Progress in NHS and PHE sustainable development David Pencheon NHS England and Public Health England Sustainable Devel

1. Progress in NHS and PHE sustainable development David PencheonNHS England and Public Health England Sustainable Development Unit Green Nephrology Summit 2013. Thanks to sponsors, Guy's and St Thomas NHS Foundation Trust and the Association of Renal Industries, and to our exhibitors, J&J, Nipro, Elga Process Water & Fresenius Medical Care.

2. 2009 - 2014 2014 - 2020

3. Consultation and Engagement Exercise • Launch event: Jan 2013 • 9 Deep Dive Exercises e.g. HWBs/CCGs/Models of Care... • 4 months engagement and consultation • Close to 1000 responses, 331 system organisations, 186 other organisations • 55% NHS Trusts, 35% CCGS, 31% LAs, 72% Royal Colleges and Faculties…

4. High level summary • Integrated and aligned across the system • A clear, practical and realistic approach • Transparent and accountable • Aligning incentives across the health and care system • Health outcomes, extreme events and community resilience • Collaboration not silo’d approaches • Research and action on behaviours, governance and innovation

5. Key issues emerging • Carbon / environmental hotspots of the healthcare system • Procurement and Commissioning • Leadership, engagement, workforce development • Strong, resilient, communities • Models of care • Innovation, including technology and R&D • An integrated metrics approach • Building social capital / value as a core role of the health and care system

6. Strategic aims of a sustainable health and care system? • Improve the quality of care whilst reducing its harmful environmental impact • Exploit the multiple benefits of future proofing that deliver social, economic and environmental benefits • Create the right conditions for resilient, safe, fair and sustainable local communities to develop

8. Goods and Services carbon footprint – carbon hotspots Primary care – pharmaceuticals including GP prescriptions Acute – medical instruments and equipment Acute - building energy use (gas and electricity) Primary care and acute – business services

9. Entry points • To save money / conserve limited resources • To comply with regulations and law / scrutiny / governance • To reduce environmental impact harmful to health • To manage risk • To improve resilience • To manage reputation • To take exemplary action • To support staff to do at work what we do at home • To take account of the strength of the scientific evidence • To align actions with core ethics and values of the health / care system • To modernise models of prevention and care in line with other changes • To discharge a duty of care to improve population health, and reduce health inequalities now, and in the future

10. Every unplanned admission to a hospital is a sign of system failure, financial failure, health failure, patient failure, (and environmental failure) until proved otherwise

11. Leadership support

12. Actions to improve protect/improve health 2. Smoking and tobacco: 1962 3. Sustainable development and climate change: 2012 1. Cholera: 1854 Broad Street Pump

13. Route map