UCLPartners Climate Collaborative – Connecting for Change to help achieve NHS net zero
In November 2022, our Climate Collaborative held an Academic-NHS Sustainability Community of Practice workshop where we discussed the challenges of achieving a net zero NHS, and identified important research questions that needed to be answered in order to drive forward progress.
Following the workshop, Greener NHS awarded us funding to develop a selection of the research ideas that were generated at the event, focusing on how to reduce the carbon footprint associated with energy use across the NHS estate.
To identify the areas that would most benefit from this funding, we applied ‘sandpit’ methodology across a series of events targeted at academics and NHS staff from institutions across UCLPartners’ geography.
Sandpits invite a multidisciplinary mix of participants – who would not normally interact – to drive lateral thinking and radical approaches to address research challenges. They are designed as intensive discussion forums – held as a series of event – where free thinking is encouraged to delve into the problems on the agenda to uncover innovative solutions. Each sandpit event is led by a director, who defines the topic, and facilitates discussions at the event. Our appointed director was Dr Fiona Adshead, Chair of the Sustainable Healthcare Coalition.
Our sandpit events
Over the course of our sandpit process, we brought together more than 30 stakeholders from academia and the NHS challenging them to develop novel research projects which could produce actionable evidence and break down the barriers to decarbonising NHS estate. Attendees included representatives from four different academic institutions and eight healthcare systems from across our geography.
Successful proposals
Following the sandpit process, all project submissions were assessed by a peer review panel comprising of academics, clinical academics and internal UCLPartners staff. The panel scored and commented on each proposal using a specifically developed assessment criteria.
We then selected four research projects and awarded them through our Connecting for Change programme. The successful proposals include:
Embedding carbon costing of resources and pathways within orthopaedic clinical trials. Led by: Catherine Borra, Research Associate (Barts Health NHS Trust)
Background and aim
This project focusses on the role that clinical research has in achieving a Net Zero NHS. Clinical practice is guided by clinical research and to date, there has been limited research to explore ways to embed sustainable practices when designing clinical research.
The project aims to embed carbon costing within a randomised clinical trial that is focused on orthopaedics and managed by Barts Health NHS Trust. Building on this, the project team will then develop a methodology to systematically embed carbon costing within clinical trials of orthopaedic research. This methodology will focus on the carbon costs relevant to clinical service pathways and the use of resources.
Impact
This project will have an impact on how orthopaedic research is conducted – from design to implementation. It hopes to limit unnecessary interventions that are harmful to the environment. It is anticipated that this project’s impact on carbon emission will occur through:
- Encouraging a culture in which carbon costing is an integral part of orthopaedic research.
- Having translational effects in sustainable clinical practice, which will come into effect at trial completion.
This project, to the team’s knowledge, is the first of its kind in orthopaedics. It has the potential to pioneer the way in which sustainability is embedded in orthopaedic research and consequently on clinical pathways.
Hear more from research associates Catherine Borra and Rebecca Wood at Barts Health NHS Trust about their project.
An evidence-based approach aiming to change perceptions about ventilation and energy efficiency. Led by: Ian Eames, Professor of Fluid Mechanics, Dept of Mechanical Engineering, Faculty of Engineering Science (University College London)
Background and aim
The energy use of hospital operating theatres and their ventilation systems is disproportionately large compared to other hospital areas, due to the requirement for high air changes per hour and temperature management. However, there is a lack of robust evidence on the clinical impact of placing these systems on ‘stand-by’ or ‘shut-down’ during inactive periods, for example, during the night. There is also significant resistance to changing how ventilation systems are run due to a perceived lack of knowledge amongst clinical and estates staff about systems and any possibles risks associated with these changes.
This project aims to change perceptions about operating theatre ventilation through improvements in training, awareness, and education for clinical and estates staff.
Impact
Empowering staff to be more aware of the role of ventilation in their environment will ultimately improve patient comfort, reduce energy wastage and improve efficiency. This project will run in different theatre settings, across four different hospital sites, covering contrasting designs, layouts, ventilation types and surgeries – offering greater insights and impact.
Assessment of the potential for energy reduction in current and future operating theatres. Led by: Dr Anne Symons, Senior Research Fellow in Healthcare Design and Healthcare Architect, Bartlett School of Sustainable Construction (University College London)
Background and aim
Hospital ventilation systems are far more complex than in other types of building types. They need to deliver both flow rate and, in some cases, control pressure differentials between spaces to deliver optimal care and reduce risk. In hospitals, the energy use of operating theatres is disproportionately large compared to other areas of a hospital, due to the requirement for high air changes per hour and temperature management.
This project aims to assess ventilation in operating theatres from a systems perspective (space, control, operation) to determine which ventilation systems can be put into ‘stand-by’ or ‘shut down’, which would lead to a potential reduction in carbon. Two NHS Trusts – Barts Health NHS Trust and University College London Hospitals NHS Foundation Trust – will participate in the project as test sites.
Impact
The continuous use of ventilation systems during inactive periods (e.g., overnight) translates into energy waste. By reducing the carbon footprint associated with unnecessary energy consumption, the NHS will make a significant contribution to combatting climate change and promoting sustainable practices.
Hear more from Dr Anne Symons and Dr Jonny Groome about their project.
Using building performance models to accelerate net zero healthcare. Led by: Dr Esfand Burman, Associate Professor of Environmental Design and Engineering, UCL Institute for Environmental Design and Engineering (University College London)
Background and aim
This project aims to harness data used to produce energy performance certificates (EPCs) for NHS buildings. This will help to identify potential interventions that could be rolled-out to achieve a Net Zero carbon NHS. It will have a specific focus on healthcare buildings which are in primary care. Historically, unlike secondary care, there has been less capacity in primary care to address issues related to the decarbonisation of NHS estates. This project seeks to address this imbalance by developing a ‘building performance stock model’ which will help to evaluate the effect of different interventions on reducing their use of carbon.
Once the most effective net zero interventions are identified, their potential application will be investigated in a pilot study across three primary care sites. The project team will work alongside those using the building (e.g., GP practices) to investigate the feasibility and practicalities of implementing these models in real-world settings.
Impact
This project will focus on NHS buildings within primary care to develop a building performance stock model and evaluate its effectiveness, before rolling it out to other sites across NHS Property Services’ portfolio of 3,000 properties. This project also has potential to be applied to other building sectors beyond the NHS (e.g., other public sector organisations) as EPCs are produced for all domestic and non-domestic buildings.
Impact of projects to achieve NHS net zero
Efforts to ensure NHS estate and facilities meet ‘zero carbon’ standards must intensify to achieve the NHS’ commitment to a net zero health service for direct emissions by 2040. Our Connecting for Change research projects will develop actionable evidence as to how NHS Trusts can reduce the carbon footprint associated with their energy use and estates.
We hope the outputs of these projects will generate real impact by supporting NHS Trusts to accelerate their net zero progress across three key areas:
- Optimising systems to reduce energy waste.
- Making use of existing estate (embodied carbon) in the most efficient and sustainable way.
- Identifying how to deliver clinical care in a more energy efficient way.
The final outputs of these projects are expected in early 2024.