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Sustainable health and social care


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Chris Naylor discusses the findings of our new report on sustainable health and social care, connecting financial and environmental performance.

Published in: Health & Medicine, Technology
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Sustainable health and social care

  1. 1. Sustainable health andsocial careConnecting financial andenvironmental performanceChris NaylorJohn Appleby
  2. 2. Clinical perspective A focus on the individual patient-professional encounter
  3. 3. Public health perspective A broader responsibility towards the whole population
  4. 4. Sustainability perspective
  5. 5. Sustainable development theory
  6. 6. The two-way relationship betweenenvironmental change and health care
  7. 7. The scale of the problem
  8. 8. Knowns and unknowns We know that – the NHS has a significant environmental impact – environmental change is likely to have effects on health and social care needs, particularly among socially marginalised groups. We know less about – the environmental impact of social care, non-NHS health care, and particular organisations, pathways or population groups – exactly how health and care needs will be affected by environmental change, who will be affected most, or how service delivery will be affected.
  9. 9. Connections with other systemobjectives
  10. 10. Sustainability and QIPP Both agendas call for a re-focusing on efficiency, value and prevention of avoidable activity „Anything we can do to achieve the QIPP agenda, which is all about reducing waste and inefficiency, is likely to improve sustainability at the same time.‟ Consultant renal physician „Whenever there is wasted expenditure, there is avoidable environmental damage as well.‟ Sustainability consultant
  11. 11. Sustainability and public health Growing evidence base on a number of potential co-benefits – Promoting active travel – Reducing meat consumption – Improving insulation in housing – Improving access to green spaces
  12. 12. Sustainability and quality of care The link between effectiveness and sustainability: „Evidence-based interventions by their nature should be greener – because they actually work.‟ Director of health care charity Would a more integrated system, providing well-co-ordinated support for people’s multiple needs, be more sustainable from both an environmental and financial perspective? “A lot of the policy aspirations that we have about reducing duplication, joining up services, offering more integrated services, would also produce sustainability benefits” Social care policy expert
  13. 13. Opportunities to improveenvironmental sustainability
  14. 14. Changing service delivery
  15. 15. Changing service delivery Where Sustainable facilities Minimising ‘care miles’
  16. 16. Changing service delivery Where What Sustainable facilities Low carbon pathways Minimising ‘care miles’ Prevention Evidence-based care
  17. 17. Changing service delivery Where What Sustainable facilities Low carbon pathways Minimising ‘care miles’ Prevention Evidence-based care How Integration Pharmaceutical & technologies Preparedness for environmental change
  18. 18. Making it happen
  19. 19. Driving sustainability withinorganisations Evidence from other sectors suggests staff engagement & senior leadership is critical Developing a learning culture within organisations – devolving responsibilities & permitting experimentation Using procurement and commissioning processes to drive sustainable practices Working with patients and the public
  20. 20. A supportive policy framework Redesigning payment systems to remove perverse incentives Using regulatory mechanisms & other levers Creating a policy framework that permits a long- term focus in organisations Holding organisations to account for performance on sustainability Development of metrics for sustainability
  21. 21. A framework for future research Research on Research on Systems-level and Research on future innovative approaches behaviours, attitudes policy research needs and pressures to health & social care and cultures Co-benefits of Barriers to change in Embedding Modelling risks to the sustainable organisations sustainability in system approaches Procurement & existing policies Health impacts of Measuring commissioning Identifying policy environmentalDirect environmental costs Engaging levers to promote change professionals & the sustainability public Developing & Building resilient evaluating metrics & communities methods Prevention Individual and Supporting Forecasts & scenarios Prescribing & community-level preventative for the future medicines behaviour change approachesIndirect management Creating ‘learning Encouraging a longer- Cost-effectiveness organisations’ term focus research Supporting integrated Self-management care
  22. 22. Conclusions