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INSTITUTIONAL RHYTHMS
Ideas and Opportunities for Energy and Mobility Demand Management in the NHS
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About DEMAND One of Six End Use Energy Demand (EUED) Centres Core Team
Funded by RCUK Energy Programme Core Team Elizabeth Shove and Gordon Walker (Co-Directors) Lancaster University Greg Marsden Institute for Transport Studies, Leeds University Sylvie Douzou EDF R&D ECLEER, Paris Multidisciplinary & Multi-Partner Research Team 14 Co-investigators from 10 Universities (Aberdeen, Birkbeck, Birmingham, Lancaster, Leeds, Manchester, Reading, Sheffield, Southampton, UCL) 14 core projects plus 4 additional linked projects and 12 PhDs EDF R&D European Centre and Laboratories for Energy Efficiency Research Transport for London, International Energy Agency
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Institutional Rhythms and Energy Demand Working Group
To provide inspiration and review to co-develop and share research output. Members from: Lancaster, Leeds, Manchester, Sheffield, and UCL universities; Airedale, Blackpool, Leeds, and Liverpool Hospital Trusts; Red Rose, Global Action Plan, the Conclude Consultancy, Yorkshire Ambulance Service, Centre for Sustainable Healthcare… 1: Exchanging Ideas (13th Sep 2016, DEMAND, Lancaster) 2: Examining Practical Cases (7th Feb 2017, Airedale) 3: Developing New Strategies (23rd May 2017, Leeds)
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Ideas and opportunities for reducing demand for energy and travel in the NHS from the Institutional Rhythms and Energy Demand Working Group The Dynamics of Energy, Mobility and Demand Greg Marsden (Institute for Transport Studies, University of Leeds) Institutional Rhythms Stanley Blue (Lancaster University) Followed by group discussions and questions to a panel of: Greg Marsden (Institute for Transport Studies, University of Leeds), Dale Southerton (Sustainable Consumption Institute, University of Manchester), Frank Swinton (Airedale General Hospital).
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? What is energy
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says “Energy is not used for its own sake but as part of accomplishing social practices at home, at work and in moving around.” “Energy demand is an outcome of the social, infrastructural and institutional ordering of what people do.”
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What do these ideas mean for
REDUCTION ?
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Some people think DEMAND says DEMAND reduction DEMAND reduction
The challenge is to maintain present ways of life but make related goods and services more efficient. DEMAND says Strategies to increase efficiency play out in a social world that is constantly on the move. Future ways of life are unlikely to be the same as they are today. DEMAND reduction depends on understanding how end-uses of energy are changing and how they can be modified and steered. DEMAND reduction depends on asking more fundamental questions about what energy is for.
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52.8 million kilometres per year
Between 2002 and 2010 8.7 to 9.6 trips/person/year 13.1% 7.23 to 8.11km average distance 10.8% 52.8 million kilometres per year Dusheiko, M. (2014) Patient Choice and Mobility in the UK Health System: Internal and External Markets, in Eds. Levaggi, R. and Monefiori, M. Health Care Provision and Patient Mobility, Springer, ISBN
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2000 65 85 2030
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Source: National Travel Survey
Source: Gordon Stokes
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The hospital shopping mall – when did this become the ‘norm’?
Driven in part by commercial revenue needs What does this mean for energy and who thought about that?
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Some people think DEMAND says DEMAND reduction
Energy demand reduction depends on making technologies more efficient, and persuading people to adopt them. DEMAND says Technologies and infrastructures of supply are implicated in making and reproducing services and practices. Efficient technologies can sustain social practices that call for high levels of energy demand. DEMAND reduction depends on reconfiguring services and social practices. depends on recognising that technologies and infrastructures do not simply meet existing needs: they shape future practices and the demands that follow. -
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Efficiency as the main solution
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Changing the ways patients interface with healthcare
Technology Enabled Care
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Some people think DEMAND says DEMAND reduction DEMAND reduction
Energy demand is something that can be turned up and down. Some think demand is like a commodity that suppliers can manage. DEMAND says Patterns and peaks of energy demand reflect sequences and societal rhythms of practice - across the day, the week and the year. DEMAND reduction at peak hours depends on understanding which practices occur at peak times, and why. What are the forms of temporal fixity/flexibility associated with each? DEMAND reduction depends on modifying social and institutional rhythms.
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Saturday 3-5pm Sunday 11am - 4 pm March Sep - Oct June - Aug Dec
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Some people think DEMAND says DEMAND reduction
The only policy relevant to energy demand reduction is energy policy. DEMAND says There are many areas of public policy that unknowingly impact on the range of social practices enacted in society, and hence on energy demand. These include education, employment, business, health, planning and more. DEMAND reduction Depends on understanding the unintended consequences that ‘non energy policies’ have on what people do, and hence on energy demand. Depends on actively fostering new social arrangements and different ways of life.
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And the NHS is rife with conventions and initiatives that have nothing to do with energy and everything to do with energy
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Some people think DEMAND says DEMAND reduction
Energy demand is about energy use in the home, or at work. Or that it is about people driving cars. But… DEMAND says These are not totally separate ‘domains’. Different forms of energy demand intersect: they link together in the course of a day, and over peoples’ lives. DEMAND reduction depends on combining expertise from traditionally separate areas – including transport and buildings.
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E.g. On-line shopping
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To finish Different methods of thinking about energy demand have practical implications for The questions that are asked The data that is needed to understand how and why energy is used The range of actors who are part of the ‘energy problem’ The types of solutions that could be considered
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INSTITUTIONAL RHYTHMS
Ideas and Opportunities for Energy and Mobility Demand Management in the NHS
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2016. "Health Check: Sustainable Development in the Health and Care System." NHS England Publications. Available at:
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How do hospitals make demand for energy, transport, and goods?
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Example 1: Sequences and Hospital Discharge
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Example 2: Boundaries of Professional Responsibility and Patient Transport
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Demand for resources is made through the organisation of hospital services.
Issues of timing, sequencing, and responsibility are central topics for sustainable development. Need to expand what counts as sustainable development to seriously engage with (what are currently) invisible energy procedures, policies, and practices.
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Extending the sustainable development agenda:
to bring together a wide range of expertise and resources, to develop and embed sequences and ways of working that can reduce demand for energy, travel, and goods.
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References: 2016. "Health Check: Sustainable Development in the Health and Care System." NHS England Publications. Available at: Home First - Thanks to noun project: Suji; Linseed Studio; Luis Prado; parkjisun; Rohit Arun Rao; Danil Polshin.
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