eco to Go cups and product information.  Trust intranet and leaflet drops advertising launch day information.  Staff encouraged to purchase the cups on the day at the reduced price (£2.99) with a free beverage included. Usual cup price = (£3.99)  Support from Keep Wales Tidy to promote the cups and benefits to the environment. This included media release, social media coverage and web article.
  25. 25. LAUNCH INFORMATION TO STAFF The Velindre Cancer Centre are proud to launch a new range of Reusable 12oz hot Drinks Mugs These reusable mugs will be available from mid-morning Tuesday 13th November 2018 in the Parkside Dining Room at an Introductorily price of £2.99 each, which includes a voucher for one hot drink of your choice. The Eco to go mugs are made from 80% Risk Husk and 20% Plant Resin which are both biodegradable. The mugs are also Microwave and Dishwasher safe. They are available in a Pink, Blue and Green. Following the purchase of your reusable mug, you will receive a 10p discount on every hot drink purchased when using your Eco to go Mug. Please ask for your Eco to go Reusable Mug in the Parkside Dining Room Did you know that in Velindre Cancer Centre we are using 70,000 single use hot drink cups. End to end that’s enough cups to reach between VCC the Centre of Cardiff. Recent figures released by the Independent showed, that in the UK we use 7 million disposable coffee cups every day – that's 2.5 billion every year You can make a difference, by purchasing an Eco to go reusable mug at the introductory price of £2.99 (including a free hot drinks voucher) from the Park Side Dining Room, you will also be eligible for a 10p discount on every hot drink purchased when using your Eco to go Mug. The mugs are made from 80% Risk Husk and 20% Plant Resin which are both biodegradable, and are Microwave and Dishwasher safe. By simply buying one of these mugs, you will help reduce the impact on our environment and save money. Please ask for your Eco to go Reusable Mug in the Parkside Dining Room
  27. 27. PROGRESS AND ACHIEVEMENTS - QUARTER ONE  300 ECO to Go cups purchased for launch. SOLD OUT by December. A further 150 purchased for January 2019.  The environment is more aesthetically pleasing, less mess and no paper cups full of slops for canteen staff to clear away  ECO display is real focal point, drawing lots of attention from both staff and visitors.  Cup sales of £1,243 to offset initial outlay.  Waste reduction of 114 kilos of general waste and continuing to fall. Cost savings.  In comparison to the same period last year, 5,000 fewer paper cups used (38% reduction. Dropped from 13,000 to 8,000). Predicted cost saving of £1,032 p.a.
  28. 28. FEEDBACK  Feedback from staff has been very positive. Some purchased cups for family and friends, so re-use message is reaching outside of Velindre too.  Some departments purchased cups for the whole teams on launch day.  There has been interest from other health boards and universities who want to start their own plastic-reduction journey.  People were very surprised to learn about the interesting facts and information used as part of our launch Campaign.
  29. 29. REDUCE SINGLE USE PLASTIC Before and After Implementation October 2018 February 2019 Removed paper cups from display and replaced with reusables
  30. 30. SUMMARY  Despite some initial expected moans from staff, the trial has been widely welcomed  Delivered cost savings (less cups bought, reduced waste costs, outlay covered by customers) and a cleaner canteen environment  Future plans include a reusable food container trial late spring/summer  Great example of how to make a start on removing single-use items  Keep Wales Tidy are keen to work with any Health Board who wants to follow Velindre’s excellent example and reduce their single-use waste
  31. 31. Contacts: Louise Tambini Susan Sheppard-Murphy David Harding
  32. 32. Value Based Healthcare in NHS Wales ©Value4Wales,NHSWales Sustainability Day Campaign - Cardiff Roadshow March 14th, 2019 James Griffiths Senior Project Manager Value Based Procurement NHS Wales Shared Services Partnership - Procurement Services Tel: 01656 641215 Email:
  33. 33. Value Based Healthcare in NHS Wales ©Value4Wales,NHSWales 1.Case for change 2.Proposed model Value Based Health Care 3.Problems to solve 4.Procurement – Traditional model to Value Based model 5.Summary – reducing waste / closing the gap 6.Questions
  34. 34. We have a financial crisis £ ©Value4Wales,NHSWales Inability / extreme difficulty to move resource to where it has the greatest impact. No slack in the system to invest in high value primary/community care interventions. Demand driven system. Historically our NHS systems increase demand e.g. systematic outpatient visits not driven by patient.
  35. 35. The Case for Change Value Based Healthcare in NHS Wales ©Value4Wales,NHSWales
  36. 36. Value Based Health Care – 2 models become 1 ©Value4Wales,NHSWales NHS Wales predicated its definition of Value on MP by improving health outcomes for the same/lower costs; combined with MG ensuring ‘allocative value’, where practicable resources are shifted across the organisation, seeking to apportion resources where it has greatest impact, resulting in a replicable and sustainable model
  37. 37. Value - Some problems to solve: ©Value4Wales,NHSWales We don’t measure value in healthcare!! If we don’t measure it how can we manage and improve it? No marrying up of technical outcomes (clinical) to functional outcomes for patients. Focus often on compliance with care processes and standards which are not outcomes!! RTT Best Practice - clinical outcomes can get in way of improvement as there is only good practice that can be constantly improved and fixing practice at a point in time can be a bad thing.
  38. 38. Value - Some more problems to solve: ©Value4Wales,NHSWales Use expensive physicians and skilled staff for less skilled activities Deliver care in over-resourced facilities e.g. routine care delivered in expensive hospital settings. Over provision of low or non-value adding services or tests - sometimes to follow rigid protocols or justify billing. Low utilisation of expensive physicians, staff, clinical space and equipment, partly due to duplication and service fragmentation
  39. 39. Value - More problems to solve (but no need to lose heart!): ©Value4Wales,NHSWales Process variation that reduces efficiency without improving outcomes. Focus on minimising the costs of discrete services rather than optimising the total cost of the care cycle. Lack of cost awareness in clinical teams.
  40. 40. Value - Many problems to solve: ©Value4Wales,NHSWales These are all wasteful and not sustainable!
  41. 41. Value: Cost Measurement – part of the solution! Various Methods: Time Driven Activity Based Costing/ Patient Level Costing/ Programme Budgeting Time Driven Activity Based Costing Peanut Butter Costing - take a lump of cost and spread it around, but are we putting funds in the right place? We are not always looking at productive versus unproductive time. Used Capacity v Unused Capacity of our staff Productive Time v unproductive Time Cost of Space Cost of Patient Space ©Value4Wales,NHSWales There is no such thing as a fixed cost just an inattentive manager!
  42. 42. The relationship of Cost to Outcome in Health Significant variation in Input Cost Consultants Cost Junior Doctors Cost Nursing Cost Therapist Cost HCSW Cost ©Value4Wales,NHSWales Output/Outcome PATIENT This wide variation in input costs is not seen in any other industry or sector anywhere in the World We must STOP spending on things that do not improve health e.g. OPD follow up, unnecessary clinical procedures and; SWAP inputs and change approaches when there are less pricey alternatives of equal value or no evidence of improved outcomes exist .
  43. 43. © Value 4 Wales, NHS Wales Value Based Health Care hand in hand with Value Based Procurement- Unified vision to combat waste: ‘Achieving the best experience and outcomes, that matter to people, whilst being good stewards of the finite resource available, working together to do the right thing across the whole system, improving VALUE for all people across NHS Wales’.
  44. 44. Value Based Health Care hand in hand with Value Based Procurement: ©Value4Wales,NHSWales Increased value/reduced waste Higher Lower PRODUCT Quality driven standardisation Once for Wales, allowing best quality above price threshold. Well proven and still appropriate, based primarily on up-front purchase costs. PROCESS • Total cost of care • Greater transparency and assessment of cost beyond product. • Focus on leaner processes, avoid unnecessary cost, increase efficiency, TDABC/PLICS PATIENT Ultimate goal - putting the PATIENT at the centre, using patient and clinical outcomes to inform the requirement, and good measurement to evidence improved outcomes. Broader socioeconomic considerations. Improved QUALITY _____________________ = VALUE Reduced/maintained PRICE Improved QUALITY _____________________ = VALUE Reduced/maintained COST Improved QUALITY & OUTCOMES _____________________ = VALUE Reduced/maintained COST Not NEW but Not the NORM Progression
  46. 46. VBHC/VBP Closing the demand/capacity gap: © NWSSP-PS © Value 4 Wales, NHS Wales Demand – continues to increase as we do not stop patients coming in. We can invest up front around prevention/services in the community Capacity – available capacity will not change significantly. We need to reduce waste. Use what we have more efficiently Process – focus on process and costs, identify unwarranted variation. Doing everything possible goes some way to closing the gap capacity / demand gap. Patient – collect outcomes so we know what matters to patients. Use outcome data to inform decisions and reduce waste. Further closes gap. Innovative approaches – partnering with suppliers, unlocking innovation and sharing risk can take us even further.
  47. 47. • H2020 EU Bid Rapid Diagnosis Hospital Acquired Pneumonia • Point of Care Testing Patient: Outcomes based payments ERAS • Reduced LOS & Post-op complication rates. • Payment based on % return and improved outcomes after Year 1 Stoma Care • Enhanced after care model - reducing variation across Wales • Financial Flow - allocative Value - shifting resources • Outcomes collection built into contract Product - Patient: Whole system approach Renal Satellite Units • Enhanced patient experience • Improved patient reported outcomes Regional Ophthalmology Faecal incontinence From theory to practice – Some examples, early pilots
  48. 48. Value Based Healthcare in NHS Wales ©Value4Wales,NHSWales Thank you for listening. James Griffiths Senior Project Manager Value Based Procurement NHS Wales Shared Services Partnership - Procurement Services Tel: 01656 641215 Email:
  49. 49. VALUE BASED PROCUREMENT Procuring Outcomes PRODUCT • Quality driven standardisation Once for Wales, allowing best quality above price threshold. Well proven and still appropriate, based primarily on up-front purchase costs. The 3 P’s: TRIANGULATING VALUE: PRODUCT, PROCESS, PATIENT PROCESS • Total cost of care • Greater transparency and assessment of cost beyond product. • Focus on leaner processes, avoid unnecessary cost, increase efficiency Not NEW but Not the NORM Wales’ Definition / Diffiniad Cymraeg ©Value4Wales,NHSWales PATIENT Ultimate goal - putting the PATIENT at the centre, using patient and clinical outcomes to inform the requirement, and good measurement to evidence improved outcomes. Broader socioeconomic considerations. Improved QUALITY _____________________ = VALUE Reduced/maintained PRICE Improved QUALITY _____________________ = VALUE Reduced/maintained COST Improved QUALITY & OUTCOMES _____________________ = VALUE Reduced/maintained COST
  50. 50. Refill Tackling plastic pollution at source.
  51. 51. City to Sea
  52. 52. The problem with plastic
  53. 53. About Refill
  54. 54. The Refill Vision – our objectives Prevent plastic pollution Make carrying a reusable water bottle 'the new normal’. Make free tap water more widely available in public spaces like transport hubs, shopping areas and civic venues.
  55. 55. The Refill Revolution
  56. 56. Refill across the NHS – let’s provide better options
  57. 57. Refill on screen
  58. 58. Step 1: Put your taps on our map!
  59. 59. Step 2: Get more taps for our app! Making it easier for people to Refill their water bottle is one of the most effective ways to prevent the use of single-use plastics. Refill can introduce Trusts to our product partners who have fantastic solutions.
  60. 60. Step 3: Reusable bottles Just 1/3 of people own a reusable water bottle 67% of people said using the Refill app made them more likely to carry a reusable bottle.
  61. 61. 4. Display signage to raise awareness
  62. 62. 5. Engage with your local Refill Scheme Refill is a grassroots, community- led campaign with over 160 local Refill schemes. Ask Refill for information on your local scheme, and get access to volunteers ready and raring to tackle plastic pollution in your area.
  63. 63. NHS – have you got the bottle?!For any more information on bringing Refill to your Trust, please contact me via
  66. 66. 1 Retired as Community Service Manager!! 2 Came back to support/ advise 3 Obvious problem with surplus assets 4 Tasked with exploring the issue Backstory How we got started 5 I knew everybody on the estate, so perfect candidate!
  67. 67. How did we tackle the problem?
  68. 68. 1 Visit areas and identify items 2 Centralise and reuse 3 Collected items myself 4 Arranged porters or external contractors Action! 5 Saved £80K in Mental Health Services!!
  69. 69. “No storage” Linked up with charity who exports items to 3rd world
  70. 70. • Co- opted into committee • Slow • Red tape • Agreed to use Warp It platform to scale up activity
  71. 71. Warp It on line reuse Staff can see Needs senior support Saved £48K Only 300 staff joined Needs more promotion!!
  72. 72. What now?
  73. 73. 2 days a week! Deputy Chief Exec Climbing Everest!
  74. 74. More meetings! 2000 members!
  75. 75. Top tips for success!
  76. 76. Do-ers not talkers! Assess and record your waste
  77. 77. ”Nid da lle gelli gwell” ”There is always room for improvement"
  79. 79. What impact is our system having? £18 million in cost avoidance in the UK University and Healthsector Link
  80. 80. What are our customers saying? • Our customer happiness monthly average score has never been below 8 out of 10 • 1800 customer have given us a 10/10 in last 2 years! More here
  81. 81. Questions to consider • Would you like to stop staff buying assets that the organisation already has surplus elsewhere? • Would you like to reduce unnecessary departmental spend? • Would you like to reduce unnecessary quote/purchase order/invoice paperwork? • Are you looking to procure sustainably? • Do you want to give the rest of the organisation a reason to champion the procurement department? • Do you want to automise your existing system so that people are not emailing and calling the procurement department or store manager looking for surplus? Procurement
  82. 82. Questions to consider • Do you have any issues with reusable items being scrapped? • Is the waste bill too high? • Is this a reputational risk? • Are staff dismantling assets? • Are staff double handling? • Are there too many skips/ dumpsters on the estate? • Are there regular large amounts of assets produced as part of room/ building refurbs which could be managed better? • Would you like to give the organization a chance to champion the FM function? Estates/ Facilities
  83. 83. NEXT STEP Join scheduled web session Link Invite Procurement Facilities Management Sustainability Space Management Logistics Or get in touch for a 121 by clicking link in description below!
  84. 84. Warp It Reuse Network DANIEL O’CONNOR |
  85. 85. #DAYFORACTION Refreshment Break #dayforaction
  86. 86. #DAYFORACTION Session 2: Tackling waste and driving savings in Wales #dayforaction
  87. 87. Reducing waste in every way NHS Sustainability Roadshow Caerdydd Cardiff 14th March 2019
  88. 88. Introduction MJ Rose - Business Development Manager
  89. 89. The importance of segregation… The way we handle waste has to change! Volume of wastes going to UK landfill - In 2016, 15.7 million tonnes of municipal waste was sent to landfill. Of this, 7.7 million tonnes was biodegradable municipal waste. Around 10 million tonnes of food and drink was wasted in the food chain in 2015 - around 60 per cent of this is avoidable. The problem with plastic… 8.3 billion tonnes of virgin plastic created to date 9% recycled 12% incinerated 79% accumulated in landfills If this trend continues, roughly 12 billion tonnes will be landfilled by 2050
  90. 90. The waste hierarchy…
  91. 91. Where can your general waste go? EfW General waste incinerated to produce energy, with incineration temperatures reaching over 850 degrees celsius Reduction in greenhouse gas emissions between 32% - 41% compared with sending to landfill Local EfW facility generates enough electricity for 50,000 homes 23% of renewable energy comes from energy from waste – equivalent to 726,000 tonnes of oil
  92. 92. Where can your food waste go? Anaerobic Digestion Uses microorganisms to break down food waste in an enclosed system, without oxygen As it breaks down, methane is produced which is collected and converted to biogas Biogas used to generate electricity, heat or transport fuels Also creates a nutrient-rich fertiliser for use in agriculture
  93. 93. The importance of segregation… Higher chance of achieving zero to landfill Valuable, recyclable materials recovered at source with lower disposal charges, or rebates achieved Full traceability of waste destinations
  94. 94. Efficient waste management in the NHS or… BEDS? BINS? Simple Choices…
  95. 95. Case study – the problem NHS hospital trust 13 tonnes of unsegregated waste produced per month general waste and cardboard all in together! Increased container collections per annum, leading to a high carbon footprint Health & Safety concerns and disruption to site through high container frequency
  96. 96. Case study – the solution General waste collected from around the hospital Residual general waste loaded into portable compactor Waste taken for onward recycling. Cardboard segregated at source and baled. Collected every 2 months with rebate achieved. Compactor emptied once a month.
  97. 97. Case study – the outcome Reduction in general waste by 50% Collection frequency's reduced from 2 visits PCM to only 1 PCM – 50% reduction! Cardboard waste generating income Carbon footprint reduction in general waste movement. Baler hire costs covered by rebate.
  98. 98. Looking at things differently…
  99. 99. Looking at things differently… Don’t look for a ‘like for like’ service Innovation Have your lifts been reduced? Is the proposed service more sustainable? Will it achieve/exceed your environmental objectives?
  100. 100. What should be happening… Elimination Minimisation Diversion Waste ManagementRisk Reduction Legal Compliance Cost Control Environmental Consultancy Removal and Disposal
  101. 101. Any questions?
  102. 102. Diolch am eich amser. Thank you for your time.
  103. 103. UK Plastics Pact Susan Jay WRAP Cymru March 2019
  104. 104. WRAP's vision is a world in which resources are used sustainably. Working with governments, businesses and communities to deliver practical solutions to improve resource efficiency. Our mission is to accelerate the move to a sustainable, resource-efficient economy by: • re-inventing how we design, produce and sell products, • re-thinking how we use and consume products, and • re-defining what is possible through re-use and recycling. Waste and Resources Action Programme
  105. 105. Ellen MacArthur Foundation ‘New Plastic Economy’ Partnership with WRAP to deliver UK initiative Voluntary commitment from industry – manufacturers, brands, LA’s and waste sector • Signatories • Supporters • Followers Operational activities • Advisory Group – Collaborative Action Groups – sprint groups UK Plastics Pact
  106. 106. 111 A world where plastic is valued and doesn’t pollute the environment
  107. 107. Scope 112 A world where plastic is valued and doesn’t pollute the environment • Initially plastic packaging • All plastic packaging placed onto the UK market (consumer, commercial) • All polymers and formats • All of the plastics value chain represented • Including citizen and householder participation
  108. 108. • Packaging makes up around 60% of manufactured plastic product • Most plastic packaging is used only once – a very durable material with a short use phase • 95% of the value of plastic packaging material (worth $80- 120 billion annually) is lost to the economy. • Change requires transformation, major overhaul of our approach to its manufacture, use and disposal. Plastic packaging
  109. 109. What will the Plastics Pact deliver? 114 • Environmental benefits: less virgin, increased recycled content. • A step change in reuse and recycling rates for all formats • Convergence of polymers and eradication of problematic materials • Reduced leakage from the system: less litter, less waste • Positive citizen participation and awareness • A constructive platform for dialogue with customers, suppliers, competitors and government • Support UK reprocessing: delivering jobs, skills and value
  110. 110. Businesses are increasingly influenced by public concern over plastic. Want to be recognised as part of the solution not part of the problem Business using recycled content for many years but not actively promoting. Evian (Danone) commitment to use 100% recycled by 2025 May require development of new business models and new technologies to become environmentally responsible The Challenge -Business & Industry response
  111. 111. 70+ businesses across the value chain + 38 supporter organisations, 500 followers Members are responsible for over 83% of the plastic packaging on products sold through UK supermarkets UK Plastics Pact Signatories
  112. 112. UK Plastics Pact Targets
  113. 113. UK Plastics Pact Guidance
  114. 114. Guide to plastic free goods – good practice for loose veg, alongside evaluation of instore trials Sustainable Packaging checklist A non-technical summary of the key considerations to make when specifying packaging Guidance on polymer choices - considerations around recyclability i.e. which polymers are ‘more recyclable’ Agreed list of which plastic items are considered recyclable/not recyclable for post-consumer rigid packaging Evaluation of Non-mechanical recycling technologies Recyclability of fibre based packaging Opportunities for compostable plastics Guidance and research in progress
  115. 115. • Food waste prevention is the key priority! • Review plastic packaging and plastics portfolio • Develop Action Plans, KPIs and embed targets in their processes and procedures • Develop a consistent plastic packaging strategy • Understand/avoid unintended consequences • Embed circularity in procurement processes and specifications Focus for businesses and organisations
  116. 116. First reporting period April 2019 ASDA - Through product innovation and redesign, Asda has reduced plastic in almost 1000 individual product lines – from fresh fruit and veg to electronics and homewares – removing the equivalent weight of 600 million empty plastic bottles. Aldi have switched the packaging for a range of cooked meat from non- recyclable packaging to clear, recyclable alternatives to save more than 1,000 tonnes of plastic annually. Coca-Cola use on-pack messaging to encourage people to recycle – a “Recycle Me” message is now on the closures of nearly 500 million bottles. All Innocent bottles contain a minimum of 30% recycled plastic and their new smoothie bottle contains 50% recycled plastic and 15% plant plastic. Tesco flavoured water bottles have been reduced in weight and now have a 25% recycled content (rising to 51% soon). What are signatories doing?
  117. 117. What does this mean for the NHS? Impact on the supply chain • Retailers demanding change • Major brands amending packaging formats • Packaging companies changing formats and developing alternatives • New product development and initiatives • support improved recycling – simpler waste streams and clearer messaging Research and Guidance Freely available see and-products/plastics?page=2 Support procurement choices Contribution to broader sustainability strategies
  118. 118. Key Messages • Major changes underway to packaging materials and formats • Influence of change likely to go beyond packaging • Lots of resources available to support decision making But….. • Be cautious – no knee jerk reactions • Beware of unintended consequences - always consider impact of alternative materials • Waste hierarchy WRAP Cymru Plastics Procurement Guidance
  119. 119. Susan Jay WRAP Cymru Carlyle House 5-7 Cathedral Road Cardiff CF11 9HA +44 (0)2920 100100
  120. 120. #DAYFORACTION Lunch #dayforaction
  121. 121. #DAYFORACTION Session 3: Invest to save through sustainability #dayforaction
  122. 122. Sustainability within the Health Sector
  123. 123. CentricaBusinessSolutions He was so learned, he could name a horse in 9 languages; so stupid, he bought a donkey to ride upon Chinese proverb 128
  124. 124. CentricaBusinessSolutions logorrhoea 129
  125. 125. CentricaBusinessSolutions 130CentricaBusinessSolutions Rapidly growing demand for services Funding shortfalls and increasing costs Staff shortages and skills gaps Pressure on performance targets Ageing equipment and infrastructure Demand for 24/7 access Move to digital healthcare The healthcare sector is facing intense pressures
  126. 126. CentricaBusinessSolutions Leading to unique energy challenges 131 of healthcare respondents agreed the cost of being resilient is far less than the impact of an energy failure of healthcare/medical respondents agreed that “we do not have enough internal expertise to monitor and implement efficiency improvements” Power outages can have a catastrophic impact on care, productivity and staff safety Regulations and funding issues driving need to improve energy efficiency and resilience Environmentally- conscious patients demanding energy sustainability Ageing and inefficient estates leading to waste and risk Skills gaps making it harder to maintain existing energy assets 77% 58%
  127. 127. CentricaBusinessSolutions The energy landscape is evolving Powering business advantage 132132CentricaBusinessSolutions CENTRALISED ENERGY MICROGRIDS RENEWABLES STORAGE DISTRIBUTED GENERATION DEMAND SIDE RESPONSE Centralised energy supply is giving way to distributed technology, providing Trusts with smart, secure and affordable solutions to the energy challenges they face.
  128. 128. CentricaBusinessSolutions Energy supply Wholesale energy Energy insight Energy optimisation Energy solutions Centrica Business Solutions has been created to develop new thinking, new technologies and new ways of working to help our healthcare customers We assisthospitalsto improvetheiroperationalefficiency, ensuresite resilienceandunlock newsourcesof valuewith energyinsight,optimisationandtechnicalsolutions. 133CentricaBusinessSolutions 2022 annual revenue target £1bn >2k Enterprise customers £700m Investment to 2020
  129. 129. CentricaBusinessSolutions There are three key areas where energy can support healthcare’s sustainability objectives 134CentricaBusinessSolutions Harnessing the potential of energy for a sustainable future Ensuring the resilience of critical health services to protect patient care Maximising operational efficiency to invest in patient outcomes
  130. 130. CentricaBusinessSolutions • Insight & analytic solutions to identify efficiency opportunities • On-site generation and Energy efficiency solutions to reduce consumption and costs • Flexible funding models to overcome capital constraints • Fully managed service options to free up resources OPPORTUNITIES Maximise operational efficiency to enable investment in improving patient outcomes • Improve energy and asset efficiency to free up opex/capex and meet regulations • Enhance energy management to overcome constraints and free up resources FOCUS 58%Of healthcare respondents have stated that they “do not have enough internal expertise to monitor and implement energy efficient solutions” 35% of healthcare respondents listed “managing cost and providing comfortable care” as the number one challenge facing healthcare professionals over the next 12 months 135
  131. 131. CentricaBusinessSolutions • On-site generation and storage to reduce exposure to grid failures • Sensor solutions to enable early detection of equipment failure • Full operations & maintenance to maximise reliability • Expert advice and Energy Management Systems to ensure safe and compliant environments • Resilience-as-a-Service to overcome resource/ capex constraints OPPORTUNITIES Ensure the resilience of critical health services to protect patient care • Ensure security of energy supply to avoid serious outages • Effectively maintain energy estates to prolong equipment life and avoid compliance breaches • Replace outdated infrastructure to improve resilience and efficiency FOCUS 66% of healthcare/medical respondents thought that sources of back-up supply in the event of a power outage were very important77% of healthcare/medical respondents agreed that the cost of being energy resilient is far less than the impact of an energy failure 136
  132. 132. CentricaBusinessSolutions • Demand Side Response and energy trading solutions to deliver new income streams • Low-carbon generation to reduce environmental impact • Insight and analytics solutions to identify efficiency opportunities • Expert advice to develop a sustainable energy strategy • Flexible funding models to enable deployment of new technologies OPPORTUNITIES Harness the potential of energy to build a more sustainable healthcare future • Improve energy sustainability to meet regulator and patient demands • Generate new revenue streams from under- utilised assets • Transition to a flexible energy platform to support diversification and digital healthcare FOCUS 90% of Healthcare sector respondents agreed that there were opportunities for energy strategies to help enable a sustainable business model 2,000 tonnes The annual reduction in CO2 emissions by Shrewsbury and Telford NHS Trust by installing a CHP unit 137
  133. 133. CentricaBusinessSolutions We can help drive energy efficiency to enable the future of the healthcare sector 138 Powering Performance Drive down energy costs and improve patient outcomes Powering Resilience Ensure the resilience of critical health services Powering the Future Build a sustainable modern healthcare sector
  134. 134. CentricaBusinessSolutions CHP helps hospital cut carbon emissions to the equivalent of removing 1,000 cars Customer objective • Offer healthcare services for three million • Make cost effective energy decisions • Produce sustainable energy The solution Centrica Business Solutions installed a brand new Combined Heat & Power (CHP) unit that: • Reduced electricity consumption • Cut energy spending • Slashed energy-related concerns • Created healthcare investment opportunities University Hospitals of the North Midlands (UHNM) 139 “We chose Centrica Business Solutions because their product offered the best fit for our needs. It offered the best savings in consumption, cost and carbon over the 15 year life of the installation. I would definitely recommend them for CHP installation and maintenance.” Charlie Cox Energy Manager University Hospitals of the North Midlands, NHS Trust £500K 2,000 20 CHP unit saves £500,000 annually Carbon emissions cut by 2,000 tonnes Efficiencies equal hiring 20 nurses
  135. 135. CentricaBusinessSolutions British Gas Business Services Specialist in designing bespoke heating and hot water solutions using renewable technologies • Access to a range of funding options • Support in accessing Government Incentive Schemes (ECO/RHI) Commercial Service and Repair • Ensure energy efficiencies of existing systems • Ensure compliance with environmental regulations Air Source Heat Pumps Ground Source Heat Pumps Micro CHP Biomass Boilers Convert outside air to use as a heating source Fully scalable and able to work independently or in conjunction with other systems High levels of efficiency, cutting running costs as well as CO2 emissions Absorb underground heat to use as a source of heating High levels of efficiency, cutting running costs as well as CO2 emissions Reduces annual maintenance costs Enhances green sustainability credentials Convert natural gas into electricity and heat Highly Energy Efficient Reduces gird dependency Helps to meet CRC targets Uses organic materials to generate heat Carbon neutral Reduces energy costs Enhances green sustainability credentials
  136. 136. CentricaBusinessSolutions The rising cost of non-commodity charges 141 Capacity market subsidy A subsidy to encourage flexible generation to meet peak demand. Contract for difference Subsidies for large scale low carbon generators, to replace the closing renewables obligation. Feed-in tariffs A subsidy for small scale renewable generators, e.g. solar panels. Transmission network charges Paid to National Grid to cover build and maintenance costs of Britain’s high voltage network. Distribution network charges Paid to regional networks to cover the cost of transporting energy from National Grid to customer meters. Renewables obligation Subsidies for large scale low carbon generators, e.g. wind farms. Balancing Services Charge Paid to National Grid for their work ensuring supply and demand are always equal. Supplier costs Debt costs, operating expenses and profit. Wholesale energy costs Energy purchased on the wholesale market plus the cost of any ‘imbalance’ caused by changes to our forecast consumption. 42% 19% 14% 8% 5% 4% 3% 2% 2% Note: British Gas forecast 2018 costs for sample customer
  137. 137. CentricaBusinessSolutions Tracking the continuing rise of non-commodity costs in the UK 142 £- £20 £40 £60 £80 £100 £120 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Environmental Levies Balancing Services Transmission Network Charges Distribution Network Charges Wholesale Energy Costs 31% 57% 64% Non-Commodity cost as % of total
  138. 138. CentricaBusinessSolutions Optimising the value of onsite generation 143 Connectionandsupply e.g. Bord Gáis, British Gas and Direct Energy Wholesalemarket trading Energyinsight Operations andmaintenance Powergeneration e.g. back up-generator AutomatedDemand SideResponse Combinedheat andpower (CHP) Energyefficiency e.g. solar panels, LED lighting, heating, ventilation and air-conditioning (HVAC) Battery storage
  139. 139. CentricaBusinessSolutions Our key solutions for the healthcare sector Combined Heat & Power (CHP) generation Panoramic Power sensors and analytics Flexible funding models Renewable generation (incl. Solar) & storage Demand Side Response End-to-end delivery & energy management LED Lighting and Controls
  140. 140. Visualising Energy Usage Main features: • Detailed energy data • Advanced analysis • Data export option • Data integration with 3rd party SW • Alert setup • Report scheduling • Account configuration • User management • Implementing advanced machine learning algorithms • Identify device state in real time Mobile App provides easy access to real-time energy data enabling an immediate action • Manage and monitor critical assets • Real-time energy and operational alerts • Off hour energy consumption • Historical analysis and benchmark data • View daily, weekly and monthly energy spend • IOS and Android Support
  141. 141. CentricaBusinessSolutions Innovative and flexible energy solutions Proven track record in the healthcare sector Reduced costs Improved patient outcomes More resilient patient care A more sustainable future Why is Centrica the right partner for healthcare organisations?
  142. 142. CentricaBusinessSolutions 24 Thank you Andrew Donald PublicSectorLead Mobile: 07769542265 Email: Darren Lane Business Development Manager Mobile: 07557614154 Email: CentricaBusinessSolutions Email: Website: Twitter: @CentricaSoln_UK
  143. 143. Mark Griffiths Operations Director Bouygues Energies & Services
  144. 144. Smart technology – are we being SMART enough with Estates & Facilities (in Healthcare)? AGENDA: • Introduction • Why be Smart • Our Leadership challenge • Delivering Smart • Our drivers • The art of the possible
  145. 145. The Bouygues Group: Building Smart Cities Communications Construction Power £36 B turnover
  146. 146. Bouygues’ French Headquarters - Challenger First building in the world to achieve triple certification (2011) • LEED® “Platinum” (US) • BREEAM® “Outstanding” (UK) • HQE® “Exceptional” (FR) Delivery Challenge • Phased works from 2010 to 2014, Shifts over 67,000m2 • Occupied site Energy • 90% Energy and CO2 savings • Ventilated, double skin façades • Geothermal energy from heat pumps • 100% of available BREEAM energy credits achieved • 25,000m2 photovoltaic panels on roofs, terraces and solar farm Water • Rainwater harvesting • 60% water savings • 100% of sewage will be treated and re-used on site (phyto-filtration garden)
  147. 147. Why be Smart?
  148. 148. Our Leadership Challenge
  149. 149. Our Leadership Challenge
  150. 150. Our Leadership Challenge
  151. 151. Delivering Smart
  152. 152. GreenCity – Zurich 2000W Community Today 5.000 W/hab Accomodation 1.500 W Transportation 900 W Consumption 1.100 W Infrastructure 900 W Electricity 600 W Goal 2.000 W/hab
  153. 153. The Drivers
  154. 154. So why SMART for NHS?
  155. 155. Smart Tech Drivers for now and the future…
  156. 156. The Art of the possible…. • 700 bed hospital • 1,800,000 sg ft of GIA • Automatic tinting windows using IP technology • Full fresh air ventilation systems • Gains in efficiency of Healthcare staff • Real time data available both clinically & estate wise • Efficiency in bed utilisation / optimisation • 50% reduction compared to a typical model hospital • A single source of data & benefits…
  157. 157. Scheduling Data (HIS) Staff Locations (RTLS) Nurse Call System Unified Comms Real Time Audit / Analytics Nurse / Bed Assignments (HIS) Agent keeps track of people, locations, Schedules, Roles, Beds, Assignments Nurse Agent receives notifications for the attached user and interacts with them… Nurse Assist Agent identifies the right nurse and notifies them Track everything in real time Capture Nurse Call Events Intelligent Alerting Voice call initiation Workflow Management End Users and Computing Devices Data, System and Healthcare Things Interaction InterconnectionIntelligence ThoughtWire makes everything smarter…Nurse Assist - Receive and respond to nurse call events on any desktop or mobile device.Health 163
  158. 158. Thank You
  159. 159. #DAYFORACTION Conference close #dayforaction