Implementing Sustainable Systems - Health and Care 27th February 2018

An Introduction to NHSI NHS Improvement was founded in 2016 We work across the provider sector – 236 NHS Trusts We are helping the NHS to meet its short-term challenges and secure its future Our 2020 objectives: Quality Continuously improving care quality, helping to create the safest, highest quality heath and care service Finance and use of resources Balancing provider sector finances and improving provider productivity Operational Performance Maintaining and improving performance against core standards Strategic Change Ensuring every area has a clinically, operationally and financially sustainable pattern of care Leadership and improvement capability Building provider leadership and improvement capability to deliver sustainable services Implementing Sustainable Systems in Health and Care

Lord Carters Review (2016) Extensive review of large acute NHS Trusts Identified unwarranted variation Savings potential of £5bn [across the system] by 2020/21 15 key recommendations Clinical Procurement Estates and Facilities Data Analysis - Model Hospital “Lord Carter's review of efficiency in hospitals suggests how large savings can be made by the NHS. The final report, productivity in hospitals, sets out how non-specialist acute trusts can reduce unwarranted variation in productivity and efficiency to save the NHS £5 billion each year by 2020/21.” (Kingsfund, 2016) Implementing Sustainable Systems in Health and Care

NHS Unprecedented Challenges Develop and deploy integrated digital strategies 1. Technology & Digitalisation Engage national workforce and cross sector bodies 2. Engagement Close £30bn Funding gap and deliver £22bn efficiency savings 3. Operational and Financial Efficiency Respond to increased demand and ageing population 4. Demand and Demographic Address increased gap in health and social inequalities 5. Inequalities and Prevention Deliver local accountability compliant with national policy 6. Local vs national (policy and delivery) Drive long-term strategies whilst delivering in year QIPP/CIP 7. Long term strategy, short term deliverables Meet increasing patient expectations for quality of care and experience 8. Patient expectation and public perception Implementing Sustainable Systems in Health and Care

Sustainability can respond Data driven change strategies: Energy Efficiency RCM BIM and IoT 1. Technology & Digitalisation National SD Campaigns and Cross Sector groups, Local Behaviour Change Programmes 2. Engagement Reduced Opex Costs £78M-£138M Improved Healthcare Estate 3. Operational and Financial Efficiency Driving behaviour to improve outcomes and reduce system demand 4. Demand and Demographic Fuel poverty, Air pollution and Food education programmes 5. Inequalities and Prevention Locally owned programmes delivering key national policies 6. Local vs national (policy and delivery) Addresses short term deliverables (QIPP/CIP) and drives long term change 7. Long term strategy, short term deliverables Measurable improvements in patient experience and public perception 8. Patient expectations and public perception Implementing Sustainable Systems in Health and Care

We know our workforce are key Our approach Embedding sustainable practice in organisations is key to our collective success, so at NHSI are approach is focused around three areas we hope will facilitate this: To Lead: help provider organisations embed Sustainability throughout their orangnsaitions, from Board to Ward and out into their communities to deliver the very best care for patients and the very best environments for our staff To Engage: To engage extensively with our stakeholders to drive positive change at both a local and national level and nurture a culture of engaging behaviour across the system To Innovate: To drive and deliver accelerated innovation for positive Environmental, Social and Economic benefit – the three pillars of sustainability To celebrate success: To celebrate the success of those who work hard to deliver these transformational changes in their organisations, recognising their efforts and dedication We know our workforce are key Presentation title

Better Buildings for our Patients Focused on creating a sustainable healthcare estate transitioning our hospitals and care facilities beacons to best practice that improve our patient experience, reduce our use of resource and connect us with our local communities and environment Transitioning to LED lighting to provide better lit, higher quality environments for patients with lower energy and carbon impact Running our hospitals on renewable energy generated onsite, providing consistent heating for our patients during the winter months and an all year round supply of hot water Reducing waste and water usage within our buildings, driving the circular economy Using our hospitals as anchor organisations to drive wider community and health benefits Pushing the boundaries of innovation Developing supportive policies and guidance to underpin current and future best practice Collect and use useful data - improving quality and granularity Our aim is to take £150M off our annual energy spend (currently £540M) by 2021 – reducing financial pressure on our clinical service Working to deliver Healthy, Resilient, Sustainable Healthcare Estates Implementing Sustainable Systems in Health and Care

Our People People are key to our success Nursing play a crucial role in how buildings are operated and used, and in what items are bought and thrown away Waste/Energy/Sustainability Managers are critical catalysts for implementing best practice, introducing innovation and driving change within hospitals and care facilities Service Leads have the opportunity to revolutionise their service and maximise their impact on environmental progress Procurement Leads directly influence the buying culture of an organsiation and by applying the principles of sustainable procurement, can influence the wider supply chain Estate Managers influence the efficiency and impact of our built environment and facilitate changes that benefit our patients, the environment and local community Finance Managers shape how organsiations approach investment for sustainable improvement And these are just a few…the best things happen when we join together in our thinking and our approach to deliver small changes that can transform our workplaces Developing the knowledge and expertise of our national workforce around Sustainable Development is key and will shape the future culture of our NHS Implementing Sustainable Systems in Health and Care

Organisational Leadership Organsiational Leadership underpins the principles of this cultural shift Core areas of focus: Sustainable Development Management Plans (SDMP): Board approved plan setting out the corporate approach to Sustainable Development with clearly defined objectives and targets, and updated within the past 3 years Sustainable Development Assessment Tool (SDAT): Online self-assessment/diagnostic tool which aligns organisational action(s) with UN SD Goals. Allows organisations to track progress and benchmark themselves against similar organsiations. Supports collaboration and aligns/informs SDMP Annual report: Organisations to report annually on their progress. There is an informal review annually (SDU) and NHSI + HFMA issue excellence certificates with SDU- top 10- 15% of Providers and CCGs Trained and knowledgeable workforce: core, job specific training, information and support on Sustainable Development, with specific SD objectives embedded into performance targets Strong leadership in Sustainable Development is a demonstrable measure of a well-led organistation Implementing Sustainable Systems in Health and Care

Better buildings for our patients Our people Organisational Leadership Your feedback Breakout Groups Better buildings for our patients Our people Organisational Leadership What else can we do? Implementing Sustainable Systems in Health and Care

Contact details Fiona Daly @Dalyfionadaly1 07519 293013 Fiona.daly1@nhs.net @Dalyfionadaly1 07519 293013 www.improvement.nhs.uk Fiona Daly MsC CBIFM MIHEEM FEMA Implementing Sustainable Systems in Health and Care