1. Daniel Maughan Royal College of Psychiatrists Sustainability Fellow RCPsych sustainability summit

2. CENTRE for SUSTAINABLE HEALTHCARE Outline What is sustainability? What is sustainable health care? Why sustainable health care? Are PD services sustainable?

3. CENTRE for SUSTAINABLE HEALTHCARE What is Sustainability? The capacity for something to endure despite potential constraints The Triple Bottom Line economic, environmental, social 3 P’s: people, profit, planet

4. CENTRE for SUSTAINABLE HEALTHCARE What is sustainable healthcare? “Sustainable healthcare is about ensuring we provide good quality health care today without compromising the ability of future generations to provide good quality health care.”

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7. CENTRE for SUSTAINABLE HEALTHCARE Sustainability = The whole truth

8. Sustainable health care system Over-burdened health care system Healthy community Chronically unwell patients

10. Environmental SocialEconomic Bearable Sustainable Viable Equitable BIOSPHERE

11. CENTRE for SUSTAINABLE HEALTHCARE Outline What is sustainability? What is sustainable health care? Why sustainable health care?

13. CENTRE for SUSTAINABLE HEALTHCARE Social Sustainability Defn: Restoring the social capital that is lost through mental illness Social capital: housing; employment; educational opportunities, community connectedness Use the personal recovery approach to ensure social capital is restored

14. Environmental SocialEconomic Bearable Sustainable Viable Equitable BIOSPHERE THE FORGOTTEN PART OF MENTAL HEALTH SUSTAINABILITY

16. What is the MORAL imperative? The WHO and the Lancet Commission both state that climate change is the largest threat to human health in the 21 st Century There is increasing evidence that floods, heat waves, drought and cyclones all impact on mental health The NHS contribution to this is significant

17. The effects of drought

18. SDU. (2013). Goods and services carbon hotspots, Climate Change Act 2008

19. SDU. (2013). Goods and services carbon hotspots,

21. CENTRE for SUSTAINABLE HEALTHCARE Outline What is sustainability? What is sustainable health care? Why sustainable health care? What does sustainable health care look like?

22. Specialty specific sustainability challenge Presentation with kidney failure Dialysis

23. £ PRINCIPLESPRINCIPLES MODELS OF CARE Prevention Lean service design Patient empowerment Use of low carbon technologies

24. CENTRE for SUSTAINABLE HEALTHCARE Outline What is sustainability? What is sustainable health care? Why sustainable health care? Are PD services sustainable?

25. CENTRE for SUSTAINABLE HEALTHCARE Why analyse complex needs? This is a new innovative service that is -- preventative and empowering The service potentially has a low carbon footprint – group based work, some occur in YERTS!!! People with untreated PD may have high health care costs; both economic and environmental The service is likely to be socially sustainable

26. CENTRE for SUSTAINABLE HEALTHCARE Outcome measures: GP appointments Medications (physical and psychotropic) Physical OPD Physical admissions A&E attendances Mental health OPD Mental health admissions Oxfordshire Complex Needs

32. Still collecting data – GP appointments – Medications (physical and psychotropic) – Mental health OPD – Mental health admissions

33. CENTRE for SUSTAINABLE HEALTHCARE Thank you