1. Implementing Sustainable Systems - Health and Care
11 April 2018

2. 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

3. 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

4. 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

5. 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

6. NHSI – Who’s Who in EFM Presentation title Simon Corben
Director and Head of Profession for Estates and Facilities
Programme & Strategic Business Lead
Vajid Mahmood
Divisional Co-ordinator and EFM Dashboard Manager
Energy Fund Programme Coordinator & Support
EFM Policy
Mike Bellas
EFM Opps
Cliff Howell
EFM Commercial
Jo Dolby
Strategy Lead
Nick Mathew
DoH
Work streams
Food
Cleanliness
Parking
Mixed sex
Safety
Fire
Care pathways
HTMS
HBNS
Regional Spoke
London
South East/West
Midlands
North
Hard FM
Soft FM
Asset Management
Estate code
Energy
Space Utilisation
Alternative Capital Funding Models
Backlog
P22+ and others
Standardisation
Income Generation
Capability and Capacity
Contract Management
STPS
SEPI’S
Pilots
Chetan Tailor
Principle Analyst
Ian Stone DoH
Capital
MOU NHSE PAU
Chris Cale / Mike Lowe– NHSI Finance
P22 Cliff Jones
Enhanced team to drive through Disposals and staff housing and general housing needs
Disposals Lead
Ian Burden
Carbon Savings
Improved resilience
Improved estate compliance
Delivers against 5 domains of CQC
Sustainability
Fiona Daly
Presentation title

7. Who I am and why I joined NHSI
16 years experience in EFM (mainly Hard FM) and Sustainability
Worked in both Public and Private Sectors
8 Years working in a provider Trust
Extensive PFI experience – from both sides
Led national programmes: NHS Sustainability Day, Clean Air programmes, Fuel Poverty, Operation TLC
Established Cross Sector Partnerships to drive local and national change
I joined NHSI because:
I am driven deliver impact
I love complex problems (and helping solve them)
I know there is [a huge] opportunity
I believe sustainability responds to a no. of current challenges
I believe in the NHS and want to do whatever I can to ensure it is here in the future
But mainly, I joined because I care. I care about the NHS, I care about people and I care about our future
Fiona Daly
MsC CBIFM MIHEEM FEMA
Presentation title

8. 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

9. 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 % 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

10. 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

11. 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

12. Workshop Session
Implementing Sustainable Systems in Health and Care

13. Contact details Fiona Daly @Dalyfionadaly1 07519 293013
@Dalyfionadaly1
Fiona Daly
MsC CBIFM MIHEEM FEMA
Implementing Sustainable Systems in Health and Care