This document discusses providing carbon literacy training to staff in Greater Manchester to help meet sustainability goals. It notes that Greater Manchester aims to be carbon neutral by 2038 with 15% annual reductions. The training would help staff understand climate change and how their work relates to carbon emissions so they are empowered and motivated to take low-carbon actions. Providing the training could help embed sustainability practices across organizations and maximize the impact of existing sustainability measures. The training is designed to be relevant, action-based learning that does not focus on polar bears but rather on local health impacts.
Maximizing_Supply_Chain_Transparency_SaudiTranstec_Dec2014_SwiftAndrew Swift
1. Effective supply chain management is essential for minimizing unforeseen risks by providing maximum visibility into a company's supply chain.
2. Many companies do not fully know the extent of their supply chains, with some estimates indicating that up to 70% of companies are unaware of all production facilities.
3. Intertek provides supply chain transparency services including supplier data collection and verification, on-site audits, and risk analysis to help companies better understand their full supply chains and mitigate risks.
RoHS2 and REACH: The good, the bad and the ugly of product substance restrict...Society of Women Engineers
This document discusses product substance restrictions like RoHS and REACH from three perspectives: the good, the bad, and the ugly. Regulations can drive safer products by eliminating hazardous substances, but they also force costly product redesigns and create complex compliance challenges for manufacturers due to differing rules around the world. As regulations increase at a faster pace than companies can respond, manufacturers must make significant investments in product stewardship to understand and provide content information for the substances in their products sold internationally.
Reliability Strategies for Combating Obsolescence RisksCheryl Tulkoff
This presentation will cover test and management strategies that can be used to protect your company and products against obsolescence risk. Topics include relevant industry standards, use of Managed Supply Programs (MSP) and Contract Pooled Options, long term storage recommendations and practices, and descriptions of the appropriate tests to use in various situations.
Component obsolescence management is a strategic practice that also mitigates the risk of counterfeit parts. Left unchecked, obsolescence issues increase support, development and production costs. So, planning ahead is critical. For companies that proactively manage component availability and obsolescence, the impact of long-term storage on manufacturability and reliability is an area of major concern. Effective test strategies are crucial in detecting and preventing problems.
11 Methods You Can Use to Meet the RoHS Declaration RequirementJim Kandler
There is more than one way to ‘skin a cat’.
While this presentation is focused on RoHS II, many of the declaration acquisition concepts presented may also be applied to other substance regulations.
DATASYST Engineering & Testing Services, Inc. is a Wisconsin based, independent, nationally accredited, third-party engineering and testing laboratory providing industry and manufacturing markets with reliable, solution-focused and cost effective product testing and development for mechanical and electrical assemblies and components. For more information please visit http://www.datasysttest.com/environmental-testing.php
Ant Group is a 20 year old company based in Ipswich, UK that provides antistatic and packaging solutions. It works with industries like electronics, defense, automotive, and medical. The company has strategic partners throughout Europe and stocking locations globally. It offers services including supply chain management, quality control, and component recovery. Case studies describe projects for the RAF, BMW, and Celestica.
CO2 incubators are widely used in scientific research to grow and maintain cell cultures.
Typical fields of application include tissue engineering, in vitro fertilization, neuroscience,
cancer research and other mammalian cell research applications.
Sleek, reliable and intuitive, Esco CelCulture® CO2 incubators provide complete sample
protection that brings your scientific dreams one step closer to reality.
Maximizing_Supply_Chain_Transparency_SaudiTranstec_Dec2014_SwiftAndrew Swift
1. Effective supply chain management is essential for minimizing unforeseen risks by providing maximum visibility into a company's supply chain.
2. Many companies do not fully know the extent of their supply chains, with some estimates indicating that up to 70% of companies are unaware of all production facilities.
3. Intertek provides supply chain transparency services including supplier data collection and verification, on-site audits, and risk analysis to help companies better understand their full supply chains and mitigate risks.
RoHS2 and REACH: The good, the bad and the ugly of product substance restrict...Society of Women Engineers
This document discusses product substance restrictions like RoHS and REACH from three perspectives: the good, the bad, and the ugly. Regulations can drive safer products by eliminating hazardous substances, but they also force costly product redesigns and create complex compliance challenges for manufacturers due to differing rules around the world. As regulations increase at a faster pace than companies can respond, manufacturers must make significant investments in product stewardship to understand and provide content information for the substances in their products sold internationally.
Reliability Strategies for Combating Obsolescence RisksCheryl Tulkoff
This presentation will cover test and management strategies that can be used to protect your company and products against obsolescence risk. Topics include relevant industry standards, use of Managed Supply Programs (MSP) and Contract Pooled Options, long term storage recommendations and practices, and descriptions of the appropriate tests to use in various situations.
Component obsolescence management is a strategic practice that also mitigates the risk of counterfeit parts. Left unchecked, obsolescence issues increase support, development and production costs. So, planning ahead is critical. For companies that proactively manage component availability and obsolescence, the impact of long-term storage on manufacturability and reliability is an area of major concern. Effective test strategies are crucial in detecting and preventing problems.
11 Methods You Can Use to Meet the RoHS Declaration RequirementJim Kandler
There is more than one way to ‘skin a cat’.
While this presentation is focused on RoHS II, many of the declaration acquisition concepts presented may also be applied to other substance regulations.
DATASYST Engineering & Testing Services, Inc. is a Wisconsin based, independent, nationally accredited, third-party engineering and testing laboratory providing industry and manufacturing markets with reliable, solution-focused and cost effective product testing and development for mechanical and electrical assemblies and components. For more information please visit http://www.datasysttest.com/environmental-testing.php
Ant Group is a 20 year old company based in Ipswich, UK that provides antistatic and packaging solutions. It works with industries like electronics, defense, automotive, and medical. The company has strategic partners throughout Europe and stocking locations globally. It offers services including supply chain management, quality control, and component recovery. Case studies describe projects for the RAF, BMW, and Celestica.
CO2 incubators are widely used in scientific research to grow and maintain cell cultures.
Typical fields of application include tissue engineering, in vitro fertilization, neuroscience,
cancer research and other mammalian cell research applications.
Sleek, reliable and intuitive, Esco CelCulture® CO2 incubators provide complete sample
protection that brings your scientific dreams one step closer to reality.
Reducing Risk: Validated Methods for Cleaning Reusable Medical Devices Design World
This webinar discussed reducing risk in cleaning reusable medical devices. Presenters discussed how device design and cleaning methods can impact cleanability and eliminate hospital-acquired infections. Testing showed that Bal Seal canted coil springs met cleaning guidelines in AAMI TIR30:2011. Alternative designs like flush ports may further improve cleanability. Speakers emphasized the importance of validation studies to establish effective cleaning methods and define what level of cleanliness ensures devices are safe for patient use.
In this 2015 presentation, the focus is placed firmly on the concept of product stewardship and the advantages to organisations who pursue product stewardship certification.
Catheter Research Inc. is a leading medical device manufacturer specializing in catheter design, medical tubing, and OBGYN disposables. It has 145 employees and is ISO 13485 certified. CRI provides contract manufacturing services for medium and large medical device companies as well as produces its own proprietary OBGYN product line under the Thomas Medical brand.
This document summarizes a panel discussion on design for sustainability. It introduces four panelists from composite and building material companies: Gale Tedhams from Owens Corning, Ken Schmidtchen from Kalwall Corp., Matt Gindlesparger from Fresh Air Building Systems, LLC, and Bob Moffit from Ashland. The panelists discuss topics like defining sustainability, leveraging materials for sustainable products, transparency and reporting, and industry resources for sustainability efforts.
Jonäno is a women's fashion brand that focuses on sustainable and eco-friendly practices throughout its entire supply chain. It produces organic and fair trade certified collections and aims for lower impact manufacturing processes. Jonäno also engages in practices like vertical integration and giving back to communities. The presentation discusses the concept of the triple bottom line approach to sustainability and outlines various strategies businesses can implement to reduce their environmental impact, such as adopting energy efficient practices, conserving water, reducing waste, preventing pollution, and designing and selling green products.
PAHO Smart Hospitals Toolkit to Build Resilience in the Health Infrastructure...Caribbean Development Bank
This document provides an overview of the PAHO Smart Hospitals initiative from 2017-2023. The initiative aims to improve the resilience of critical health infrastructure in Latin America and the Caribbean to withstand multiple hazards through retrofitting existing facilities and building new smart hospitals. Key aspects included strengthening structures, reducing energy and water use through renewable technologies, and conducting vulnerability assessments of over 400 facilities in 7 countries. The results demonstrated increased safety ratings, reduced operational costs through energy and water savings, and facilities that were better able to function during and after disasters.
Intertek is a global assurance, testing, inspection and certification company with over 40,000 employees across 100+ countries. It provides quality and safety solutions to customers across various industries. Intertek has a long history dating back to 1885 and offers a comprehensive portfolio of assurance, testing, inspection and certification services. It has a global network of laboratories and auditors and focuses on sectors like products, trade and resources. Intertek achieved steady revenue growth and increasing market capitalization in recent years.
This document outlines the agenda for a conference on obtaining FDA approval for AI-based medical devices. The agenda includes presentations on paving the path for FDA approval of AI devices, an open Q&A session with the FDA's Digital Health Center of Excellence, how to align product development with FDA regulations for AI, best pre-submission practices, and an update on the 510(k) program. There will also be breaks and a summary session. The presentations will provide guidance on navigating the FDA approval process for AI medical devices and obtaining feedback prior to formal submissions.
This 6-month internship report summarizes services provided by TÜV SÜD South Asia Pvt. Ltd., a leading testing, inspection, and certification company. The report describes TÜV SÜD's history and global presence. It provides an overview of the wide range of testing, auditing, inspection, training, and certification services offered to ensure product and system quality and compliance across many industries. A major focus is food inspection services to check for quality and compliance throughout the production process.
Aviosat Technology Private Limited is a young and growing organization started with the passion to serve the best by its quality products and services to demanding customers in the area of Broadcast, Aviation and Power Conditioning.
At Aviosat we work with the philosophy of Vision->Initiative->Implementation->Delivery
5
A Pragmatic Approach to
Lifecycle Analysis
Formal lifecycle analysis is not new; in fact, lifecycle analysis tools andtechniques have been around in various forms for decades. What is newis an urgent need to improve the tools and expand the use of lifecycle
analysis to a broader spectrum of products and services.
We’re going to use a pragmatic approach to lifecycle analysis that keeps
the focus on the main goals: understanding the overall impact and making
improvements. The truth is that you don’t always need to measure every-
thing; you don’t always need precise data; you don’t always need complete
information. You just need to know what to measure, when, and how—and
where to place your priorities.
To get started we’ll need a model of the product/service lifecycle that we
can use to organize our work. So, let’s take a closer look at the phases of a
typical lifecycle and the key considerations at each phase.
A Basic Lifecycle Model
Every product is different; every lifecycle has unique time frames and char-
acteristics. As a result, many different lifecycle models have been produced
over time. For this book, we use a basic three-stage model. We prefer this
model because it is straightforward and matches most people’s personal expe-
rience with the lifecycle stages of common products. The three stages of our
model are
• “Make,” which covers everything that happens before a product is
actually put into operation—including the materials and chemicals
45
that are used to create it, the processes involved in assembling and
manufacturing it, the packaging that encases it, and the supply chain
that distributes it
• “Use,” which includes the power the product consumes as it is
operated, the greenhouse gas (GHG) and other emissions it creates,
the water it uses, and the noise, light, and heat it generates during
operation
• “Renew,” which covers everything that happens after the product is
used, including the demanufacture or disassembly of the product,
reuse of key components, recycling, and take-back
At each stage of the lifecycle we focus on three primary aspects of the
environmental impact of a product or service:
• Energy and emissions, including the calculation of energy and
power, finding the cleanest source of energy for your product, using
energy efficiently, calculating GHG emissions and CO2 conversion,
and so on
• Chemicals, materials, and waste, including the legal and business
considerations of hazardous and toxic substances, packaging and doc-
umentation, waste disposal, recycling, take-back, and process-related
GHG emissions
• Water and other natural resources that are embodied in the product
or service, including social and business considerations of using
scarce or nonrenewable materials, calculating the water footprint, and
so forth
Additional Lifecycle Considerations
Our three-phase model is intentionally simplistic. So, before we discuss
each aspect of the lifecycle in more detail, we’d like to offer a few notes.
Intertek provides strategic support across the entire supply chain through testing, inspection, auditing, and certification services. They have a global network with over 35,000 employees in more than 100 countries. Their services help clients innovate while complying with regulations, focus on core business by mitigating risks, and make decisions based on data. Case studies show how they have helped clients with regulatory compliance, material selection, sustainability assessments, and developing partnerships with suppliers.
This document discusses reducing single-use plastics through remanufacturing of medical devices. It begins by explaining that Vanguard AG is a leading European company that remanufactures single-use medical devices to high quality and safety standards. Remanufacturing devices can provide significant cost savings compared to original manufacturers' prices, while reducing waste. The document then discusses Vanguard's remanufacturing process and regulatory compliance. It provides examples of the types of devices that can be remanufactured and estimates the potential cost savings for the NHS from expanding remanufacturing of devices.
Sterilization Standards Update: Strategies for ComplianceMedTech Review, LLC
This document summarizes the key points of a presentation on sterilization requirements and strategies for compliance. The presentation covered general sterilization requirements, radiation sterilization and its impacts, and EO sterilization and its impacts. It discussed the main changes in ISO 11137 for radiation sterilization and ISO 11135 for EO sterilization, and the impacts these standards have on sterilization contractors and medical device manufacturers.
The document discusses environmentally sound technologies (ESTs) and the process for assessing and selecting them in Oman. It defines ESTs as technologies that are less polluting and more environmentally friendly than conventional options. It outlines Oman's regulatory requirements for selecting best available technologies and demonstrating an internationally recognized EST assessment. The assessment process involves gathering information on proposed and alternative technologies, evaluating them based on environmental and other impacts, consulting stakeholders, and making recommendations. The goal is to select options that minimize environmental degradation and risks to human health and welfare.
NSF International is a public health organization that has been working to promote food safety since 1944. They have over 700 auditors globally and are a leading provider of food safety audits and certification. NSF discussed the history and increasing importance of cold chain management in ensuring food safety and quality across the supply chain. Proper cold chain management requires integrated strategies including planning, policies and procedures, and management practices to control risks. Global food safety standards like GFSI are driving innovation in the food industry by requiring continuous improvement and management commitment to meet new food safety expectations.
SPLC 2018 Summit: Making the Business Case: Measuring the Economic Outcomes o...SPLCouncil
1. EPA recommends specifications, standards, and ecolabels for green products in over 20 categories. Using these recommendations can save the government and businesses time and money while increasing sales of greener products.
2. Product registries and calculators help measure the impacts of the recommendations by tracking product availability, and quantifying cost savings and environmental benefits from purchasing certified products.
3. Improving data sharing between product registries could further increase the benefits by making it easier to find certified products and integrate registry data into procurement tools.
Webinar - Creating an SDMP for your NHS trustWalt Whitman
The document summarizes a webinar about creating an SDMP (Sustainable Development Management Plan) for an NHS Trust. It includes presentations from three speakers: Claire Igoe from Central Manchester University Hospitals NHS Foundation Trust discussing their experience developing and implementing an SDMP; Alex Hammond from ETL discussing shaping an SDMP to a Trust's needs and making it engaging; and Adam Newman from Leeds Teaching Hospitals NHS Trust discussing the value of an SDMP for an NHS organization.
This document summarizes initiatives to promote sustainability across the NHS in Wales. It discusses measuring the NHS Wales carbon footprint, relevant policies and legislation, data reporting tools, and sharing best practices through the Welsh Health Environmental Forum. Key points covered include the 2016/17 carbon footprint of 733,185 tonnes of CO2e, using data to inform targets and policies, and tools for benchmarking like the Estates & Facilities Performance Management System.
Reducing Risk: Validated Methods for Cleaning Reusable Medical Devices Design World
This webinar discussed reducing risk in cleaning reusable medical devices. Presenters discussed how device design and cleaning methods can impact cleanability and eliminate hospital-acquired infections. Testing showed that Bal Seal canted coil springs met cleaning guidelines in AAMI TIR30:2011. Alternative designs like flush ports may further improve cleanability. Speakers emphasized the importance of validation studies to establish effective cleaning methods and define what level of cleanliness ensures devices are safe for patient use.
In this 2015 presentation, the focus is placed firmly on the concept of product stewardship and the advantages to organisations who pursue product stewardship certification.
Catheter Research Inc. is a leading medical device manufacturer specializing in catheter design, medical tubing, and OBGYN disposables. It has 145 employees and is ISO 13485 certified. CRI provides contract manufacturing services for medium and large medical device companies as well as produces its own proprietary OBGYN product line under the Thomas Medical brand.
This document summarizes a panel discussion on design for sustainability. It introduces four panelists from composite and building material companies: Gale Tedhams from Owens Corning, Ken Schmidtchen from Kalwall Corp., Matt Gindlesparger from Fresh Air Building Systems, LLC, and Bob Moffit from Ashland. The panelists discuss topics like defining sustainability, leveraging materials for sustainable products, transparency and reporting, and industry resources for sustainability efforts.
Jonäno is a women's fashion brand that focuses on sustainable and eco-friendly practices throughout its entire supply chain. It produces organic and fair trade certified collections and aims for lower impact manufacturing processes. Jonäno also engages in practices like vertical integration and giving back to communities. The presentation discusses the concept of the triple bottom line approach to sustainability and outlines various strategies businesses can implement to reduce their environmental impact, such as adopting energy efficient practices, conserving water, reducing waste, preventing pollution, and designing and selling green products.
PAHO Smart Hospitals Toolkit to Build Resilience in the Health Infrastructure...Caribbean Development Bank
This document provides an overview of the PAHO Smart Hospitals initiative from 2017-2023. The initiative aims to improve the resilience of critical health infrastructure in Latin America and the Caribbean to withstand multiple hazards through retrofitting existing facilities and building new smart hospitals. Key aspects included strengthening structures, reducing energy and water use through renewable technologies, and conducting vulnerability assessments of over 400 facilities in 7 countries. The results demonstrated increased safety ratings, reduced operational costs through energy and water savings, and facilities that were better able to function during and after disasters.
Intertek is a global assurance, testing, inspection and certification company with over 40,000 employees across 100+ countries. It provides quality and safety solutions to customers across various industries. Intertek has a long history dating back to 1885 and offers a comprehensive portfolio of assurance, testing, inspection and certification services. It has a global network of laboratories and auditors and focuses on sectors like products, trade and resources. Intertek achieved steady revenue growth and increasing market capitalization in recent years.
This document outlines the agenda for a conference on obtaining FDA approval for AI-based medical devices. The agenda includes presentations on paving the path for FDA approval of AI devices, an open Q&A session with the FDA's Digital Health Center of Excellence, how to align product development with FDA regulations for AI, best pre-submission practices, and an update on the 510(k) program. There will also be breaks and a summary session. The presentations will provide guidance on navigating the FDA approval process for AI medical devices and obtaining feedback prior to formal submissions.
This 6-month internship report summarizes services provided by TÜV SÜD South Asia Pvt. Ltd., a leading testing, inspection, and certification company. The report describes TÜV SÜD's history and global presence. It provides an overview of the wide range of testing, auditing, inspection, training, and certification services offered to ensure product and system quality and compliance across many industries. A major focus is food inspection services to check for quality and compliance throughout the production process.
Aviosat Technology Private Limited is a young and growing organization started with the passion to serve the best by its quality products and services to demanding customers in the area of Broadcast, Aviation and Power Conditioning.
At Aviosat we work with the philosophy of Vision->Initiative->Implementation->Delivery
5
A Pragmatic Approach to
Lifecycle Analysis
Formal lifecycle analysis is not new; in fact, lifecycle analysis tools andtechniques have been around in various forms for decades. What is newis an urgent need to improve the tools and expand the use of lifecycle
analysis to a broader spectrum of products and services.
We’re going to use a pragmatic approach to lifecycle analysis that keeps
the focus on the main goals: understanding the overall impact and making
improvements. The truth is that you don’t always need to measure every-
thing; you don’t always need precise data; you don’t always need complete
information. You just need to know what to measure, when, and how—and
where to place your priorities.
To get started we’ll need a model of the product/service lifecycle that we
can use to organize our work. So, let’s take a closer look at the phases of a
typical lifecycle and the key considerations at each phase.
A Basic Lifecycle Model
Every product is different; every lifecycle has unique time frames and char-
acteristics. As a result, many different lifecycle models have been produced
over time. For this book, we use a basic three-stage model. We prefer this
model because it is straightforward and matches most people’s personal expe-
rience with the lifecycle stages of common products. The three stages of our
model are
• “Make,” which covers everything that happens before a product is
actually put into operation—including the materials and chemicals
45
that are used to create it, the processes involved in assembling and
manufacturing it, the packaging that encases it, and the supply chain
that distributes it
• “Use,” which includes the power the product consumes as it is
operated, the greenhouse gas (GHG) and other emissions it creates,
the water it uses, and the noise, light, and heat it generates during
operation
• “Renew,” which covers everything that happens after the product is
used, including the demanufacture or disassembly of the product,
reuse of key components, recycling, and take-back
At each stage of the lifecycle we focus on three primary aspects of the
environmental impact of a product or service:
• Energy and emissions, including the calculation of energy and
power, finding the cleanest source of energy for your product, using
energy efficiently, calculating GHG emissions and CO2 conversion,
and so on
• Chemicals, materials, and waste, including the legal and business
considerations of hazardous and toxic substances, packaging and doc-
umentation, waste disposal, recycling, take-back, and process-related
GHG emissions
• Water and other natural resources that are embodied in the product
or service, including social and business considerations of using
scarce or nonrenewable materials, calculating the water footprint, and
so forth
Additional Lifecycle Considerations
Our three-phase model is intentionally simplistic. So, before we discuss
each aspect of the lifecycle in more detail, we’d like to offer a few notes.
Intertek provides strategic support across the entire supply chain through testing, inspection, auditing, and certification services. They have a global network with over 35,000 employees in more than 100 countries. Their services help clients innovate while complying with regulations, focus on core business by mitigating risks, and make decisions based on data. Case studies show how they have helped clients with regulatory compliance, material selection, sustainability assessments, and developing partnerships with suppliers.
This document discusses reducing single-use plastics through remanufacturing of medical devices. It begins by explaining that Vanguard AG is a leading European company that remanufactures single-use medical devices to high quality and safety standards. Remanufacturing devices can provide significant cost savings compared to original manufacturers' prices, while reducing waste. The document then discusses Vanguard's remanufacturing process and regulatory compliance. It provides examples of the types of devices that can be remanufactured and estimates the potential cost savings for the NHS from expanding remanufacturing of devices.
Sterilization Standards Update: Strategies for ComplianceMedTech Review, LLC
This document summarizes the key points of a presentation on sterilization requirements and strategies for compliance. The presentation covered general sterilization requirements, radiation sterilization and its impacts, and EO sterilization and its impacts. It discussed the main changes in ISO 11137 for radiation sterilization and ISO 11135 for EO sterilization, and the impacts these standards have on sterilization contractors and medical device manufacturers.
The document discusses environmentally sound technologies (ESTs) and the process for assessing and selecting them in Oman. It defines ESTs as technologies that are less polluting and more environmentally friendly than conventional options. It outlines Oman's regulatory requirements for selecting best available technologies and demonstrating an internationally recognized EST assessment. The assessment process involves gathering information on proposed and alternative technologies, evaluating them based on environmental and other impacts, consulting stakeholders, and making recommendations. The goal is to select options that minimize environmental degradation and risks to human health and welfare.
NSF International is a public health organization that has been working to promote food safety since 1944. They have over 700 auditors globally and are a leading provider of food safety audits and certification. NSF discussed the history and increasing importance of cold chain management in ensuring food safety and quality across the supply chain. Proper cold chain management requires integrated strategies including planning, policies and procedures, and management practices to control risks. Global food safety standards like GFSI are driving innovation in the food industry by requiring continuous improvement and management commitment to meet new food safety expectations.
SPLC 2018 Summit: Making the Business Case: Measuring the Economic Outcomes o...SPLCouncil
1. EPA recommends specifications, standards, and ecolabels for green products in over 20 categories. Using these recommendations can save the government and businesses time and money while increasing sales of greener products.
2. Product registries and calculators help measure the impacts of the recommendations by tracking product availability, and quantifying cost savings and environmental benefits from purchasing certified products.
3. Improving data sharing between product registries could further increase the benefits by making it easier to find certified products and integrate registry data into procurement tools.
Similar to NHS Sustainability Roadshow Manchester (20)
Webinar - Creating an SDMP for your NHS trustWalt Whitman
The document summarizes a webinar about creating an SDMP (Sustainable Development Management Plan) for an NHS Trust. It includes presentations from three speakers: Claire Igoe from Central Manchester University Hospitals NHS Foundation Trust discussing their experience developing and implementing an SDMP; Alex Hammond from ETL discussing shaping an SDMP to a Trust's needs and making it engaging; and Adam Newman from Leeds Teaching Hospitals NHS Trust discussing the value of an SDMP for an NHS organization.
This document summarizes initiatives to promote sustainability across the NHS in Wales. It discusses measuring the NHS Wales carbon footprint, relevant policies and legislation, data reporting tools, and sharing best practices through the Welsh Health Environmental Forum. Key points covered include the 2016/17 carbon footprint of 733,185 tonnes of CO2e, using data to inform targets and policies, and tools for benchmarking like the Estates & Facilities Performance Management System.
Paul Dark - Biomarker guided duration of antibiotic treatmentWalt Whitman
The document summarizes the ADAPT-Sepsis Trial, which is a multicenter randomized controlled trial investigating the effectiveness and safety of using biomarkers (procalcitonin and C-reactive protein) to guide the duration of antibiotic treatment for hospitalized patients with sepsis. The trial aims to enroll 2760 patients and randomize them to either biomarker-guided antibiotic discontinuation protocols or standard care. The primary outcomes are total duration of antibiotic treatment within 28 days and 28-day all-cause mortality. The trial aims to determine if biomarker monitoring can safely reduce antibiotic use without increasing mortality.
Detecting, analysing and interpreting diagnostic devicesWalt Whitman
Novarum DX provides smartphone-based readers and image analysis technology that can interpret various diagnostic tests performed outside clinical laboratories. Their technology supports monitoring of chronic/autoimmune diseases and infectious disease testing. They have CE marked products for inflammatory bowel disease in Europe and Canada, and expect FDA approval in the US. Their technology prevents errors and ensures accurate results by guiding users through sample preparation and incubation times. It allows decentralized healthcare by enabling at-home testing and sharing results securely online.
Mike Wakeman - Case Study - CRP in community pharmacyWalt Whitman
This document summarizes a case study evaluating point-of-care C-reactive protein (CRP) testing in community pharmacies to help manage respiratory tract infections. Over 6037 patients received CRP testing for conditions like tonsillopharyngitis, sinusitis, bronchitis, and the common cold. The aims were to evaluate acceptability of CRP testing in pharmacies, assess impacts on general practitioner appointments and antibiotic prescribing. Results found high acceptability among patients, many would have otherwise visited their GP, and CRP testing helped inform care and reduce unnecessary antibiotic prescribing. The study aims to expand CRP testing to more pharmacies to better manage respiratory infections.
Ronald's story illustrates how undiagnosed medical issues led to repeated falls and eventual loss of independence. The project aimed to use point-of-care blood testing (POCBT) by paramedics on elderly patients presenting with acute frailty syndromes to inform safe hospital avoidance, enable earlier disease management, and increase clinician confidence. Initial results found POCBT improved discharge rates and recontact rates compared to previous frailty projects, and case studies showed it supported earlier disease identification and management. While more research is needed, the quality improvement project demonstrated POCBT's potential positive impact on assessing and treating elderly patients experiencing acute frailty.
Main Presentation UK Diagnostic Summit 2018Walt Whitman
The document summarizes a conference on maximizing diagnostic technology to tackle antimicrobial resistance (AMR) in the UK. It discusses the UK AMR Diagnostic Collaborative, which provides leadership and alignment across the diagnostic system. Key areas of focus for 2018-2019 include diagnostic stewardship, innovation, and understanding how health policy can support rapid diagnostic adoption. Upcoming milestones are surveys on blood culture and industry engagement to help accelerate diagnostic usage and solutions. Continued focus on diagnostics is crucial as the government refreshes its AMR strategy and action plan.
Real World Evaluation and implementation of a diagnostic test for pre-eclampsiaWalt Whitman
The document discusses a case study evaluating the real-world implementation of a diagnostic test for pre-eclampsia across 7 hospitals in the Thames Valley region, with the goals of standardizing adoption of preeclampsia testing to improve patient safety, clinical capacity, reduce unnecessary admissions, and lower overall system costs.
The UK AMR Diagnostic Collaborative aims to maximize the use of diagnostic technology to tackle antimicrobial resistance. It provides single point of focus and leadership for the complex UK diagnostic system. Key areas of focus include diagnostic stewardship, innovation, and addressing unwarranted variation. Upcoming milestones include a national blood culture survey and engagement with industry to accelerate innovative solutions. The collaborative works in partnership across agencies to ensure a responsive diagnostic system.
The document summarizes the state of pathology consolidation in the UK. It notes that consolidating pathology services into networks allows for more consistent turnaround times, better use of skilled staff, and equal access to tests across regions. Approximately one third of planned pathology networks are currently operational, with the goal of having all networks established by 2021. NHS Improvement will continue supporting trusts to establish networks and ensure milestones are met. Specialist testing networks and a pathology quality dashboard are also being developed to further improve services.
Assay Standardisation - how this leads to improved patient resultsWalt Whitman
Clare Morris from NIBSC discusses the importance of assay standardization for improving patient results. Standardization leads to more accurate, robust and reproducible diagnostic assays by providing a common unit of measurement for comparison. This allows results from different laboratories and assays to be comparable. NIBSC establishes biological reference standards and reference materials to facilitate standardization. Examples are given showing how standardization has improved comparability for assays measuring PSA, HCV RNA, HIV RNA, and other markers. Challenges in standardizing assays across different sample matrices are also discussed.
The document discusses a potential collaboration between LifeArc and Biocartis to develop a circulating tumor ESR1 Mutation Test using Biocartis' Idylla platform. The test would detect mutations in the ESR1 gene indicative of resistance to endocrine hormone therapy in metastatic breast cancer. LifeArc has expertise in diagnostic development and Biocartis has an automated molecular testing platform. The test could help guide treatment decisions for breast cancer patients by monitoring their risk of resistance to hormone therapies.
This document discusses a project in Oldham, England that aimed to reduce antibiotic prescribing through the use of C-reactive protein (CRP) point-of-care testing. The project provided CRP testing machines to 8 high-prescribing general practices over 6 months. A total of 359 CRP tests were completed, with 78% showing results under 20mg/L where antibiotics are not routinely needed. Based on the results, antibiotics were prescribed in line with NICE guidelines 88% of the time. Patient and staff feedback on the testing was positive, finding it aided diagnosis and reduced unnecessary antibiotic use. Further funding and adoption of CRP testing could help Oldham and other areas improve antibiotic stewardship.
This document discusses the challenges and opportunities for in vitro diagnostic medical devices in the UK post-Brexit. Currently, the EU Withdrawal Bill would make EU directives like the Medical Device Directive part of UK law but most provisions of new regulations like the Medical Device Regulation would not be. The UK government has said it will comply with the key elements of the MDR and IVDR, but there is uncertainty around the final outcome of Brexit negotiations. Medical device companies need to take action to ensure they can continue sales in the EU after 2020 when the transition period ends. The UK may also create opportunities through mutually recognizing regulations with other countries like the US and developing its own guidelines.
How diagnostics can drive efficiency within the NHSWalt Whitman
This document summarizes a presentation on how diagnostics can drive efficiency within the NHS. It notes that demand for diagnostic tests and waiting lists have increased in recent years without equivalent funding growth. Wide variation exists in diagnostic quality and access across regions. The presentation calls for diagnostics to be optimized by reducing unwarranted variation, improving data sharing and digital infrastructure, addressing capacity issues, and incentivizing efficiency. Recent NHS data collection and modeling identified over 30 million fewer tests, £33.6 million in cost savings, and opportunities to standardize practices and reduce costs in imaging services.
Centrica Business Solutions helps major healthcare organizations improve energy efficiency and performance through onsite generation. They provide energy insights, optimization, and technical solutions like combined heat and power to increase efficiency by 25% and solar power. Centrica works with hospitals to reduce costs and carbon emissions through measures like installing a new CHP unit at University Hospitals of the North Midlands NHS Trust that saves £500,000 annually and cuts carbon by 2,000 tons, equivalent to the emissions of 20 nurses.
Sustainability in the NHS and leadershipWalt Whitman
Sustainability in the NHS and leadership is a document discussing sustainability in the UK's National Health Service. It notes that while the profile of sustainability has been raised with funding for old buildings, more enforceable legal protocols are still needed. Respondents felt more financial support could help avoid pressure on individuals to cut costs at the expense of sustainability. Central funding separate from local budgets was seen as needed to improve sustainability initiatives beyond just energy projects. Respondents called for greater prioritization of environmental sustainability over immediate costs and for dedicated sustainability offices in each NHS trust.
Securing funding to deliver cost-saving energy efficient technologiesWalt Whitman
Salix Finance provides interest-free funding to public sector organizations, including NHS trusts, to invest in energy efficiency projects. It has allocated over £930 million in funding since 2004, resulting in annual energy savings of over 63,000 tonnes of carbon dioxide. Frimley Health NHS Foundation Trust has utilized £995,000 in Salix funding for 15 projects, achieving annual savings of £258,000 and reducing carbon emissions by 1,624 tonnes. Salix offers a simple application process and supports projects from development through installation to help organizations like Frimley Health lower energy costs and meet carbon reduction targets.
The document discusses sustainable waste management for the healthcare sector. It outlines the different types of waste bins used including blue for confidential shredding, clear sacks for recycling, and black sacks for domestic waste. The various medical waste streams such as infectious, sharps, medicines, and anatomical waste are also described. Most waste is sent for energy recovery through incineration to be rendered safe and sustainable.
Is care without carbon fit for the futureWalt Whitman
The document discusses sustainability initiatives within the NHS. It covers:
1) Organizational changes like Sustainability Transformation Partnerships and pursuing an energy performance contract for multiple NHS trusts to reduce costs.
2) A transport revolution addressing air pollution and a shift to electric vehicles for NHS fleets.
3) A materials revolution embracing circular economy principles and adapting to changes in global recycling markets.
4) Developments in climate change including a recent UK heatwave, flooding incidents, and targets to limit global warming to 1.5 degrees Celsius.
AHMR is an interdisciplinary peer-reviewed online journal created to encourage and facilitate the study of all aspects (socio-economic, political, legislative and developmental) of Human Mobility in Africa. Through the publication of original research, policy discussions and evidence research papers AHMR provides a comprehensive forum devoted exclusively to the analysis of contemporaneous trends, migration patterns and some of the most important migration-related issues.
Combined Illegal, Unregulated and Unreported (IUU) Vessel List.Christina Parmionova
The best available, up-to-date information on all fishing and related vessels that appear on the illegal, unregulated, and unreported (IUU) fishing vessel lists published by Regional Fisheries Management Organisations (RFMOs) and related organisations. The aim of the site is to improve the effectiveness of the original IUU lists as a tool for a wide variety of stakeholders to better understand and combat illegal fishing and broader fisheries crime.
To date, the following regional organisations maintain or share lists of vessels that have been found to carry out or support IUU fishing within their own or adjacent convention areas and/or species of competence:
Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR)
Commission for the Conservation of Southern Bluefin Tuna (CCSBT)
General Fisheries Commission for the Mediterranean (GFCM)
Inter-American Tropical Tuna Commission (IATTC)
International Commission for the Conservation of Atlantic Tunas (ICCAT)
Indian Ocean Tuna Commission (IOTC)
Northwest Atlantic Fisheries Organisation (NAFO)
North East Atlantic Fisheries Commission (NEAFC)
North Pacific Fisheries Commission (NPFC)
South East Atlantic Fisheries Organisation (SEAFO)
South Pacific Regional Fisheries Management Organisation (SPRFMO)
Southern Indian Ocean Fisheries Agreement (SIOFA)
Western and Central Pacific Fisheries Commission (WCPFC)
The Combined IUU Fishing Vessel List merges all these sources into one list that provides a single reference point to identify whether a vessel is currently IUU listed. Vessels that have been IUU listed in the past and subsequently delisted (for example because of a change in ownership, or because the vessel is no longer in service) are also retained on the site, so that the site contains a full historic record of IUU listed fishing vessels.
Unlike the IUU lists published on individual RFMO websites, which may update vessel details infrequently or not at all, the Combined IUU Fishing Vessel List is kept up to date with the best available information regarding changes to vessel identity, flag state, ownership, location, and operations.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Monitoring Health for the SDGs - Global Health Statistics 2024 - WHOChristina Parmionova
The 2024 World Health Statistics edition reviews more than 50 health-related indicators from the Sustainable Development Goals and WHO’s Thirteenth General Programme of Work. It also highlights the findings from the Global health estimates 2021, notably the impact of the COVID-19 pandemic on life expectancy and healthy life expectancy.
United Nations World Oceans Day 2024; June 8th " Awaken new dephts".Christina Parmionova
The program will expand our perspectives and appreciation for our blue planet, build new foundations for our relationship to the ocean, and ignite a wave of action toward necessary change.
Contributi dei parlamentari del PD - Contributi L. 3/2019Partito democratico
DI SEGUITO SONO PUBBLICATI, AI SENSI DELL'ART. 11 DELLA LEGGE N. 3/2019, GLI IMPORTI RICEVUTI DALL'ENTRATA IN VIGORE DELLA SUDDETTA NORMA (31/01/2019) E FINO AL MESE SOLARE ANTECEDENTE QUELLO DELLA PUBBLICAZIONE SUL PRESENTE SITO
Donate to charity during this holiday seasonSERUDS INDIA
For people who have money and are philanthropic, there are infinite opportunities to gift a needy person or child a Merry Christmas. Even if you are living on a shoestring budget, you will be surprised at how much you can do.
Donate Us
https://serudsindia.org/how-to-donate-to-charity-during-this-holiday-season/
#charityforchildren, #donateforchildren, #donateclothesforchildren, #donatebooksforchildren, #donatetoysforchildren, #sponsorforchildren, #sponsorclothesforchildren, #sponsorbooksforchildren, #sponsortoysforchildren, #seruds, #kurnool
7. • In 2016, Greater Manchester took control of its health
and social care system.
• At the same time we launched our five-year plan to
improve health and social care, called Taking Charge
• It involves NHS, councils, voluntary, community & social
enterprise, Healthwatch, other public services
•
•
•
•
•
•
•
•
•
•
.
Taking Charge
8. •
• More children reaching a good level of social and
emotional development - ready for school
• Fewer people dying from: cancer, heart and lung disease
• Supporting people to stay well and live at home for as long
as possible
• Ensuring we contribute in a leading way to a ‘sustainable’
system
•
•
•
•
•
•
.
A Reminder of Our Aims – by 2021
9. GMHSCP Partnership Opportunities
•
•
•
| 9
GMHSCP
Partnership
Opportunities
Carbon
Neutrality
(2038)
Environmental
Plan
GM Spatial
Framework
Industrial
Strategy
Clean Air Plan
Air Quality
Strategy
Transport
Strategy and
Made to Move
10. Health Benefits of
Action
•
• Cleaner Air
• Warmer Homes
• Healthier Eating
• Active Travel
• Green Space and Biodiversity
• Community Cohesiveness
• Healthier, Sustainable Economies
• Resilient communities and
health/social care system
•| 10
11. Locality
• Carbon Literacy Training
• Plastic & paper reduction
• Recyclable stationary
• Advocacy
• Social Value Strategy
14. Phil Korbel
•
• Co Founder/Director Carbon Literacy Project
• Board Member, G Mcr Low Carbon Hub
•
15. Just think
•
• how different it would be if…
• everyone ‘got it’
• thought low carbon
• acted low carbon
• how much more effective would your existing SD measures be?
•
16. Carbon Literacy is
•
• a day’s-worth of adaptable, relevant, action-based
learning-and-doing on climate change that you deliver
• the foundation for upping your game on climate change
• is not about polar bears
• about health
•
•
21. The bosses agreed
•
• tackling climate change is part of the job
• is rarely a high priority
• why?
• “…because I won’t get fired if I don’t…”
• What gets measured gets done
•
22. What leeway does ‘Devo Manc’ offer?
•
• align with the GMCA plan
• standing agenda item
• Providers Board action group
• what gets measured gets done
• embed in funding contracts??
• spread best practice nationally
•
26. Dedicated to your
sustainability goals
§ Remanufactured devices are backed by
Stryker’s comprehensive quality
system
§ All devices are individually tested to
ensure the highest quality
§
Patient Care sustainability
§ Maximise savings through case
support, business reviews,
education and utilising Stryker’s
entire remanufacturing program
§ Leverage partnership to provide
purchasing power and price
containment
Financial sustainability
§ Purchasing and collection processes
designed to minimise waste
§ Alignment to prioritize the reuse of
remanufactured devices
Environmental sustainability
Sustainability Solutions | CIS10315 Rev. A
28. ‘Single-use’ devices (SUDs)
§ Most SUDs cannot be reused
§ The‘single use’label is determined by
the manufacturer, not the regulatory
body:
• Perceived limitation of liability
• Reduced scrutiny by regulatory body
• Increased sales and profits
§ Specialised technology and knowledge
allows manufacturers to
remanufacture certain SUDs
DVT
HARMONIC
SCALPEL
Sustainability Solutions | CIS10315 Rev. A
29. § OEM devices are studied to identify critical
quality attributes and establish performance
specifications
§ Multiple Considerations:
• Analysis of the product
• Materials characterisation
• Chemical compatibility
• Generation of intermediate level
product description, including
engineering drawings
• Analysis of clinical application to
produce a specification
§
Reverse engineering
Sustainability Solutions | CIS10315 Rev. A
30. § Complex medical devices must often be
disassembled
• Enables thorough cleaning
• Allows replacement of components
worn out during original use
• Increases yield
§ Replacement components are designed
and sourced based on OEM
specifications
• Validated as equivalent to new
Remanufacturing
requires
disassembly to
facilitate cleaning
Disassembly and replacement
components
Sustainability Solutions | CIS10315 Rev. A
31. § Receiving and Sorting
• All orders are ticketed to ensure order
content integrity and traceability
• Gross rejects, heavily soiled items, and
unapproved products are removed
• Devices are identified according to OEM
convention
§
§ Device Marking/Tracking
• All devices are indelibly marked with
Unique Device Identifiers via pad
printing, bar coding, laser etching, etc.
• Allows traceability for cycle counts, reject
reconciliation, and potential post-market
field actions
Identification and traceability
Sustainability Solutions | CIS10315 Rev. A
32. § Accepted devices undergo comprehensive cleaning that incorporates prolonged
soaking, cleaning and rinsing in pH-neutral enzymatic cleansers and sanitisers
that are compatible with all device materials
§
§ Residual levels of organic materials, such as protein, hemoglobin and total organic
carbon are quantified and compared with acceptable standards
§
Decontamination and cleaning
Sustainability Solutions | CIS10315 Rev. A
33. § Performance is compared to baseline catheters
§
§ Testing performed in house and/or by third party
Material strength and
performance testing
Tensile
Strength
Tensile
Strength FatigueFatigue Joint Seal
Testing
Joint Seal
Testing
Introduction
&
Withdrawal
Introduction
&
Withdrawal
Torsion /
Deflection
Torsion /
Deflection
Bending /
Buckling
Bending /
Buckling
Sustainability Solutions | CIS10315 Rev. A
34. § DEPCTS (Diagnostic EP Catheter Test System)
§
§ Complete electrical profile testing including isolation and continuity
• Isolation test
• Captures internal and/or minor insulation breakdowns that can result
in cross-talk or noise on the electrogram signals
•
• Continuity test
• Closely mimics actual clinical use
• Verifies that the signal from each electrode is consistent and unbroken
•
• Both tests are performed during active deflections of the test catheter
Electrical integrity testing
Sustainability Solutions | CIS10315 Rev. A
35. § Requirements
• Package variation (i.e. lot to lot)
• Storage
• Human interaction (i.e. shipping)
§
§ Validation Steps
• Validation Plan
• Material/Design Qualification
• Performance Qualification
• Product Qualification
§
§ Testing
• Shock/Drop Test, Vibration Test, Seal/Package Strength, Ship
Test
• ISO 11607, ASTM D4169, ASTM F-1140-00, ASTM F1980-02
• Accelerated Aging (thermodynamic temperature coefficient)
Packaging and shelf life testing
Sustainability Solutions | CIS10315 Rev. A
36. § Conventional Release
• Biological Indicators
• 72 hour quarantine
§
§ Sterilisation validation:
• AAMI/ANSI/ISO 11135
• EN550
• Annual Revalidation
• SAL of 10-6
• EO Residuals: ISO 10993-7; TIR 19
• Not an irritant to patients or clinicians
Sterilisation
Sustainability Solutions | CIS10315 Rev. A
38. Remanufacturing
in the EP / cath lab
• Diagnostic ultrasound catheters
(3D mapping catheters)
• Electrophysiology catheters
• Electrophysiology interface
cables
• Catheter introducer sheaths
EP catheters
Diagnostic ultrasound catheters
Catheter introducer
sheaths
EP cables
Stryker Corporation or its affiliates own, use, or have applied for the following trademarks or service marks:
Stryker. All other trademarks are trademarks of their respective owners or holders.
Sustainability Solutions | CIS10315 Rev. A
39. • Laparoscopic devices (trocars and
directed energy – bipolar and ultrasonic)
•
• Arthroscopic devices (shavers and
wands)
•
• Orthopedic devices (bits / blades / burs
and external fixation devices)
§
Trocars
Harmonic scalpels
Sealer / dividers
Stryker Corporation or its affiliates own, use, or have applied for the following trademarks or service marks:
Stryker. All other trademarks are trademarks of their respective owners or holders.
Remanufacturing
in theatre
Sustainability Solutions | CIS10315 Rev. A
41. Safety evidence
§ Reprocessors have been regulated since
2000
§ Millions of SUDs have been reprocessed
with no evidence of increased
infection rates.
§ No deaths have been attributed to
reprocessed devices in the FDA’s
Manufacturer and User Facility Device
Experience (MAUDE) database.
2008 GAO report: Of the 320,000+ adverse events filed with FDA between
2000 and 2006, only 65 adverse events “actually involved or were
suspected to involve a reprocessed SUD and that the reprocessed SUD
was one of several possible causal factors in the adverse event. In
reviewing these 65 reports, FDA found that the types of adverse events
reported to be associated with the use of reprocessed SUDs were the
same types of events that were reported for new devices.”
2008 Government Accountability Office (GAO) report: noted the findings
of FDA’s Medical Product Safety Network (MedSun) Program and
confirmed that “none of the representatives of MedSun hospitals who
participated in the FDA focus groups reported being aware of any
infections related to the use of reprocessed SUDs.”
Established record
Sustainability Solutions | CIS10315 Rev. A
42. Protecting your patients
§ Remanufacturing of single-use devices is
regulated by governmental authorities
§ Remanufactures must obtain premarket
clearance and comply with the same medical
device regulations as original equipment
manufacturers
§ Premarket clearance is intended to validate that:
• The remanufacturing is able to clean
and sterilise the device
• Functional performance of the
remanufactured device is
equivalent to the predicate device
§ NO BATCH TESTING – every device is fully
function tested
Regulatory oversight
Sustainability Solutions
§ FDA QSR compliant
§ 105+ premarket clearances
for reprocessing
§ ISO 13485 certified
Sustainability Solutions | CIS10315 Rev. A
43. Regulatory
§ MHRA issued remanufacturing guidance document
§
§ BSI is Stryker’s notified body
§
§ EU Council’s and Parliament’s Committees on ENVI endorsed
remanufacturing agreement
§
§ Stryker Sustainability received CE mark for select vascular devices
Market activities
Regulations
Sustainability Solutions | CIS10315 Rev. A
45. Remanufacturing: making a
difference
In 2017, our
single-use
medical device
remanufacturing
programs helped
our U.S.
customers:
$326 million
in supply costs
13.4M lbs.
of waste from landfills
Save Divert
Sustainability Solutions | CIS10315 Rev. A
46. 3_89
Effective remanufacturing prices will be determined as a 10-45%
discount from OEM prices, depending on Market Share commitment.
• Hospitals/GPOs will provide usage data, including pricing. List price can
be used as a starting point when actuals are not available.
•
• Each individual system may have variations with OEM prices and annual
volumes.
Tier 1
Less Than
10% Market
Share
Tier 2
10% Market
Share
Tier 3
20% Market
Share
Tier 4
30% Market
Share
Tier 5
40% Market
Share
Tier 6
50% Market
Share
10% 15% 21% 28% 36% 45%
% Market Share of Customer Spend
(Please state if discount or actual price is being offered)
Pricing and contracting plan
47. Current
Annualized
Expenditures
Total
Remanufactured
Spend at 30%
Adjusted OEM
Spend
Total Adjusted
Spend
Total Adjusted
Savings
Total Adjusted
% Savings
£ 1,227,293 £ 143,152 £ 905,743 £ 1,048,894 £ 178,399 15%
14% 86%
Total KG
Collected
Rate
Total Waste
Savings
10,000 £ 0.20 £ 2,000
Total Savings
Remanufacturing Savings +
Waste Savings
£ 180,399
Customer Spend & Remanufacturing Savings
Summary of Total Annualized Savings
Waste Savings
3_89
Savings Opportunities:
1. Sustainability devices
2.
3. OEM price erosion
4.
5. Waste diversion
6.
7. Totals
Savings analysis
1 2
3
1 2 4
4
50. Dedicated to your
sustainability goals
§ Remanufactured devices are backed by
Stryker’s comprehensive quality
system
§ All devices are individually tested to
ensure the highest quality
§
Patient Care sustainability
§ Maximise savings through case
support, business reviews,
education and utilising Stryker’s
entire remanufacturing program
§ Leverage partnership to provide
purchasing power and price
containment
Financial sustainability
§ Purchasing and collection processes
designed to minimise waste
§ Alignment to prioritize the reuse of
remanufactured devices
Environmental sustainability
Sustainability Solutions | CIS10315 Rev. A
52. 52
References:
Anderson, L. (2013, April). Clinical business strategies. Retrieved from: www.hpnonline.com
Ferguson, M. & Toktay, B. (2007, July). Effects of competition on recovery strategies. Retrieved from: www.insead.edu
NuRep. (2015, April 23). Are repless models the answer to PPI cost management? Retrieved from: www.nurep.com
Scott, B. (2016, April 22). Savings war: The pros and cons of SUD reprocessing growth. Retrieved from:
www.dotmed.com
White, B. (2016, May 4). Single-use device Options – Promoting Cost Savings and Infection Prevention. Retrieved from:
www.medicaldealer.com
54. Discussion Framework
• Introductions
• Who are JRP?
– What do we do?
– Who do we work with?
• Energy Training
– Why do it?
– Levels of training
– eLearning
– Costs
• Any questions?
•
•
55. Why do it?
ü NHS annual energy spend of approximately £544m
ü Increased consumption due to more energy hungry technology
ü Pressure on to deliver savings
ü Little capital available to invest in energy saving projects
ü Inefficient building stock
ü Effecting behavioural change is low cost and delivers immediate benefits
ü A 5% - 10% reduction in energy use would realise a £30 - £60m annual saving
ü We all have a moral duty to change what we do and prevent waste wherever possible as
we face ‘A Climate Emergency’
56. Energy Awareness Training
Harness the inherent knowledge of your staff – they know
your business better than any consultant!
JRP provide five levels of training from Level 1 General Energy
Awareness to Level 4 Embedding Energy Culture Change ensuring it
is always relevant, engaging and practical
57. Making it relevant
Level 1 – General Energy Awareness Training
ü Face to face or eLearning modules
ü Fundamental principles of energy – what it is, where it comes
from, what it costs, security of supply, environmental impacts
ü The impacts of inaction in the home and workplace
ü Can be bespoke for larger organisations
ü EUSR approved
58. Energy – the big picture
•
•
•
•
•
•
•
• Provides a universal understanding of what energy is, where it comes from and why CO2
emissions are so harmful to the planet
59. Energy at home
Looks at how energy is used within a typical home and provides some useful tips to help
reduce energy consumption and reduce energy bills at home
60. Energy at Work
Every day £000’s of energy is wasted at work with lights, heating & cooling and equipment
being left on when it’s not actually needed.
This module looks at simple ways in which energy consumption can be reduced to help make
the workplace more sustainable and save the NHS significant amounts of money.
62. Making it relevant to the NHS
• Relevant to all staff – clinical, medical and support
• Builds universal understanding of energy and CO2 through modules
• Adds personal value by relating energy to the home environment
• Relates to NHS priorities and values e.g. improved patient comfort
• Can be used for Induction Training, Team Talks or as a complete course
• Very affordable @ £3k per annum with unlimited usage in each Trust
•
66. Why have a reuse system?
• £100s disposing of unwanted items
• £1000s procuring same items
• Match up the 2
üAvoid waste
üReduce carbon footprint from procurement
üSave ££££££
67. In figures
Since February 2016 we have….
• Registered 1252 colleagues as users
• Reused 3558 items over 861 transactions
• Saved estimated £175k in procurement costs
• Avoided 25 tonnes of waste
68. Things to consider
• Know your stakeholders
• Know your own resources
• Know your audience
• Keep it fair
• Keep it in focus
•
69. Know your stakeholders
• Procurement and budget holders
• Health and Safety, Infection Prevention, Fire Safety
• Medical Engineering, Informatics
•
• Capital Works/Property and Estates
•
70. Know your own resources
• Time, transport, storage
• Be clear on everyone’s responsibilities
• Accept there are limitations
71. Know your audience
• What do people want?
• What items have restrictions on procurement
• Use popular items to promote the system
72. Keep it fair
• Everything for reuse goes through Warp It
• Everyone has an equal chance to claim
• Users are expected to give as well as receive
73. Keep it in focus
• Case studies in staff newsletter
• Sign-up at events
• Criteria for Green Impact award
•
•
77. Reducing waste in every way
NHS Sustainability Roadshow
Manchester
14th February 2019
78. Introductions
MJ Rose - Business Development Manager
Kerry Jones – Sales Director
www.forwardwaste.co.uk
79. 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
www.forwardwaste.co.uk
81. Where can your general waste go?
www.forwardwaste.co.uk
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
82. Where can your food waste go?
www.forwardwaste.co.uk
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
83. 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
www.forwardwaste.co.uk
85. 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
www.forwardwaste.co.uk
86. Case study – the solution
General waste
collected from around
the hospital
Residual general
waste loaded into
portable compactor
www.forwardwaste.co.uk
Waste taken for
onward recycling.
Cardboard segregated
at source and baled.
Collected every 2 months
with rebate achieved. Compactor emptied
once a month.
87. 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.
www.forwardwaste.co.uk
88. What should be happening…
Elimination
Minimisation
Diversion
Waste
Management
Risk Reduction
Legal
Compliance
Cost Control
Environmental
Consultancy
Removal and
Disposal
www.forwardwaste.co.uk
92. Introduction
•2.4 million patient contacts
•+- 15,000 staff
•A 900-year history
•Almost £1.5 billion annual turnover
•6,659 babies born
•+- 5,000 tonnes of waste p.a.
•Awarded TWM contract in 2014
•Close working relationship
•Education & communication
•Innovations & initiatives
•
•
93. About us
Partnership Approach
•Recycling & Resource Management company - contract lead
•Dedicated staffing – team of 35 on site
•Sustainability Director & Team
•
•
•
•
•
•
Head of Health &
Sustainability
Contract Manager
Key Coordinator Supervisors
Waste/ Obsolete Porters
Guy’s and St Thomas’ sites
Trust Waste Manager
Logistics Assistant
Sustainability
Team
94. About us
Initiatives
•SAVE - savings of up to £150,000 p.a.
•Waste data from Byweigh mini-weighbridge
•Senior Management buy in & SAVE Champions
•Support for events and sustainability activities
•Staff induction education
•
•
•
•
•
•
•
95. About us
Mini-weighbridge system
•Identifies and weighs every bin - ward/ department level tracking
•Bespoke software and tagging system
•Performance and cost - real-time, to pin-point problem areas
•Staffing and efficiency benefits
•
96. About us
Reuse and Food recycling
•Reuse
•Trust signed up to Warp-it in November 2017
•12 months savings of £76,000
•Initial Roll Out - Ward Clerks and
Procurement Buyers
•Procurement decisions for purchase are
prompted to use StockDoc
•Food waste
•Tonnage from 1 tonne to 14 tonnes per
month
•Training of Food Service Assistants
97. About us
Single – use packaging
•Installed August 2018 at
St Thomas’
•4,000 bottles refilled
since being introduced
•Machine also to be
installed at Guy’s and in
community sites
•
98. About us
Single – use packaging – market reactions
•Customer enquiries and questions
•Commitment and leadership
o Unilever – 100% plastic
packaging fully
recyclable,
compostable, reusable
by 2025. Increase
recycled content in
packaging to 25% by
2025
o Costa – 500million single-
use coffee cups recycled
in the UK
99. About us
Inspiring action and useful resources
•Leading by example
•Spread the word enthusiastically
•Resources out there:
•https://www.ellenmacarthurfoundation.org
/
•https://skyoceanrescue.com/
•https://thesra.org/
•https://lessplastic.co.uk/
•https://
www.flipsnack.com/Bywaters/new-flipbook-fti01qafh.html
•
•
•
104. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Securing funding to deliver cost-saving
energy efficient technologies
Thursday 14th February 2019
Liam Gillard, Salix Finance
105. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Overview of Salix Finance
Independent, not-for-profit company working in partnership with the Public Sector
since 2004
Salix provides interest-free funding to accelerate investment in energy efficient
technologies
National profile working in England, Scotland and Wales
Funded by the Department for Business, Energy and Industrial Strategy (BEIS), the
Department of Education, the Welsh Government and the Scottish Government
107. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Funding model Funding committed
following successful
application
Project delivery and
installation
(interim payments available)
Salix loan paid out
on completion
Financial and
carbon savings
achieved
Repayments made
back to Salix
(10 equal instalments over 5
years)
108. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Our achievements
*calculated using emissions factors published by government for carbon foot printing
client pilot
schemes
Salix funding
allocated
£930,000
energy saving
per annum
6,000*
tonnes CO2
per annum
£3.4m19 500
client projects
committed
tCO2e*
annual
saving
766k*2301
Salix funded
projects
£692m
energy
saving per
annum
£158m
client projects
committed
16,656
Clients
supported
2004
2018
109. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Technologies supported
Salix funding can support over 100 energy
efficiency technologies
Boiler replacements
Building energy management systems
Combined heat and power
Heat recovery
Heat networks
Heating and hot water upgrades
Building fabric insulation
LED lighting upgrades
Street lighting
Solar PV
110. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Salix Finance and the NHS
Funding criteria – 5 year loan payback (no technical payback anymore), costs less
than £172 to save tCO2e over lifetime of the project
Funding can be used to improve existing equipment or to install equipment to
achieve higher standards in new build developments
Funding can be secured over multiple years to support Sustainable Development
Management Plans and long term estate strategies (including EPCs)
NHSI approve of Salix’s Invest to Save model
111. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
£70.5m
100,000
£19.5m 63
236
£567.5m
Salix working within the NHS
*Calculated using emission factors published by government for carbon footprinting
63
227
TOTAL TRUST ENERGY
SPEND 2017/18
£567.5m
TOTAL SALIX LOAN
VALUE
ESTIMATED ANNUAL
tCO2e*
TOTAL ANNUAL
SAVINGS
£71m
100,000
£19.5m
112. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Top Salix NHS clients
Imperial College Healthcare NHS Trust
East Kent University Hospitals NHS Foundation Trust
Wrightington, Wigan and Leigh NHS Foundation Trust
Frimley Health NHS Foundation Trust
George Eliot Hospital NHS Trust
Northern Devon Healthcare NHS Trust
University Hospitals of Morecambe Bay NHS Foundation Trust
Lewisham and Greenwich NHS Trust
North West Anglia NHS Foundation Trust
Northampton General Hospital NHS Trust
113. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Salix project knowledge slides
Sharing of knowledge between clients
Before and after project delivery
Supporting comments
Lessons learnt
Supplier information
Contact details
NHS knowledge slides
Gaining internal approval
114. •
•
BEFORE
• 3 x 4.5MW LTHW boilers
• Annual energy spend of £407,000 gas and £1.6m electricity at Whiston
Hospital
• Whiston Heating System is maintained by Vinci Facilities. The heating
demand from Whiston hospital is approx. 3,728Kw in the coldest
months of the year.
Project Knowledge – CHP and Heat Recovery by
St Helens & Knowsley NHS Trust
AFTER
• CHP providing 1.28MW of electricity and 1403kW of Low
Temperature Hot Water
• FluAce direct contact gas condensing economiser fitted to current
boilers to recover ~20% of the energy currently in the flu gas
•
•
•
•
•
•
Project completion date – October 2018
• Project value
£2,108,365
• 8,986,157 kWh
annual
electricity
saving (51%)
• £713,258/year
savings
• Payback 2.96
years
• 1,638 tCO2 saved
per year
•
•
•
115. Supporting Comments:
Project Knowledge – CHP and Heat Recovery by
St Helens & Knowsley NHS Trust
• Proposed savings derived from a)Use of expected kwh reductions from initial feasibility study ‘plugged’ into Trust invoicing
monitoring spreadsheet, and b) Pre and post consumption (kwh) figures and cost per kwh also plugged into the SALIX
compliance tool to test payback <5years.
•
• Electricity costs of 9.16 p/kWh and gas costs of 1.80 p/kWh at Whiston Hospital
•
• Clark Energy, Cogenco and Centrica put in a bid in our tender for the installation and maintenance of the CHP and Flue-Ace
heat recovery unit. Centrica was the chosen supplier.
•
• Advice/lessons learned:
• Consider whether your site has an A and B electrical supply, which is usual in modern hospitals. If this is the case
you may have to consider the electrical demand of one of these supplies, rather than total site demand, when
sizing the CHP.
• Ensure you have a good log of constant temperature hot water return data and primary heating loop temps prior to
the project.
• Be patient from initial SALIX approval through to feasibility to actual completion….. 3 years, we are however a PFI
trust so were held up with Deed of Variation and Funder approval.
• SALIX had equal patience with our delays……Thank you.
•
116. Measurement of Savings:
Project Knowledge – CHP and Heat Recovery by
St Helens & Knowsley NHS Trust
• The savings for December and
January are greater than the
expected savings amount.
This is because the expected
savings calculation took into
account unforeseen
downtime, scheduled
downtime, Scheduled
maintenance, and peak
summer intervals over the
course of the year.
• There aren’t any aspects of the
savings calculation we would
approach differently after
considering post verification
results.
•
Graph 2 –
Metered
consumptio
n to Jan 19
•
• Savings have been monitored on this project using manual mains meter readings, STARK smart meter readings, utilities bills
and the Web portal supplied by the CHP contractor which details Gas used as well as electrical and thermal energy
generated.
•
•
•
Graph 1 –
Metered
consumption
to Oct 18
118. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Supporting project delivery
FeasibilityFeasibility Internal
Consultation
Internal
Consultation ProcurementProcurement MobilisationMobilisation InstallationInstallation
Business case
checks
Meet with finance
department
Offer reservation of
funding for Trust Board
Workshops and calls with
other Trusts for advice
Interim Payments
Phase works over
financial years
119. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Summary
100% interest free funding available for NHS Trusts and
Foundation Trusts – no maximum loan amount
Cost neutral - loan repaid through savings
Supporting long-term funding plans, Sustainable
Development Management Plans and estates
strategies
Helping the NHS achieve energy and carbon reduction
targets
Reduce energy bills at your Trust
120. SOLVING ENERGY EFFICIENCY FINANCE IN THE PUBLIC SECTOR
Thank you
liam.gillard@salixfinance.co.uk
0203 714 5655
123. Powering Performance:
Helping major energy users in the healthcare sector to improve
energy efficiency and operational performance through onsite
generationTony Orton
Centrica Business
Solutions
Thursday 14th February
2019
124. Centrica Business Solutions
The energy landscape is evolving
Powering business advantage 124124Centrica Business Solutions
CENTRALISED
ENERGY
MICROGRIDS RENEWABLES
STORAGE
DISTRIBUTED
GENERATION
DEMAND SIDE
RESPONSE
Centralised energy supply is
giving way to distributed
technology, providing
businesses with smart,
secure and affordable
solutions to the energy
challenges they face.
125. Centrica Business Solutions
Energy
supply
Wholesal
e
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 assist organisations to improve their operational
efficiency, ensure site resilience and unlock new sources
of value with energy insight, optimisation and technical
solutions.
125Centrica Business Solutions
2022 annual
revenue
target
£1bn >2k
Enterprise
customers
£700m
Investment
to 2020
126. Centrica Business Solutions
The rising cost of non-commodity charges
126
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
127. Centrica Business Solutions
Tracking the continuing rise of non-commodity costs in the UK
127
Environmental Levies
Balancing Services
Transmission Network
Charges
Distribution Network
Charges
Wholesale Energy Costs
31% 57% 64% Non-Commodity cost as % of
total
128. Centrica Business Solutions 128
21 3
Panoramic Power’s non-invasive, self-powered wireless sensors can be
installed quickly and easily, with little or no disruption or downtime to your
operations. Enabling access to energy data and analytics through a single
platform.
Sensor installation
Easily attach the non-invasive
self-powered sensors to the
outgoing electrical wire. Each
individual sensor will start
tracking the energy usage of the
device, equipment or process.
Analysis and action
Capturing energy data in a single
platform provides a powerful interface
to monitor, measure, report, and
understand energy consumption from
multi-site level to individual device
level.
Monitoring and data
Data is continuously received from
the sensors and wirelessly
transmitted to the analytics platform
via cloud technology, all in real-time.
Panoramic Power
Energy insights
130. Centrica Business Solutions 130
Energy Insights
Device level visibility and
energy insights
14bn global data points
across 53k sensors and in
30 countries
Demand Side
Response
Additional revenues from existing
assets
Europe’s #1 Demand Side Response
provider with c. 5GW under
management globally
Battery Storage
Additional revenue
Patented battery optimisation
driving industry leading
returns
Roosecote 49MW and
Gateshead 3MW battery
developed, 18MW battery live
this week in Belgium
Combined Heat and
Power
25% increase in energy
efficiency
UK’s largest CHP provider,
with over 3k units in market
Integrated
Solutions
Platform
Solar
100% renewable generation
150MW of solar power
managed globally with 6.5k
solar panels in the UK
Delivering an integrated approach
131. Centrica Business Solutions
Optimising the value of onsite generation
131
Connection and
supply
e.g. Bord Gáis, British
Gas and Direct Energy
Wholesale market
trading
Energy insight
Operations
and
maintenance
Power generation
e.g. back up-
generator
Automated
Demand Side
Response
Combined heat
and power
(CHP)
Energy efficiency
e.g. solar panels, LED
lighting, heating, ventilation
and
air-conditioning (HVAC)
Battery
storage
132. Centrica Business Solutions 132
Combined Heat and
Power
Solar
PV
Battery storage
charge
Battery storage
discharge
Grid
import
An illustrative Distributed Energy strategy
133. Centrica Business Solutions
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)
133
“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
£500
K
2,000 20
CHP unit saves £500,000 annually
Carbon emissions cut by 2,000 tonnes
Carbon cuts same as hiring 20 nurses
134. Centrica Business Solutions 24
Thank you
If you have any questions please contact us:
Tony Orton
Distributed Energy Sales Manager
Centrica Business Solutions
Email: Tony.Orton@centrica.com
Centrica Business Solutions
Email: CentricaBusinessSolutions@centrica.com
Website: www.centricabusinesssolutions.com
Twitter: @CentricaSoln_UK
136. IntroductionTo Sterimelt
and a Sustainable Recycling Solution for
Clinical ‘SterilisationWrap’
• Burton Queen’s Hospital
• Sterilisation Wrap
• Legal and Compliance
• Sterimelt
• Benefits to Health care industry
• BBC News – NHS News - Awards - Social Media
• Ongoing Solutions, Projects and Opportunities
• Questions and Comments
•
October 2018 www.tcg.ltd136
Today’s Presentation Agenda
139. SterilisationTheatreWrap
Typical operating room featuring “Wrap”
• Clinical “Wrap” is a non-woven polypropylene
sterile wrap that is used to maintain the sterility
of instruments and equipment and can also be
used as bed sheets, drapes and covers in the
operating theatre.
• “Over 4 Million Operations are performed across
the NHS in England each year”- Natalie Roddis,
Waste and Sustainability Officer- NHS Burton
• WHO estimates, 75-90% of waste from healthcare
facilities is non-hazardous.
• Queen’s Hospital Burton produces about 16 tonnes
of “Sterilisation wrap”-previously sent for
incineration at very high cost.
• Merged with the Royal Derby NHS in August 2018
to become University Hospitals Of Derby And
Burton NHS FoundationTrust.
October 2018 www.tcg.ltd139
140. October 2018 www.tcg.ltd140
Legal and Compliance
Independent EmissionsTest
Environment Agency &
Natural ResourcesWales Independent Lab Report
141. October 2018 www.tcg.ltd141
Ø Reduction inVolume by 80 to 85%
Ø Operator Free for Other Duties During Densification Process
Ø Diverts From Landfill and/or Incineration - Sustainable
Ø 100% Compliant Recycling Process – Circular Economy
Ø Current Revenue Stream from PP
Ø Processed Blocks Re-Manufactured–Circular Economy
Ø
Ø ”Savings from disposal costs for the UK of Circa £12,750,000
should Sterimelt be implemented across the NHS.The
revenue created for the UK could reach £6,500,000”-
Natalie Roddis, Waste and Sustainability Officer- NHS Burton
Ø Save on disposal costs
Ø Earn Revenue for tonnages recycled
Ø
145. TCG Ltd- Further Projects, Solutions and Opportunities…….
• Single Use Disposable PatientTransfer Sheets
• Successfully processed PTS supplied by
M.I.P. UK Ltd (Formerly Cromptons)
• Significant opportunity to recycle yet more
“single use disposable” products.
October 2018 www.tcg.ltd145
• Disposable Curtain Recycling – Innovate UK
• Ongoing trials of volume reduction and
recycling of disposable curtains
• Significant opportunity to recycle yet more
“single use disposable” products.
147. Delivering Energy Savings
through ‘Low Cost’ Interventions
Presented by:
Darren Jones BSc (Hons), C.Eng. FCIBSE LCC LCEA
Manchester NHS Sustainability Day Roadshow – 14th February 2019
www.lowCO2.eu
148. An overview
1. Hospital Energy Efficiency; the Drivers & Barriers
2. BMS Optimisation
3. Operating Theatre Optimisation - Case Studies
4. Lighting Upgrades & Controls
5. Steam and Condensate Systems
6. Chiller Upgrades & Optimisation
7. Summary - Technological Improvements
8. Summary - Non Technical Opportunities
9.
10.
149. Ø
Ø Economic: Electricity and other energy prices are rising, NHS Trusts
are currently in financial deficit.
Ø Political: Global, European and National Targets. Climate Change
Act, Carbon Reduction Targets.
Ø Environmental: Reducing energy waste reduces GHG emissions
and accompanying environmental impacts.
Ø Social: Energy efficiency has health benefits, both in the home and
at work. Fuel poverty impacts on the whole health economy.
Ø
Hospital Energy Efficiency – The Drivers
150. Common barriers include:
Ø Financial Restrictions
Ø Economic Uncertainty and Risk
Ø Information and Skill Gaps
Ø Poor Commissioning
Ø Poor Maintenance
Ø Sub-optimum Engineering Design
Hospital Energy Efficiency – The Barriers
151. Ø Avoid a wide range of set temperatures. Adopt a heating
schedule policy.
Ø Ensuring a dead band of at least 3 C (+/-1.5ºC) is factored into○◦
BMS strategies will help to prevent simultaneous heating
and cooling taking place.
Ø
Ø Reviewing temperature and pressure sensor calibration on a
frequent basis will help maintain optimum control
efficiency.
What you see on the BMS, is often not the reality…
•
Quick Win – BMS Control Set-point Optimisation
153. Recommendation – Replace Fresh Air Actuator
Issue – Actuator Removed
Annual Energy Saving – 190,000kWh
Annual Cost Saving – £9,500
Implementation Cost – £500
Payback Period – Under 1 Month
Damper Actuators
154. Ø The cooling and heating control
valves on many AHUs ‘let-by’,
which isn’t always evident
from the BMS head-end.
Ø A more invasive inspection of
plant will identify this type of
issue. Replacing or repairing
control valves on AHUs will
prevent losses across the
system.
AHU Heating/Cooling Emitters
155. Ø Chiller Flow Temperatures – 5 Degrees C. too low!!
Ø 1 Degree C. increase equates to a 3% performance improvement…
Ø
Ø
Ø
Ø
Ø
Quick Win – Control Set-point Optimisation
Office Building Sever Room
161. Variable Speed Drives - Interlocked with BMS
Ø Chiller Compressor Control
Ø Chiller Condensing Fan Control
Ø Chilled Water Circuits
Ø Condensing Water Circuits
Ø Heating Water Pump Control
Ø Ventilation Fan speed control
162. Ø We have proved that by improving
the air supply in one theatre
alone, a Trust could save in the
region of £5,000 a year.
Ø
Ø If this figure was extended to all the
Trusts in England, it could mean a
saving of more than £10m and a
reduction in carbon emissions of
80,000 tonnes a year!
Operating Theatre Optimisation
164. Rec.
No.
Complexity (1
= Simple,
3 = Complex)
Relates
To:
Recommendation Est. Cost (£) CO2 Emissions
Reductions
(Tonnes)
Annual Energy
Saving (kWh)
Annual
Saving (£)
Simple Payback
Period
(Months)
1 2 All
Theatres
Consider reducing Air Change Rate in line with
HTM requirement in order to reduce energy.
£600 14.27 26,718 £2,671 3
2 1 All
Theatres
Consider removing the HEPA filters to reduce
system pressure.
£100 5.7 10,512 £1,051 1
3 3 All
Theatres
Consideration should be given to replacing
supply fans with high efficiency units in order to
reduce power drawn by the systems.
£5,000 3.88 7,183 £718 84
4 2 All
Theatres
It is recommended that the time schedules for
the Theatre unit are changed in line with
occupancy hours.
£600 6.44 11,913 £1,190 6
5 3 Cooling
Plant
Consideration should be given to installing
variable speed drives (VSDs) and controlling
pumps based on demand, and the adoption of a
2-way valve system on the chiller plant.
£6,300 13 23,875 £2,387 32
6 2 Heating
Plant
A review of installation of a software interlock,
and the adoption of time schedule to prevent the
unnecessary operation of heating pumps during
low demand.
£600 6.2 11,466 £1,147 6
7 2 All
Theatres
Consideration could be given to reducing the
temperature set-point.
£600 16.3 88,595 £2,658 3
8 2 All
Theatres
It is recommended that the existing VSDs on the
Theatre unit are utilised by modulating the fan
speed in accordance with system demand.
£600 11.3 21,000 £2,100 3
Totals* £14,400 77 201,262 £13,922 12
*Savings are not considered cumulative, totals shown for representation purposes only.
Summary of Recommendations – Mile End Hospital
165. Recommendation 1
Consider Reducing Air Change Rates
Room Room Size (m²) Total Flow Rate
(m³/h)
Air Change Rate
(per hour)
Recommended Air
Changes
(per hour)
Achievement of
Design Values (%)
Theatre & Scrub 188.2 3178.8 16.9 15 113
Anaesthetic 61.0 1746.0 28.6 15 191
Prep 44.5 648.0 14.6 10 146
Air Flow Results
Ø The Theatre & Scrub AHU is running at 3,178.8 m³/h vs. the required duty of 2,813 m³/h, the volume can
therefore be reduced by 13%. The Anaesthetic & Prep AHU is running at 2,394 m³/h vs. the required duty
of 1,357.98 m³/h, a 44% reduction is therefore possible.
Ø
Ø This initiative can be achieved through modification of the operating frequency on the Variable Speed Drive
(VSD).
Ø
Ø Following the fan laws, this equates to a reduction in energy of 34% and 82.4% respectively.
166. Recommendation 2
Consider removing the HEPA filters from the AHUs
ØThe AHUs serving the theatres at Mile End were found to contain
HEPA filters. As HEPA filters are only a requirement for ultra
clean theatres, it is recommended that consideration be given to
their removal from the system.
Ø
ØOwing to the high pressure drops developed by HEPA filters, the
reduction in energy has been calculated to be 1.2kW, equating to
a £1,051 saving per annum.
167. Recommendation 7
Consider reducing temperature set-point
The existing controls for the Air Handling Units are controlled to a set-point of 25˚C; this is considered high. It is
recommended that this set-point be reviewed and adjusted to nearer 21˚C. Reducing the temperature by 4˚C
would reduce the energy consumption by approximately 27%.
Supply Air Temperature (Heating Coil) = 25.00 0
C
Total Air Volume = 0.88 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 25.00 20.47 16,473.56
Feb 309 28 11.04 1.00 4.46 25.00 20.54 14,930.23
Mar 261 31 8.42 1.00 7.08 25.00 17.92 14,421.41
Apr 197 30 6.57 1.00 8.93 25.00 16.07 12,515.41
May 111 31 3.58 1.00 11.92 25.00 13.08 10,526.34
Jun 49 30 1.63 1.00 13.87 25.00 11.13 8,668.11
Jul 20 31 0.65 1.00 14.85 25.00 10.15 8,168.38
Aug 23 31 0.74 1.00 14.76 25.00 10.24 8,240.81
Sep 53 30 1.77 1.00 13.73 25.00 11.27 8,777.14
Oct 128 31 4.13 1.00 11.37 25.00 13.63 10,968.96
Nov 234 30 7.80 1.00 7.70 25.00 17.30 13,473.34
Dec 308 31 9.94 1.00 5.56 25.00 19.44 15,644.65
Totals 2,033 365 142,808.34
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 190,411.12 kWhr
Annual Heating Cost = £5,712.33
Thames Valley - Heathrow
Supply Air Temperature (Heating Coil) = 25.00 0
C
Total Air Volume = 0.67 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 25.00 20.47 12,406.48
Feb 309 28 11.04 1.00 4.46 25.00 20.54 11,244.17
Mar 261 31 8.42 1.00 7.08 25.00 17.92 10,860.97
Apr 197 30 6.57 1.00 8.93 25.00 16.07 9,425.54
May 111 31 3.58 1.00 11.92 25.00 13.08 7,927.54
Jun 49 30 1.63 1.00 13.87 25.00 11.13 6,528.08
Jul 20 31 0.65 1.00 14.85 25.00 10.15 6,151.72
Aug 23 31 0.74 1.00 14.76 25.00 10.24 6,206.27
Sep 53 30 1.77 1.00 13.73 25.00 11.27 6,610.19
Oct 128 31 4.13 1.00 11.37 25.00 13.63 8,260.88
Nov 234 30 7.80 1.00 7.70 25.00 17.30 10,146.97
Dec 308 31 9.94 1.00 5.56 25.00 19.44 11,782.21
Totals 2,033 365 107,551.02
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 143,401.36 kWhr
Annual Heating Cost = £4,302.04
Thames Valley - Heathrow
24 Hours at 25˚C = Annual heating cost of £10,014.37
168. Recommendation 7
Consider reducing temperature set-point
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 0.88 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 21.00 16.47 13,254.50
Feb 309 28 11.04 1.00 4.46 21.00 16.54 12,022.69
Mar 261 31 8.42 1.00 7.08 21.00 13.92 11,202.35
Apr 197 30 6.57 1.00 8.93 21.00 12.07 9,400.19
May 111 31 3.58 1.00 11.92 21.00 9.08 7,307.28
Jun 49 30 1.63 1.00 13.87 21.00 7.13 5,552.89
Jul 20 31 0.65 1.00 14.85 21.00 6.15 4,949.31
Aug 23 31 0.74 1.00 14.76 21.00 6.24 5,021.74
Sep 53 30 1.77 1.00 13.73 21.00 7.27 5,661.92
Oct 128 31 4.13 1.00 11.37 21.00 9.63 7,749.90
Nov 234 30 7.80 1.00 7.70 21.00 13.30 10,358.12
Dec 308 31 9.94 1.00 5.56 21.00 15.44 12,425.59
Totals 2,033 365 104,906.48
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 139,875.31 kWhr
Annual Heating Cost = £4,196.26
Thames Valley - Heathrow
24 Hours at 21˚C = Annual heating cost of £7,356.52
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 0.67 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.00 4.53 21.00 16.47 9,982.15
Feb 309 28 11.04 1.00 4.46 21.00 16.54 9,054.46
Mar 261 31 8.42 1.00 7.08 21.00 13.92 8,436.65
Apr 197 30 6.57 1.00 8.93 21.00 12.07 7,079.42
May 111 31 3.58 1.00 11.92 21.00 9.08 5,503.22
Jun 49 30 1.63 1.00 13.87 21.00 7.13 4,181.96
Jul 20 31 0.65 1.00 14.85 21.00 6.15 3,727.40
Aug 23 31 0.74 1.00 14.76 21.00 6.24 3,781.95
Sep 53 30 1.77 1.00 13.73 21.00 7.27 4,264.07
Oct 128 31 4.13 1.00 11.37 21.00 9.63 5,836.56
Nov 234 30 7.80 1.00 7.70 21.00 13.30 7,800.85
Dec 308 31 9.94 1.00 5.56 21.00 15.44 9,357.89
Totals 2,033 365 79,006.58
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 105,342.11 kWhr
Annual Heating Cost = £3,160.26
Thames Valley - Heathrow
Ø This initiative can be achieved by a simple adjustment on the BMS.
170. Rec.
No.
Complexity (1
= Simple,
3 = Complex)
Relates
To:
Recommendation Est. Cost (£) CO2 Emissions
Reductions
(Tonnes)
Annual Energy
Saving (kWh)
Annual
Saving (£)
Simple Payback
Period
(Months)
1 2 Theatre 3 Consider reducing Air Change Rate in line with
HTM requirement in order to reduce energy.
£300 7 12,973 £1,297 3
2 1 Theatre 1 It is recommended that the run around coil
pump system be reinstated in order to reduce
load on the boilers.
£1,000 25.6 138,842 £4,165 3
3 3 All
Theatres
Consideration should be given to replacing
supply fans with high efficiency units in order to
reduce power drawn by the systems.
£29,000 34 61,854 £6,186 56
4 1 Theatre 2 Consider replacing air seals around openings in
order to reduce air leakage.
£150 0.2 328 £33 56
5 1 Theatre
4/5
Consideration should be given to repairing the
thermal wheel in order to reduce load on heating
and cooling.
£3,000 55 297,518 £8,925 4
6 2 All
Theatres
Consider adjusting the frost coil set-point in
order to reduce heating load which could be
recovered through use of the run around coil.
£1,000 210 1,141,658 £34,250 1
7 2 All
Theatres
Consideration could be given to introducing PIR
control so that energy can be reduced during
periods of inactivity.
£1,000 11 20,617 £2,062 6
Totals* £35,450 342.2 1,673,790 £56,918 8
*Savings are not considered cumulative, totals shown for representation purposes only.
Summary of Recommendations – Newham University Hospital
171. Recommendation 2
Consider reinstating the run around pump system
The run around coil recovery system is capable of recovering around 50% of the heating/cooling energy. With the
pumps out of order, the heating coil is operating at a higher demand than would be expected. Through the use of
simulation software, we can calculate that the heating energy used is 277,683.67kWh. By repairing the run around
coil pump we can assume that this figure will be reduced by 50%; this equates to a £4,165 saving per annum.
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 3.50 m3
/s
Daily Running Hours = 14.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.20 5.44 21.00 15.56 28,953.66
Feb 309 28 11.04 1.25 5.58 21.00 15.42 25,916.39
Mar 261 31 8.42 1.21 8.57 21.00 12.43 23,129.43
Apr 197 30 6.57 1.19 10.63 21.00 10.37 18,673.78
May 111 31 3.58 1.16 13.83 21.00 7.17 13,341.76
Jun 49 30 1.63 1.13 15.67 21.00 5.33 9,598.00
Jul 20 31 0.65 1.12 16.63 21.00 4.37 8,131.59
Aug 23 31 0.74 1.11 16.38 21.00 4.62 8,596.78
Sep 53 30 1.77 1.13 15.51 21.00 5.49 9,886.12
Oct 128 31 4.13 1.14 12.96 21.00 8.04 14,960.63
Nov 234 30 7.80 1.15 8.86 21.00 12.14 21,861.11
Dec 308 31 9.94 1.34 7.45 21.00 13.55 25,213.50
Totals 2,033 365 208,262.75
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 277,683.67 kWhr
Annual Heating Cost = £8,330.51
Thames Valley - Heathrow
172. Recommendation 5
Consider repairing the thermal wheel
At the time of inspection, the wheel serving Theatre 4/5 had failed and was therefore not rotating.
Repairing the thermal will provide savings equating to a £8,925 per annum.
173. Recommendation 5
Consider repairing the thermal wheel
The thermal wheel is capable of recovering around 75% of the heating energy. Through the use of simulation
software, we can calculate that the heating energy used is 396,690.96kWh. By repairing the thermal we can
assume that this figure will be reduced by 75%; this equates to a £8,925 saving per annum.
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 5.00 m3
/s
Daily Running Hours = 14.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 340 31 10.97 1.20 5.44 21.00 15.56 41,362.37
Feb 309 28 11.04 1.25 5.58 21.00 15.42 37,023.42
Mar 261 31 8.42 1.21 8.57 21.00 12.43 33,042.05
Apr 197 30 6.57 1.19 10.63 21.00 10.37 26,676.83
May 111 31 3.58 1.16 13.83 21.00 7.17 19,059.65
Jun 49 30 1.63 1.13 15.67 21.00 5.33 13,711.43
Jul 20 31 0.65 1.12 16.63 21.00 4.37 11,616.55
Aug 23 31 0.74 1.11 16.38 21.00 4.62 12,281.12
Sep 53 30 1.77 1.13 15.51 21.00 5.49 14,123.03
Oct 128 31 4.13 1.14 12.96 21.00 8.04 21,372.33
Nov 234 30 7.80 1.15 8.86 21.00 12.14 31,230.15
Dec 308 31 9.94 1.34 7.45 21.00 13.55 36,019.29
Totals 2,033 365 297,518.22
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 396,690.96 kWhr
Annual Heating Cost = £11,900.73
Thames Valley - Heathrow
175. *Savings are not considered cumulative, totals shown for representation purposes only.
Rec.
No.
Complexity
(1 = Simple,
3 = Complex)
Relates To: Recommendation Est. Cost (£) CO2 Emissions
Reductions (Tonnes)
Annual Energy Saving
(kWh)
Annual Saving (£) Simple Payback
Period (Months)
1 2 All Theatres Consider installing occupancy detection in order to control
ventilation on demand.
20,000 53 114,395 11,439 21
2 1 Theatres 5 - 8 Consider reviewing filter specification in order to reduce
system pressure and associated fan power requirement.
50 11 23,060 2,306 1
3 2 Theatres 5 & 6 Consider reducing the extract ventilation rate to the HTM03-01
standard so that fan power is reduced.
500 5 10,353 1,035 6
4 3 Theatres 3 & 4 Consider installing an energy recovery device to theatre 3 & 4
in order to reduce the heating requirement.
12,000 30 160,717 4,822 30
5 3 Theatres 3 & 4 Consider replacing the plant serving theatre 3 & 4 with a
packaged AHU in order to greatly improve system efficiency.
- - - - -
6 3 All Theatres Consider replacing fans with high efficiency units in order to
reduce power draw.
22,000 23 48,697 4,870 54
7 1 Theatres 5 – 8 Consider improving thermal insulation on pipework in order to
reduce system losses.
1,000 2 13,140 395 30
8 1 Boiler Plant Review boiler room insulation and pumps in order to increase
system efficiency.
4,500 12 56,502 1,971 27
9 2 All Theatres Consider reinstating automatic control in order to avoid
excessive energy use.
40,000 146 665,844 25,980 18
Totals* £100,050 282 1,092,708 52,818 23
Summary of Recommendations - Whipps Cross University Hospital
176. Recommendation 4
Consider Installation of an Energy Recovery Device
A run around coil system normally consists of two coils that are connected to each other via
a pumped circuit of water. The water absorbs heat from the exhaust air coil and dissipates it
through the supply air coil.
177. Recommendation 4
Consider Installation of an Energy Recovery Device
There is currently no heat recovery device installed within the system serving theatres 3&4. A run-around-coil energy recovery
system is typically capable of recovering around 50% of the heating/cooling energy from the extracted air, which is then
transferred to the supply air. Installing a RAC will provide savings of 50%; this equates to a £4,821 per annum.
Supply Air Temperature (Heating Coil) = 21.00 0
C
Total Air Volume = 1.92 m3
/s
Daily Running Hours = 24.00 hr
UK Geographical Location =
Month
Total Degree
Days
(K.day)
No. of Days in
Month
Mean
Deviation (∆T)
from Base
Temp (15.5)
(0
C)
Operational
Hours Load
Factor
Average Fresh
Air Temp
(0
C)
Supply Air
Temp Required
(0
C)
Mean Heating
Coil Uplift
(0C)
Mean Monthly
kWhr
Jan 351 31 11.32 1.00 4.18 21.00 16.82 29,433.12
Feb 327 28 11.68 1.00 3.82 21.00 17.18 27,153.75
Mar 283 31 9.13 1.00 6.37 21.00 14.63 25,600.86
Apr 218 30 7.27 1.00 8.23 21.00 12.77 21,625.23
May 135 31 4.35 1.00 11.15 21.00 9.85 17,236.40
Jun 68 30 2.27 1.00 13.23 21.00 7.77 13,158.03
Jul 32 31 1.03 1.00 14.47 21.00 6.53 11,426.77
Aug 38 31 1.23 1.00 14.27 21.00 6.73 11,776.75
Sep 75 30 2.50 1.00 13.00 21.00 8.00 13,547.52
Oct 158 31 5.10 1.00 10.40 21.00 10.60 18,548.81
Nov 254 30 8.47 1.00 7.03 21.00 13.97 23,657.36
Dec 324 31 10.45 1.00 5.05 21.00 15.95 27,910.71
Totals 2,263 365 241,075.31
Boiler Efficiency = 75.00 %
Gas Tariff = 3.00 p/kW
Annual Input kWhr = 321,433.75 kWhr
Annual Heating Cost = £9,643.01
South Eastern - Gatwick
178. Recommendation 6
Consider changing fans to high efficiency direct drive
There are multiple options for a direct drive replacement but as shown in the example below, removing the
existing fan (1) from the AHU, then enlarging the opening (2) would allow for a new plenum wall to be
installed (3), which would then facilitate the installation of a plug fan (4).
The new direct drive fan in this example has an absorbed power of 1.7kW at the same volume and
pressure as the original, this represents a 43% reduction.
179. Lighting upgrades & Controls
Provide advice on energy efficient lighting upgrades:
Ø LED
Ø Induction lamps
Ø Integrated sensor systems with light reflectors for optimum output
Ø Retro fit or upgrade from T12 & T8 to T5
•
Provide advice on lighting system controls and their efficiency:
Ø Dimmable control systems
Ø PIR sensors
Ø Photocells
•
Our approach is to undertake a lighting survey using calibrated Lux meters to determine current
lighting levels, which are then compared against healthcare requirements in accordance with the
relevant CIBSE Lighting Guide.
•
•
180. Steam and Condensate Systems
Ø Steam raising plant optimisation – pressure
regimes and boiler setback/sequencing
Ø
Ø Suitability of steam traps and associated
components
Ø
Ø Reduction of thermal losses – pipework insulation
review utilising infrared thermography
Ø
Ø Water treatment – TDS levels
Ø
Ø Heat & condensate recovery – boiler blow down,
flue gas economisers
Ø
Ø System zoning – minimisation of live circuits and
utilising motorised valves
Ø
Ø Steam metering and monitoring
Ø
Ø Condensate pump optimisation – demand control
on VSDs
Ø
Ø Oxygen trim – burner optimisation
Ø
Ø Feed pump modulation
181. Chiller Upgrades & Optimisation
Ø Review and improve chiller controls
Ø
Ø Establish opportunities for condenser coil heat reclaim
Ø
Ø Investigate opportunities for liquid pressure amplification (LPA)
Ø
Ø Investigate opportunities for condensing fan optimisation
Ø
Ø Review opportunities to retro-fit chiller, free-cooling circuits
•
•
•
183. Ø 7 Temperatures
Ø 2 Pressures
Ø 1 Power Input
Evaluating chiller performance & the Scope
for Optimisation
184. Advantages of this method:
Ø No need to install flow meters
Ø
Ø Easy to use
Ø
Ø Analysis within 30 minutes, without reliance on pre-installed
device
Ø
Ø Better field accuracy at much lower cost than traditional method
Ø
Evaluating chiller performance & the Scope
for Optimisation - Recommissioning
185. Performance evaluation
Ø COP (+/- 5 %)
Ø
Ø Capacity (+/- 7%)
Ø
Ø Power input
Ø Super-heat
Ø
Ø Sub-cool
Ø
Ø Evaporator performance
Ø Condenser performance
Evaluating chiller performance and the
Scope for Optimisation
Operational evaluation
Ø Correct charge
Ø
Ø Optimisation of expansion
device
Ø
Ø Compressor defects
Ø
Ø Stability or instability
186. Summary - Technological Improvements
Ø BMS Optimisation
Ø HVAC Optimisation
Ø Air Handling Unit Optimisation
Ø Effective control of Variable Speed Drives
Ø Improved Lighting and Lighting Controls
Ø Re-commissioning – no building is fully commissioned
187. Summary - Non Technical Opportunities
Ø Behavioural Change Programme
Ø Monitor Energy and Water Consumption Trends
Ø Invoice Validation
Ø CHP QA
Ø Review of Energy Tariffs
GMHSCP is committed to partnership working to develop and implement GM wide plans in support of the Springboard to a Green City Region and Air Quality. We are working to embed public health messages (both the impact of inaction) and the benefits.All of thesepolicy areas have clear health impacts
4
[PK Will need less of this as vast majority ofpeople in the room will get this. I swapped out clean water [is that an issue?] for warm homes. Does less extreme weather count has a health outcome? I’d argue it does especially as it kills the most vulnerable]
5
Carbon Literacy Training
4 sessionsdelivered, 33 accreditedCarbonLiterateemployees, more sessions to be planned later this calendaryear. 1stGP practice preparing to become Carbon Literate
Plastic reduction
Milk received in glass bottles, commitment to ensuring no plastic crockery used at any event hosted by the CCG
Paper reduction
Paper-liteorganisation
Commitment to reduce the amount of paper used at events hosted by the CCG. Example of this; Members event held on the 27thNovember:
Use an online voting platform (slido) to carry out the evaluation, saving 250 doubled sided print copies.
Replaced 20 x A3 colour prints by incorporating the document into slide presentation.
Reduced the number of print outs by providing all slide presentations and supporting documents via download (links).
Use recycled note pads from previous events.
Recyclable Stationary
Regular stationary amnesty
Non-bleached paper ordered as standard
Ordering other recyclable stationary when possible
Advocacy
Sharing our work with our Members whenever possible e.g. Members event held on the 27thNovember
Plan to share at our citizens panel in the near future
Strategy
Currently engaging on a draft Social Value Strategy; one of the focusses will be the environment. As part of the action plan we’ll be scoping what we can be doing as an employer to support our workforce to be kinder to the environment (e.g. support physical activity and green travel), but also what we can be doing as a commissioner (e.g. holding providers to account through contract monitoring).
6
March 2018 - We created the opportunity for Carbon Literacy to be presented to the Greater Manchester Health and Social Care Strategic Partnership Board
April 2018 - Salford CCG created the opportunity for Carbon Literacy to be presented at an NHS Sustainable Development Unit national roadshow event, with a film created for this purpose with you promoting Carbon Literacy. To bring an awareness of Carbon Literacy to this national organisation is an important step in advocacy within the NHS commissioning and provider sectors
June 2018 - You presented the detail of Carbon Literacy to the Governing Group of the Association of Greater Manchester CCGs proposing each organisation commits a Governing Body/Executive Team senior leader to attend the training which was offered in 2018; and commit to obtaining at least Bronze level Carbon Literacy certification.
October 2018 – Sat as part of the Q&A panel at the Senior Officer Carbon Literacy Training during Green Great Britain Week. We’ve since been approached by Bolton CCG to support them to become Bronze Accredited.
Nov – you presented the CCG’s CL story at a CL training session for GM public sector chief execs –inpsiredother AO’s & LA CE’s to act
You continue to advocate for Carbon Literacy to be adopted across the Greater Manchester Health and Social Care Partnership, with the CCG’s Chief Accountable Officer meeting with key Greater Manchester Leads on this matter
Always keen to share our story at events similar to today; encouraging others to take action!
7
Pleased to say that we are now a ‘Silver’ accredited Carbon Literate Organisation [the first NHS CLO – anywhere]
Bronze obtained in July 2018
Silver obtained in January 2019
Our planned next steps:
Further training to ensure more of our workforce become Carbon Literate, again, offering training places to provider and partner organisations at no cost, encouraging them to become Carbon Literate Organisations them into ; with the offer to support this if required.
Further work to ratify the Social Value Strategy and supporting action plan
A commitment from our CAO and Executive Team to continue to advocate Carbon Literacy/action onCarbon Neutralityat a GM level wherever possible
8
Intro tobehav. change if needed, presuming that most people in the room are already on board/involved in SDdelivery, then alook at how CL could shift SD practice in the NHS…
9
Intro tobehav. change if needed, presuming that most people in the room are already on board/involved in SDdelivery [can be dropped if we’re short of time]
10
VERY quick sketch
11
Won’t go into detail but… gives an idea of scale/reach. Again, fast
12
Intro Burnham Green City Summit
13
That CO2 target is massive – imagine running your organisation without fossil fuels within19 years
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15
This was one result of the summit – public sector chief execs from across sectors – including some health leaders
Last point made by a CCG AO
16
So far [and it’s early days] the CCG AO’s across half GM’s CCG’s are engaged, along with a v strong CApolicy imperative…
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So far [and it’s early days] the CCG AO’s across half GM’s CCG’s are engaged, along with a v strong CApolicy imperative…
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Sustainability Roadshow Manchester - Thursday 14th February 2019
www.forwardwaste.co.uk - 0345 4633 952
Forward Waste Management - Beds or Bins
Sustainability Roadshow Manchester - Thursday 14th February 2019
Forward Waste Management - Beds or Bins
www.forwardwaste.co.uk - 0345 4633 952
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Florence Nightingaleand MarySeacole
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£25k per month savings on disposal costs from retender. Large degree of support for on the contract from Director level atBywatersand all levels below.Eg. monthly visits from our HR Manager to site.
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Unileverhave committed to:
ensurethat 100% of our plastic packaging will be designed to be fully reusable, recyclable or compostable by 2025.
halve the waste associated with the disposal of our products by 2020 and increasing the recycled plastic content in our packaging to 25% by 2025.
Costapledge for 500 million coffee cups recycled in the UK annually – that is one in every five coffee cups recycled. This is being administered through a third party who will issue the certificates for every tonne of coffee cups recycled. Note that this is a considerable effort to sort and collect with approximately 100,000 cups needed to make a tonne. However there is an economic incentive created with the payment of £70 per tonne to the waste collector.Bywatersis offering a collection service of £1 per bag of cups, the collections will be made with our new electric vehicle.
In 2016, France became the first country to announce a total ban on plastic cups, plates, and cutlery, to be brought in from 2020. As of August 2017, anyone in Kenya who’s found using, producing, or selling a plastic bag faces up to four years in jail, or a $38,000 fine. In February, Taiwan announced one of the farthest-reaching bans on plastic in the world, restricting the use of single-use plastic bags, straws, utensils, and cups.
The UK Parliament has committed to move to plastic free as of the end of 2018. In partnership withBywaters, they will be moving to plant based disposable packaging,
5
Coffee grounds recycling
6
We are hopeful that there has been a tipping point reached –it seems we are waking up to the horrific effect that single-use packaging, particularly plastics, are having on our environment, notably the oceans.
Calling this the Blue Planet effect, Sir David Attenborough’s show was enormously successful in the UK, topping the ratings for 2017 with more than 14 million viewers. In China, more than 100 million tuned in online and slowed the internet down
Sky TV has also led the way with their Oceans Rescue campaign whichBywaterswas very involved with, providing the plastic material from our recycling operation and beach cleans for the construction of their 250kg plastic monument to oceans plastic. The footfall at the locations that the whale toured around theUkand Europe was over 1 million.
On Saturday (August 18) the government revealed it received an “unprecedented” 162,000 responses which were overwhelmingly in favour of introducing taxing measures.
15 of the worlds 20 most polluted rivers are in Asia. Marine litter is a huge concern, but only 2% of plastic waste in the oceans is estimated to come from the whole of Europe and the US combined.
7
Unileverhave committed to:
ensurethat 100% of our plastic packaging will be designed to be fully reusable, recyclable or compostable by 2025.
halve the waste associated with the disposal of our products by 2020 and increasing the recycled plastic content in our packaging to 25% by 2025.
Costapledge for 500 million coffee cups recycled in the UK annually – that is one in every five coffee cups recycled. This is being administered through a third party who will issue the certificates for every tonne of coffee cups recycled. Note that this is a considerable effort to sort and collect with approximately 100,000 cups needed to make a tonne. However there is an economic incentive created with the payment of £70 per tonne to the waste collector.Bywatersis offering a collection service of £1 per bag of cups, the collections will be made with our new electric vehicle.
In 2016, France became the first country to announce a total ban on plastic cups, plates, and cutlery, to be brought in from 2020. As of August 2017, anyone in Kenya who’s found using, producing, or selling a plastic bag faces up to four years in jail, or a $38,000 fine. In February, Taiwan announced one of the farthest-reaching bans on plastic in the world, restricting the use of single-use plastic bags, straws, utensils, and cups.
The UK Parliament has committed to move to plastic free as of the end of 2018. In partnership withBywaters, they will be moving to plant based disposable packaging,
8
Leadingby example – as they say, change starts at home. See what your business can do.
Publiseand advocate
Ellen Macarthur foundation – The New Plastics Economy is an ambitious, three-year initiative to build momentum towards a plastics system that works. Applying the principles of the circular economy, it brings together key stakeholders to rethink and redesign the future of plastics, starting with packaging. big brands collaborating such as Google, Unilever, Nike, Philips, H&M, Danone
UN Single Use Plastics – Roadmap for Sustainability. Problematic single use plastics, Actions to minimize single use plastics, Case studies from around the world – including my home country of South Africa
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Include photoof Gradice above
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Split beachclean photos apart with a gap
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Introduction to Salix and our funding model
Working within the NHS
Knowledge sharing and case studies
Application process
Summary and questions
1
Salix’s work is focused exclusively on the public sector where lack of capital has prevented the modernisation of buildings and infrastructure
Aim to develop a strong, long term and positive relationship with public sector clients
Salix is a well trusted, successful company that is growing
Salix must ensure effective stewardship of public funds
2
Need to think holistically about energy.Important to also consider behaviour change.
Salix recently moved into renewables – Solar PV
3
So how does our model work?
A Trust or FT would come to Salix with a proposed project and the estimated savings, once we’ve assessed the project, Salix provide you with the upfront-capital that is often not available to invest in energy efficient technologies that will reduce energy bills. The savings in the energy bills are then used to repay the interest-free loan making it a cost neutral approach and Salix then re-invest the repayments in to further projects in the public sector.
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Part funded and assessed on a case by case basis if over funding criteria
CRL is adjustable for Salix financing – important to get in contact with NHSI regional lead
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Over 200 PKS (project knowledge slides)
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Salix tendto get involved in projects once an organisation knows which technologies they want to implement and have an idea on costs and savings.
Weare happy to look over yourBusiness case – gives you confidencein your savings and payback figures
At the stage of getting approval – happy to meet with finance departmentsto run through the Salix offer.
Salix can provide a reservation of funding once we have seen calculations if this wouldhelp you with board approval and we can put you in touch with other Trusts that have done similar projects or faced similar barriers to you to help overcome issues.
Throughout installation we can pay out funds in instalments as you progress the project –eg.First interim for when you raise the order making it easier to pay contractors, with last payment being on completion of the project.
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Information and Skill Gaps: There are a wide range of skills needed; from understanding the benefits of improving energy use, through to the engineering skills needed to install and optimise energy using equipment.
Bounded Rationality: Using the old &quot;rule of thumb&quot; to problems that require a different structure to the decision making process. For example an energy efficiency upgrade may save significantly on energy costs but the maintenance departments budget is the only part of the business that considers asset replacement, and energy costs are ignored or under estimated in their decision making.
Principal-Agent Problems: Improving energy efficiency can have multiple benefits to multiple people, but the costs may not align with the benefits. For example a tenant may pay the electricity bill which doesn&apos;t directly impact on the landlord, so the landlord may not want to invest in more efficient heating, cooling, air conditioning or insulation.
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The AHUs serving the theatres at Mile End were found to contain HEPA filters. As HEPA filters are only a requirement for ultra clean theatres, it is recommended that consideration be given to their removal from the system.
Owing to the high pressure drops developed by HEPA filters, the reduction in energy has been calculated to be 1.2kW, equating to a £1,051 saving per annum.
Additional savings are also generated through the reduced maintenance time and replacement filter costs.
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Commissioning –Plans for proper hand-over and commissioning.
Sub-meters and reconciliation – strategy, commissioning reconciliation and calibration
BMS – full specification, timely training, co-ordinated installation and commissioning
Controls – clear, simple, intuitive, instructions and labels
Lighting – performance specifications, appropriate controls, labelled and explained
Fabric performance –Provision made for follow-through by builders/designers after hand over
HVAC –systems to be optimised, not just meeting set-points
Renewables – retain input from specialists, site resourcing
Plans for proper hand-over and commissioning – programmes such as soft landing might be considered
Suppliers of specialist equipment or services, retained or consulted on integration and commissioning.
201 Bishopsgate is a high spec office in the City of London, with a floorspace of more than 37,000m2 over 14 storeys,
Contractors were tasked with identifying energy saving opportunities, using the BMS and metering. Good sub-metering was critical for this task.
In one seven-month period in 2011, they found issues leading to a reduction of roughly 20% of the total building electricity consumption. This included refining the local BMS settings e.g. inappropriate time clock or demand settings, switching off the underfloor heating in reception in the summer, and investigating and correcting motion controlled back-of-house lighting - which was consuming energy at weekends.
As part of carbon management programmes - JLP re-commissioned HVAC and controls – delivered typical savings of ~ 10%
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Commissioning –Plans for proper hand-over and commissioning.
Sub-meters and reconciliation – strategy, commissioning reconciliation and calibration
BMS – full specification, timely training, co-ordinated installation and commissioning
Controls – clear, simple, intuitive, instructions and labels
Lighting – performance specifications, appropriate controls, labelled and explained
Fabric performance –Provision made for follow-through by builders/designers after hand over
HVAC –systems to be optimised, not just meeting set-points
Renewables – retain input from specialists, site resourcing
Plans for proper hand-over and commissioning – programmes such as soft landing might be considered
Suppliers of specialist equipment or services, retained or consulted on integration and commissioning.
201 Bishopsgate is a high spec office in the City of London, with a floorspace of more than 37,000m2 over 14 storeys,
Contractors were tasked with identifying energy saving opportunities, using the BMS and metering. Good sub-metering was critical for this task.
In one seven-month period in 2011, they found issues leading to a reduction of roughly 20% of the total building electricity consumption. This included refining the local BMS settings e.g. inappropriate time clock or demand settings, switching off the underfloor heating in reception in the summer, and investigating and correcting motion controlled back-of-house lighting - which was consuming energy at weekends.
As part of carbon management programmes - JLP re-commissioned HVAC and controls – delivered typical savings of ~ 10%
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