Sustainability Day Leeds 2017

Welcome to the Leeds Sustainability Day
2016 Road Show
#Dayforaction

Chair’s welcome
Roger Tolman, 4 All of Us
#Dayforaction

09:10 Chairs Welcome
09:20 Implementing the national Sustainable Development Strategy for the NHS – A local perspective
Frank Swinton, Consultant Anaesthetist, Clinical Lead for Sustainability, Clinical Director for
Anaesthetics, Theatres and Critical Care, Airedale Hospital NHS Foundation Trust
09:40 Delivering a Sustainable Development Management Plan
Jane Money, Sustainability Manager, York Teaching Hospital NHS Foundation Trust
10:00 Implementation of an Environmental Management System - SDMP and EMS Twin Track Approach
Libby Moss, Sustainability Manager, Leeds Teaching Hospitals NHS Trust
10:20 How software can provide solutions to NHS issues - Oxford Heath NHS Foundation Trust/TRACC case
study
Dan Saunders, Basemap
10:40 Need to renew your power-plants or to provide stand-by power?
Gordon Watt, European Business Development, Doosan - Babcock
11:00 Question and answer session
11:20 Refreshments and Networking

A Local Perspective
Dr Frank Swinton
Consultant Anaesthetist
Clinical Lead for Sustainability
@frankswinton

Goal 1 - A healthier environment
Goal 2 - Communities and services are
resilient to changing times and climates
Goal 3 - Every opportunity contributes to
healthy lives, communities and environments
Vision - A sustainable system protects and improves
health within environmental and social resources now
and for the future
The Strategy
@frankswinton

Enable the
positives
Reduce the
negatives
@frankswinton

@frankswinton
Northern Region Website
http://www.sduhealth.org.uk/delivery/engage/r
egional-and-local-networks/north-
sustainability-network.aspx

@frankswinton
• Regional
• 5YFV/STP
• Air Pollution
• Local
• SDMP

Food and Drink Strategy
• Diet drinks, water, low volume fruit juice
• Low fat (trans) crisps, yoghurts
• Increase fibre
• Small portion confectionary/foods
• Enhance Cultural choices
• Positioning of food/drinks in retail outlets
• Traffic Light system/labelling in food outlets
• Promote healthy foods/drinks
• Restaurant, Friends Shops, Vending Machines
• Proportionate response to promote health in our patients, staff &
visitors
• Eat Well, Exercise Well, Think Well!
@frankswinton

Delivering the NHS Trust
Sustainable Development
Management Plan

Introduction
•Background
•Where were we then ?
• Where did we want to be ?
• How did we get there?
• What did we achieve?
• What next ?

Background
• Delivering acute hospital and healthcare to 530,000
• York and North Yorkshire- covering 3,400 miles
• York Acute Hospital– circa 50% energy
• Scarborough and Bridlington hospitals – 25% &10%
• 8 hospitals,1100 beds
• 8500 staff
• Energy Bills- 68 sites
•Annual turnover c.£400M

Where were we then ?
• Trust Board Commitment to
Carbon Reduction
• Lack of budget
• Old and obsolete plant
– Inefficient lighting
– Inefficient equipment
– Limited monitoring and control

Where did we want to be?
• Project Aims
• Reduce carbon emissions
• Reduce energy costs
• Improve resilience
• Tackle barriers through
• Securing funding
• Identifying project scope and costs
• Guaranteed financial savings
• Eliminating backlog maintenance issues

How did we get there ?
Starting point
• NHS SD Unit Marginal Abatement Cost Curve
• Board objectives
• CEF Framework
The Carbon & Energy Fund
• NHS Countess of Chester Framework
• Best value, competition and innovation
• Upfront free advice – no contract = no fee
• Funding/loan provided (if required)
• Predicted minimum guaranteed savings
• All procurement, design, legal, delivery and
verification costs included within scheme

What did we achieve ?
Contract 1-York Hospital (completed Sept 2014)
• £3.8M capital project
• Savings
– 3k tonnes carbon (22%)
– £810k p a guaranteed
• New energy generation
– 1.2 MVA Gas CHP
– Waste heat boiler
• New demand reduction
– Remote monitoring and control
– Resulting from more efficient infrastructure (including
new pumps, heat exchangers, new pipework,
insulation, sensors and variable speed drives
– Energy efficient lighting
• 15 year EPC with independent M& V from CEF

What did we achieve ? (continued
1)
Contract 2- Scarborough and Bridlington
Bridlington Hospital (April 2016)
• £1.2M capital project
• £151k minimum guaranteed savings
• 676 tonnes carbon saved per annum
Scarborough Hospital (Jan 2017)
• £3.2M project
• £512k predicted guaranteed savings
• 2,130 tonnes carbon saved per annum
Contract 2 – Total carbon savings 38% per annum
and 31% reduction in energy costs.

What did we achieve ? (continued
2)
CHPA Integrated Energy Project Winner (2014)
H &V News Retrofit Project of the Year Winner
(2016)
NHS SD Unit – Innovation Award
– Highly commended runner up (2016)
Building Better Health Care - Efficiency Award
– Highly commended runner up (2016)

What Next ?
- Some of our SDMP activities
• Energy – review of SD Unit advice with other
low to medium cost measures to identify next
steps for top energy using sites
• Procurement and Waste – influence tenders –
recent taxi tender -4% score on carbon
emissions, waste audit on Wards
• Travel -Travel Planning Coordinator shared with
City of York Council – Liftshare, Evs, Pool cars
• Buildings - Work to improve capital estates
policies and procedures to achieve more
sustainable design and delivery
• Engagement – Assessment of level of
engagement upon which to base plans to build
in capacity and integrate more widely .

Sustainable Development Unit for health and care system
in England www.sduhealth.org.uk/
Carbon and Energy Fund www.carbonenergyfund.net
Email peter.fairclough@cef.net (Director) or
Becca.warren@cef.net (Monitoring and Verification)
Vital Energi www.vitalenergi.co.uk
Jane Money, Head of Sustainability
Email jane.money@york.nhs.uk
For more information

Relieving Pressure on Parking
and Encouraging Active Travel
Dan Saunders, Product Manager
Basemap

PARKING PRESSURES IN NHS
• Pressures of hospital car parking constantly in
the news
• Reduce the number of car parking spaces &
introduce a sustainable parking permit system
• Parking very emotive
• Complaints about lack of spaces
• People who could travel by alternative means or
park somewhere else
• Need fair system for monitoring and controlling
to ensure spaces allocated in the best way

ENCOURAGING ACTIVE TRAVEL
• Active travel relieves parking pressures &
encourage staff health and wellbeing
• Promote cycle to work and car share scheme
- Provisions for cycle racks & showers
• Communicate the benefits of walking/cycling
• Highlight public transport options & routes
• Collaborate with local transport
partnerships/companies
• 2030 target of reducing carbon emissions by
40%

OXFORD HEALTH NHS FOUNDATION TRUST - THE PROBLEM
• Needed to introduce sustainable car parking permit system following increase
pressure on parking
• Increase due to business growth, changes in services & staff travelling further
• Health & safety issues - cars blocking emergency access
• Wanted to increase active travel & reduce congestion around hospital
• New car parking management system needed to be fair to all
• Manage over 100 sites
• Straight line or circle approach not sufficient - important to look at travel time &
consider all variables

42,290 People
TRADITIONAL METHODS

▪ Quick easy analysis of travel time and distance
• Public transport (all modes)
• Car
• Cycle
• Walking
▪ Can adjust the transport network
• Add new roads, exclude dangerous roads
• Add or remove a bus service
WHAT IS TRACC?
• Outputs
• Travel time contours maps
• Origin to destination
time/distance spreadsheets
• Origin to destination path report
• Demographic data reports
• Catchment maps

15,493 People
ADVANTAGES OF USING SOFTWARE

OXFORD HEALTH NHS FOUNDATION TRUST: THE SOLUTION
Get the union to decide to cut off travel times
• 25 minute Cycle
• 25 minute Walk
• 45 minute public transport outbound – morning peak
• 45 minute public transport Inbound – afternoon peak
Analyse every postcode within a 2 hour buffer
• New and Existing Staff
• Results outputted as a large CSV file
• Results imported linked into existing HR system
• Gave a score where travel time was an element
Change in travel behaviour after system went live
• Increase in active travel
• Reduction in congestion
• Robust evidence for appeals

OXFORD HEALTH NHS FOUNDATION TRUST: THE SOLUTION

“If we hadn’t had TRACC, our only alternative would
have been a system that wouldn’t have considered public
transport options and we wouldn’t have been able to
achieve these very detailed results”
“We have seen an increase in people travelling a
different way & finding different solutions as a result”
Tanya Street, Estates & Facilities Business Change Manager at Oxford
Health NHS Foundation Trust
www.basemap.co.uk/oxford_nhs

HOW IS TRACC USED IN OTHER NHS DEPARTMENTS?
• Distance: staff and patient access to NHS sites
• Travel times to NHS sites for staff and patients using postcode data
• Have an educated look at bus subsidies
• Looking at public transport access to NHS sites
• Impact on service cuts
• Look at new developments and impact of site/unit closures on staff and patients
• Use TM-Speeds data to look at car driving times
• Look at catchment areas of hospitals and services
• Look at commissioning of new and existing health services

NHS STROKE SERVICES: CASE STUDY

WWW.BASEMAP.CO.UK/NHS-STROKE-SERVICES

SUMMARY
• Saves time
• Easy to use
• Accurate demographic reporting
• Flexible - view and edit data
• Influence new site proposals or closures
• Assist with pressure on parking
• Encourage active travel for staff & patients
• Control of data/queries - no need to outsource

INFO@BASEMAP.CO.UK
BASEMAP.CO.UK
01483 688470
CONNECT:
@BASEMAP
LINKEDIN.COM/COMPANY/BASEMAP

Fuel Cell Technology Part of the NHS
Energy Mix
2017

Doosan Babcock
Building a Low Carbon Future
AGENDA
44
• INTRODUCTION TO DOOSAN BABCOCK
• THE DRIVERS
• THE PURECELL FUEL CELL
• UK FUEL CELL INSTALLATIONS
• ARUP STUDY FINDINGS
• THE UKS LARGEST FUEL CELL INSTALLATION

45
Reduction of
Energy
Consumption
Financial
savings
Reduced
Carbon
levels
Low
maintenance
Optimised
solution
THE DRIVERS

Doosan Babcock
DOOSAN FUEL CELL IN CONNECTICUT
46

5
PURECELL® MODEL 460 – WHAT & HOW
1 Electrical Power
Inverter generates high
quality AC power
3 Air Conditioning
Utilising an Absorption Chiller
Hot Water can efficiently provide
Air Conditioning
4 Hydrogen
Pure Hydrogen
slipstreamed for
Transportation
5 Vitiated Air
Provides Data Centers with Inert
Atmosphere for fire protection
A Natural Gas
Connect to
Existing UK Gas
Infrastructure
B Hydrogen
Ready
100% Hydrogen
with Minor
Modification
447kW of Power and 530kW of Heat created from hydrogen
2 Hot Water
Heat Recovery System
Generate Hot Water
47

Doosan Babcock
Design Features
• 10 year cell stack life
• Grid-independent operation
• Electric load following
• Low pressure natural gas fuel & H2 ready
• Low noise and vibration
• Low emissions
PURECELL® - WHAT…
48
Performance
• Fleet availability 98% -12 month rolling average
• No shutdown required for planned maintenance
Output and Efficiency
• 447kW electric output
• 530kW/h heat output
• 42% electrical efficiency
• 90% system efficiency
Cleanest source of continuous on site energy generation
48

Doosan Babcock
Key Client Examples
Data Centers /
Telecom
HospitalsUniversities Industrial
District Heat &
Power
CommercialRetail Government
20 year
Product life
>12 million
Hours of fleet field operation
>110 MW
Installed referenceProven
Technology
>220 PureCell
Units globally
KEY SECTORS ADOPTING DOOSAN FUEL CELLS
49

Doosan Babcock
FUEL CELL ADOPTERS IN THE UK
50

Doosan Babcock
FUEL CELL ADOPTERS IN THE UK
51

Daily Peak Load Energy Mix
•Fuel Cell / CHP solution supplies majority of demand
• >60%
•Solar PV provides top-up during mid-day
• Max Solar output coincides with mid-day demand peak
• Up to 150kW in Summer
•Remaining Demand met by grid import
• Only 30% of total peak daily demand is grid electricity
New Energy Mix:
Fuel Cell
&
CHP
Grid
Solar
NHS Estate Trust Project - current

Strictly Private & Confidential, © Copyright Doosan Babcock
TRUST BENEFITS
Air Quality Benefits – Healthy Local Hospital
Resilient Technology – Heat & Power
CSR Project Opportunity
Low Noise & Vibration
Future Proof
De-Steam
Long Term
Triple Bottom Line Improvements
(+ Financial + Social + Environmental)
COST
CARBON

Doosan Babcock
ARUP STUDY BASIS OF COMPARISON
54
• Purecell® 400 Versus Gas Fired CHP
• Mixed Use Commercial Building
• Central London
• Run at Full Load with No Heat Rejection
• MCPD NOx Limits of <95mg/Nm3

Doosan Babcock
• 400 kWe
• 472 kWth
• 92% Availability
SYSTEM OUTLINE
55
• Gas Fired CHP System

Doosan Babcock
SYSTEM OUTLINE
56
• Fuel Cell CHP System
• 447 kWe
• 530 kWth
• 98% Availability

Doosan Babcock
METHODOLOGY
57
• Whole Systems & Whole Lifecycle Cost
• Equipment Schedule for Both Systems
• O&M Costs for all Major Equipment
• Total Parasitic Loads Calculated
• Space Requirements Compared
• End of Life and Decommissioning Costs Assessed
• Analysis for 20 Years Lifetime of Purecell®
• Economic Comparison using Cash Flow Model

Doosan Babcock
TECHNICAL COMPARISON (20 YEARS)
58
Item Purecell® 400 Gas Engine CHP
Average Electrical Efficiency (NCV) 41.2% 40%
Average Thermal Efficiency (NCV) 49% 47%
Availability Factor 98% 92%
Total Electrical Output (MWh) 76,267 63,241
Total Heat Output (MWh) 91,033 76,079
Total Energy Output (MWh) 167,660 139,320
Total Fuel Input (MWh) 206,400 177,631
Carbon Emissions per Unit Heat (kgCO2e/kWh) 0.201 0.219

Doosan Babcock
CONCLUSIONS OF THE ARUP REPORT
59
• Highest Electrical Efficiency
• 41 % NCV, giving rise to 8% reduction in Carbon emissions
• Smallest Plant Room Size
• 70 m2 less floor area
• Significant Superior Air Quality Performance
• 0.65mg/Nm3
• Improved Modulation Performance
• Electrical efficiency maintained down to 40%
• Better Economic Performance Over 20 Years
• £380,000 more revenue generated
• Lower Energy Costs
• Undiscounted LCOE & LCOH 7- 10% lower respectively
• Greater Economic Return
• Additional investment of a Purecell® over conventional CHP gives an IRR of 3.8%
Key Findings of Techno-Economic Analysis of Purecell® 400 Compared
to a Similar Sized Gas Engine CHP With SCR Nox Reduction Technology

Doosan Babcock
FUTURE PROJECTS
60

Doosan Babcock
THE LARGEST FUEL CELL INSTALLATION IN THE UK
61

ABERDEEN
AECC Energy Centre Layout (Plan View)
CHP
Offices
Thermal
Stores
Electrolysers Chilling Fuel Cells
Switch
Rooms
120m
20m

SUMMARY
The Purecell unit is being considered by many in the NHS because it
delivers
 Resilience
 Negligible Nox & Sox
 Low maintenance
 Step change technology
 Quiet
 Most efficient technology
 Financially viable
63

Strictly Private & Confidential, © Copyright Doosan Babcock Limited
Thank You For Listening,
Any Questions?
Gordon.Watt@doosan.com

Question and answers
#Dayforaction

Refreshments & Networking
#Dayforaction

11:40 Welcome back
Roger Tolman, 4 All of Us – Confirmed
11:45 Role of reuse within the NHS
Daniel O Connor, CEO, Warp-It
12:05 Comprehensive water management
Fiona Daly, Director, Sustainable Business Development, ADSM
12:25 Smart Cities and how they have the potential to be an integral part of Health & Social
care
Mark Griffiths, Regional Director, Bouygues Energy & Services FM Division, Bouygues
12:45 Liverpool Women’s Hospital uses sustainable reusable sharp’s containers
Mary Fotheringham, Business Development Manager, Sharpsmart
13:05 Lunch & Networking

The Power of
Habit.
Changing
Organisational
Habits
An introduction

Overview
 Habits basics
 Organizational
habits
 Demonstrated via
reuse but can be
applied wherever!

Daniel BedeO’Connor
Head ofCustomer
Happiness
GetWarpIt.com
daniel@GetWarpIt.com
@WarpIt_

The power
of habit
Why do we do what we do and how to change.
Charles Duhigg

What habit would
you like to develop
or change?

You want to
improve
things right?
Organisational
habits

GetWarpIt.com
Surplus assets
redistribution
internal estate

New disposal/
procurement
habits
NHS London
save £3K ,
NHSTayside
save £15K

Keystone
habits in
organisations

Reuse
as a
Keystone
habit
Frame within crisis, not
sustainability
Unacceptable to dispose of
assets to waste
Change
Other sustainability behaviours

“Once a small win is
accomplished , forces are
set in motion that favour
another small win”
Small wins

“Smallwins fuel transformative
changeby leveragingtiny
advantagesinto patternsthat
convincepeoplebigger
achievementsarewithin reach”
Small wins

Wishlists
Direct
transfer- no
double
handling

Watchlists
Plan building
moves.
Direct transfer.

Demonstrate
savings.
Metrics from
NHSTayside

Small wins for
reuse
Or any
sustainability
project
 Just start off with a stationery amnesty? Show impact?
 Ask procurement to block purchase of stationery
 Demonstrate savings let’s do full reuse system
 Develop intranet content
 Deliver newsletter
 First £20K saving
 Feedback to staff
 Feedback to senior staff
 1st year review
 Yes we’ve got the CE on board!

Review
Anatomy of habits
Keystone habits
Small wins

Do you want
to improve
things?

Do
you
Hate buying new
when the
organisation
already has it?

Do
you
Hate seeing
surplus
assets in
skips?

Do
you
Like reducing
waste?

Do
you
Like reducing
procurement?

Do
you
Like helping
staff
collaborate?

Do
you
Like saving
money and
carbon?

Do
you
Like
collaborating
with other
Trusts?

Do
you
Want to get me in to
illustrate the hooks and
benefits of reuse for each
department?

Habit?
Cue
Routine
Reward?
Craving!

DanielO’Connor
Head ofCustomer
Happiness
daniel@GetWarpIt.com
@WarpIt_

questions and contact
Fiona Daly
fdaly@adsm.com
07595219719
@AdsmUK

Mark Griffiths
Regional Director
Bouygues Energies & Services

Smart Cities can they be an integral part of
Health & Social care?
AGENDA:
• Introduction
• What is a Smart City
• Building Smart
• The challenges
• Drivers and Benefits

The Bouygues Group: Building Smart Cities
Communications Construction Power
£36 B turnover

Bouygues’ French Headquarters - Challenger
First building in the world to achieve triple certification (2011)
• LEED® “Platinum” (US)
• BREEAM® “Outstanding” (UK)
• HQE® “Exceptional” (FR)
Delivery Challenge
• Phased works from 2010 to 2014, Shifts over 67,000m2
• Occupied site
Energy
• 90% Energy and CO2 savings
• Ventilated, double skin façades
• Geothermal energy from heat pumps
• 25,000m2 photovoltaic panels on roofs, terraces and solar farm
• 100% of available BREEAM energy credits achieved
Water
• Rainwater harvesting
• 60% water savings
• 100% of sewage will be treated and re-used on site (phyto-filtration garden)

Human Activities: City Impact!!!

Smart City Challenges: Approach

Process – Identify the needs
Public Spaces
Infrastructures
Housing
Public amenities
Commerce and
business
New
usages
Local
services
Nature in the
city
Water Energies Wastes Mobility Digital

Create the best solution with
the best partners
More lively, more communal and more
intense
More efficient, more renewable and
greener
More connected, smarter and more
intermodal
Group
Global
Local
FM

GreenCity – Zurich
2000W Community
Today
5.000 W/hab
Accomodation
1.500 W
Transportation
900 W
Consumption
1.100 W
Infrastructure
900 W
Electricity
600 W
Goal
2.000 W/hab

Smart City & Health and Social Care
Drivers & Benefits
Internet Of Things
High-Tech Ecosystem
Data Development
Sensor networks
Data Collection
Storage
Mobility
Predictive Healthcare –
App based ?
Improved environment –
Air Quality
Reduced inpatient time
Social Inclusion
Benefits
Drivers

There is one game changer that will help us
deliver these benefits

www.bouygues-es.co.uk
Thank You

SHARPSMART & LIVERPOOL
WOMEN’S HOSPITAL

AGENDA
• WHO ARE SHARPSMART?
• THE CHALLENGE
• THE SOLUTIONS
1. SHARPSMART
2. CLINISMART BAG-TO-BEDSIDE
• THE RESULTS

Making waste invisible!
Defining the future for
safe management of
Healthcare Waste.

ALIGNING WITH THE NEEDS OF THE NHS
• We don’t just ensure that you
achieve your goals….
We make it harder for you to fail.

LIVERPOOL WOMEN’S HOSPITAL - THE
CHALLENGE
Liverpool Women’s Hospital is a specialist NHS Trusts in the UK that is dedicated
to the healthcare of women, babies and their families.
Over 8,000 babies delivered and
10,000 gynaecological procedures
untaken each year, as well
multiple genetics departments to
maintain.
Vital that the trusts waste
disposal methods are as safe and
sustainable as possible.

THE CHALLENGE
DISPOSABLE ‘BURN’ BINS ISSUES
Safe?
The single-use system was not the safest option for sharps disposal.
• Small size
• Absence of protective features (permanent locks, pre-assembly)
Efficiency
The time taken to construct some of these containers impinged on carers’ time.
Plastic Disposal
Single-use containers saw the disposal of 6.5 tonnes of polypropylene plastic
per year
- Not in line with the 2008 climate change act
- Costly

THE CHALLENGE
REDUCE CLINICAL WASTE & CO2
Promoting Sustainability
One of Liverpool Women’s biggest environmental objectives
was to reduce their clinical waste and, consequently, their
carbon emissions.
Compliance
• Independent audit had highlighted instances of non-compliance with waste
guidelines
• Trust were concerned that they were incinerating significantly more waste than
necessary
• Wanted to ensure they were fully compliant on all fronts
• Trust’s environmental manager was under growing pressure to introduce an
offensive waste stream.

THE SOLUTION -
SHARPSMART
DISPOSABLE ‘BURN’ BINS ISSUES:

WHAT IS THE SHARPSMART SYSTEM?
A Reusable Engineered Safety Device designed for point-of-care disposal of sharps,
pharmaceuticals and recyclable devices.
Reusable sharps containment system &
accessories designed for traceable safe point-
of-care disposal.
Bespoke blended learning programmes built on
‘5 Moments’ Concept including hard copy ‘touch
point’ training tools and e-learning modules.
Auditsmart Perpetual Audit system designed
for continual optimisation and compliance

THE SOLUTION –
CLINISMART BAG-T-BEDSIDE
REDUCE CLINICAL WASTE & CO2:

WHAT IS THE BAG TO BED SYSTEM?
A total waste optimisation solution including an array of bespoke blended-learning tools and accesories ensure
that optimised segregation, safety and compliance can be achieved routinely without compromising correct
segregation techniques.
Flexible accessories designed to ensure safe,
compliant point-of-care segregation/disposal
Bespoke blended learning programmes built on
‘5 Moments’ Concept including hard copy ‘touch
point’ training tools and e-learning modules.
The system reduces the possible risk of
infection by the removal of the infectious
waste bins from patient areas.

PROCESS
 Sharps Management
 Pharma Program
 C64 Reusable Containment
 Bag to Bed
 Cyto Programme
 Device Recycling
 Vacsmart
 Total Waste Management
 Vacsmart
Waste Policy
Design and/or
Review
5 Needs KPI
Strategy
Development
Safe Containment Options
and Management of
Other Waste Streams
Education & ComplianceCustomer Excellence
Review & Verification
Program
Quarterly Strategy
Review & Annual
Policy Adjustment
Safety, Waste Minimisation
& Efficiency Programs

THE RESULTS – SHARPSMART
Forecast:
Sharpsmart will not have to manufacture any additional containers for the hospital to use for the next 10 years,
leading to an estimated 560 tonne reduction in CO2 emissions from the trust & 65 tonnes of plastic being
removed from the incineration stream.
In 19 months since the Sharpsmart installation:
• Sharps Management Savings of 10%
• 10 tonnes of polypropylene plastic saved from being incinerated
• CO2 emissions reduced by approximately 56 tonnes
• Safer working environment for staff
• 6,000 fewer containers are handled by both clinical and portering staff each year.
• Reduced waste volumes and educational opportunities for all staff.

THE RESULTS - CLINISMART BAG-TO-BEDSIDE
All cost and time-related savings from introducing these systems have been diverted to the maintenance and
improvement of frontline services, including waste, portering and domestic services.
In 6 months since the Clinismart Bag to Bedside system installation:
• Minimised the presence of waste containers in bay areas
• 40% of waste diverted from clinical to offensive and infectious streams
• Cost savings of 45%
• Touch-point education available for all staff involved in the production
& movement for healthcare waste
• Its value as an educational tool has helped the Trust stay compliant with CQC guidelines and 2012
Controlled Waste Regulations.

PROJECT FEEDBACK
Regarding the success of the project, John Foley, Environment Manager at the
Trust, commented;
“By providing a significant reduction in carbon emissions and clinical waste volumes, the
introduction of the Sharpsmart and Clinismart systems to the Trust has greatly assisted
with our efforts to become more sustainable in line with the Climate Change Act.
Results were noticed almost immediately by both staff and patients, which has greatly
enhanced the Trust and its prestigious reputation as a safe and environmentally-conscious
healthcare provider. The ability to audit and see what is inside a container is a real eye-
opener and extremely useful in educating staff.”

Lunch & Networking
#Dayforaction

13:45 Welcome back
Roger Tolman, 4 All of Us – Confirmed
13:50 Providing an efficient patient journey in both the emergency care and patient transport
fleet
Clare Swift, Environmental & Sustainability Manager, North East Ambulance Service
NHS Foundation Trust
14:10 Uniting ambulance services - the Green Environmental Ambulance Network (GrEAN)
Alexis Keech, MSc (MEng) BSc, Environmental & Sustainability Manager, Yorkshire
Ambulance Service
14:30 The Professionalism in Parking Accreditation
Ian Goodwin, Owner and Founder, the Parking Consultancy & Chair, BPA Special
Interest Group for Higher Education
14:50 Question and answer session
15:00 Concluding comments
15:10 Conference Close

Dr Clare Swift, Environmental &
Sustainability Manager
NHS Sustainability road show 2nd March
Providing a more
sustainable
patient journey

• Introduction to NEAS
• Baseline Carbon footprint &
CMP
• Sustainable Transport projects
• Future plans & barriers
Providing a more sustainable patient journey
Overview of presentation

• NEAS provides a number of NHS services, and covers the
counties of County Durham, Northumberland, Tyne &
Wear, along with the boroughs of Darlington, Hartlepool,
Middlesbrough, Redcar, Cleveland & Stockton on Tees
• 60 Stations spread across 3,200 square miles
• Our fleet of more than 500 vehicles clock up 10 million
miles per year
• We employ > 2000 staff in Emergency Care, Patient
Transport, Contact Centre including 111, along with
Support Services
Introduction to NEAS
Who we are

• Emergency Care 999
service for life
threatening calls
• Patient Transport (PTS)
for those that require
transport to outpatient
appointments
• NHS 111 for urgent
healthcare needs
Introduction to NEAS
What services we offer
Emergency Care and
PTS are both supported
by NEAS contact centres
in Newcastle & South
Tyneside
2015/16 Phone calls:
• 400,000 x 999
• 83,000 x urgent
• 665,000 x 111 calls
• 353,000 x PTS calls

Estate
24%
Transport
75%
Waste &
Water
1%
NEAS carbon footprint
2012 / 13 baseline

NEAS will reduce the carbon emissions from our
operations by 30%, from a 2012/13 baseline of
11,017 tonnes CO2, by the end of March 2020. This
represents a reduction of 33%
The potential cost of taking no action on carbon
reduction, compared to achieving the target in this
plan, is a cumulative sum of £10.6 million by March
2020.
Carbon Management Plan
Overall target

What our overall target
means for the fleet:
* NEAS needs to reduce
the carbon produced by
the fleet by around 2500
tonnes by 2020 to be in
with a chance of hitting
the overall target *
Fleet

25% reduction in electricity
33% reduction in gas
7.2 % increase in diesel
(sigh!)
Carbon Saver Gold Standard
achieved in August 2016
Overall progress so far

NEAS Fleet
Current numbers of the 3 main vehicle types
149 Dual
Crewed
Ambulances
(DCA)
239 Patient
Transport
Service (PTS)
52 Rapid
Response
Vehicles
(RRV)

1. Telematics – Driver Vehicle Data
Management System (DVDMS)
2. Alternative fuels
3. New technologies
4. Trust CIP projects: ‘See & Treat’ and ‘Hear
& Treat’
Fleet sustainability
Overview

A number of potential wide ranging benefits:
• Improved driver behaviour
• Increased fuel consumption & reduced CO2 emissions
• Reduced traffic collisions
• An improved patient experience
• Increased evidence to defend
motor claims
• Reduced maintenance & repair
costs
• More accurate statistical analysis
Fleet Sustainability
Telematics

• Dual Crewed Ambulances (DCA) restricted to 56mph
when not on blues and RRVs to 70mph
• Monitoring & Speed limiting produced an initial 10%
fuel saving on DCAs and 14% on RRVs
• From this success it was rolled out to the full
Emergency care fleet
• Savings stabilised at 3.2%
• Having the system on its own will not produce
savings, must be used as a driver behaviour
management system
Telematics savings so far

• Driver feedback systems in conjunction with Cranfield
University
• Monitoring and targeting driver behaviour
• Potentially a further 10% reduction in CO2
• Couple with fuel efficient driver training
• League table drivers based on their off blues driving
• A 10% reduction = around 800 tonnes CO2 and just
under £300k
• Potential for PTS fleet if payback right
Telematics – where we go from here

EST Fleet Review in 2014
Go Smarter funding for the
Trust’s first charge point
2 month loan of BMW i3 as
a pool vehicle
2015: funding for 5 Nissan
Leafs: pool cars
Charging infrastructure at 7
Trust properties
Alternative fuels

Pool cars:
2p per mile saving over the whole life cost
compared to a diesel fiesta
25% reduction in carbon emissions compared
diesel based on 12,000 miles per year
Alternative fuels – savings so far

• Energy Saving Trust
fleet review v2
• BMW i3 currently being
tested as an RRV
• 18 months through 2
year OLEV project
Alternative fuels – where we go from here

Compass 4D collaborative project in conjunction with
Newcastle University
Traffic light management
System – UK first
11 PTS vehicles
Delivers information to the
driver about speed at which
the vehicle needs to travel to get to the next set of traffic
lights on green (within limits!)
New technologies

We made the national press…!

• Compass 4D – 12% reduction in fuel savings
• A reduction of 66% in time spent below 5pmh
• Real world reduction was small as few vehicles &
junctions
• Huge scope for creating a smoother, more efficient
patient experience
• 2017 – expanding the number of junctions, and
potentially vehicles.
New technologies - savings

By end 2017/18 20% of 999 calls will result in ‘Hear &
Treat’ or ‘See & Treat’ rather than a conveyance to
hospital
Further reductions are planned through use of
Advanced Practitioners in RRVs rather than Dual
Crewed Ambulances (DCAs)
Changes to how crews are despatched – currently on
average 1.7:1 aim to reduce to 1.3:1
CIP projects

• Huge way to go – unsure if its even possible to create
the CMP reductions by 2020 on the fleet
• Need full buy-in from Ambulance Manufacturers
• Invest to save budget to be set up – fleet specific. Try
and replicate the success we have seen with estates
invest to save
• Engine cleans
• Engine remapping
Fleet projects
Plans for the future

Large geographical area of NEAS doesn’t lend itself
well to electric vehicles
Ambulance manufacturers need to buy-in to the low
carbon agenda
In-house resources
Needs all Ambulance Trusts to work as one through
Green Environmental Ambulance Network (GrEAN) and
National Fleet Managers Group.
Fleet projects
Barriers to further work

Uniting the British Ambulance Service
Alexis Keech, Yorkshire Ambulance Service
Turning the Blue
Lights Green

GrEAN
• GrEAN – Green Environmental Ambulance
Network set up in 2011
• Formed to identify leads in a difficult area of
the NHS to reduce carbon
• Helped to recruit further Sustainability
Managers into the Ambulance Service

The British Ambulance Service
National fleet
– 9 services in England, 13 in UK
– Over 50,000 staff
– Circa 10,000 vehicles
– Circa 250 million miles/year
– Circa 150,000 litres/day of diesel

Number of vehicles
0
200
400
600
800
1000
1200
1400
2014/15
2015/16
Graph to show number of vehicles on fleet by ambulance service
NoofVehicles

Fuel consumed
-
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000
2014/15
2015/16
Graph to show the fuel consumed (litres) by ambulance service
Litresofdiesel

Mileage covered
0
5000000
10000000
15000000
20000000
25000000
30000000
35000000
2014/15
2015/16
Graph to show the mileage covered by ambulance service
Mileagedriven

Green Passport
• Guide to ambulance
service carbon footprint
• Help in reducing personal
carbon footprint

Resource Sharing
• All Carbon Management
plans are shared between
ambulance services
• We share awareness
campaigns, posters, carbon
monitoring methods and
support
• A GrEAN newsletter is issued
on a biannual basis to all
ambulance services

NHS Forest
• NHS Forest – planting a
tree for everyone of the
1.3 million people that
work in the NHS
• Ambulance Services
planted trees on
ambulance stations and at
their HQ to provide
sustainable food sources
as well as greening their
stations.

Work with SDU
• Investigating Nitrous Oxide emissions (a GHG
more potent by 310 x)
• Climate change risk
• Fleet emissions project to identify emissions
that are currently not identified by SDU

Adaptation report
• Requirement from
DEFRA as part of ARP2
• Identified issues that
will affect ambulance
services across country

New Technology
• StorSense –
generator charge into
the grid
• Pyropure – small
scale waste
incinerator-CHP
• Sharpsmart –
reusable sharps box
• Dyson hand dryers –
reduce paper towel
use

New Technology
• Lighting – LED and
garage lighting
• Solar panels at
Ambulance stations,
offices and HQs
• Computer Power
management
systems

New Technology
• Sharing information on
new technologies
• Exploring cutting edge
technologies and
sharing outcomes

Alexis Keech
Yorkshire Ambulance Service
Alexis.Keech@yas.nhs.uk

PiPA: Professionalism in Parking
Accreditation – Healthcare
Ian Goodwin

Overview
• Introductions
• Background to PiPA
• Current accredited organisations in HE and Healthcare
• The PiPA assessment process
• The areas of assessment
• An example of an area of assessment
• Key drivers to adopt PiPA
• The benefits
• Recognition package
• Costs and
• Testimonials

Building on experience…
• BPA raising standards since 1970
• Park Mark ®
• Approved Operator Scheme (AOS)
• HE/FE and Healthcare Charters
• PiPA

BPA is a pioneer with PiPA
BPA Professionalism in Parking Accreditation (PiPA)
• A single organisational audit, covering:
– shared standards applicable to all sectors;
– plus standards specific to a given sector (e.g., higher
education and Healthcare.).

PiPA assessment process
1) Organisation applies for audit.
2) BPA sends organisation self-assessment pack.
3) Organisation submits pre-audit self-assessment to BPA.
4) BPA area manager reviews pre-audit self-assessment.
5) BPA area manager conducts site-visit audit, liaises with organisation.
6) BPA moderator reviews audit to ensure consistency, high standards.
7) BPA notifies organisation of audit outcome.
8) If successful, organisation is accredited for two years.
9) Self-assessment at half-way point (after 1 year) maintains standards.

PiPA assessment standards for healthcare
• Customer service and stakeholder relationships
• Safer and properly maintained parking facilities
• Fair pricing and easy-to-use payment services
• Fair enforcement of parking terms and conditions
• Impartial and fair appeals service, accessible to all
• Clear and comprehensive parking information
• Employee wellbeing, development and recognition
• Social responsibility and equality of service delivery
• Continuous improvement

PiPA – Areas of Assessment Example
‘Customer service and stakeholder relationships’
1) ‘the organisation follows an up-to-date travel-plan for the purpose of
managing car parks’
2) ‘the organisation liaises with neighbours and the local community’..
3) ‘the organisation considers the needs of all car-park users, including
patients, visitors and staff’
4) ‘the organisation engages in wider professional practice.’
5) ‘the organisation offers appropriate facilities for people with special
access needs’.
6) ‘the organisation offers identified pick-up / drop-off parking areas’.
7) ‘the organisation collects and learns from car-park user feedback’.

Key Drivers
• Healthcare Technical Memorandum on Parking
• Demonstrating excellence and reducing complaints
• Heath and Safety – identifying and reducing risk
• Efficiency savings
• Improving accessibility to healthcare - support Sustainable
Travel Plans and a holistic access strategy

Benefits
• Celebrating success and raising standards through an accredited
standard - structured audit
• CQC audits – holistic view of the patient journey
• Helps to reducing Do Not Attends
• 5.6 Million 2014/15;
• £700-£800 Million
• More efficient car parking operations, reduces costs and highlights
potential cost savings
• Increased customer satisfaction and reduced stress – better
recovery rates
• Principals of the Lord Carter review – ‘Model Hospitals’
• Good PR & help to combat bad press

PiPA Recognition Package
• National recognition & awards event
• 1st 10 PiPA accreditations-1 year free BPA Corporate
Membership
• Marketing pack – making the best use out of the award
• Pin badges & recognition plaque
• Vinyl banners and stickers (signs)
• Discounts off other professional development courses
and schemes

Testimonials
PiPA is the culmination of a professional journey, recognising all our efforts
over the past few years to improve and maintain our car-park facilities while
implementing good security measures and management practices.
The University of Kent’s Teresa Curteis, Travel & Transport Manager
The post-audit feedback was very informative and detailed. Although the
university did not meet the standard on this occasion, we were presented
with the necessary information and detail as to which standards require
work, with specific issues identified and resolutions suggested.
Bournemouth University’s Richard Wintrip, Travel Plan Co-ordinator

Thank you – any questions?
Ian Goodwin
theparkingconsultancy@outlook.com
07410117113

Closing comments
#Dayforaction

Sustainability Day Leeds 2017

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