1. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Progress in NHS and PHE sustainable development David Pencheon NHS 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. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk 2009 - 20142014 - 2020

3. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk 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. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk 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. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Key issues emerging 1.Carbon / environmental hotspots of the healthcare system 2.Procurement and Commissioning 3.Leadership, engagement, workforce development 4.Strong, resilient, communities 5.Models of care 6.Innovation, including technology and R&D 7.An integrated metrics approach 8.Building social capital / value as a core role of the health and care system

6. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Strategic aims of a sustainable health and care system? 1.Improve the quality of care whilst reducing its harmful environmental impact 2.Exploit the multiple benefits of future proofing that deliver social, economic and environmental benefits 3.Create the right conditions for resilient, safe, fair and sustainable local communities to develop

7. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk

8. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Acute – medical instruments and equipment Acute - building energy use (gas and electricity) Primary care and acute – business services Primary care – pharmaceuticals including GP prescriptions Goods and Services carbon footprint – carbon hotspots

9. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Entry points 1.To save money / conserve limited resources 2.To comply with regulations and law / scrutiny / governance 3.To reduce environmental impact harmful to health 4.To manage risk 5.To improve resilience 6.To manage reputation 7.To take exemplary action 8.To support staff to do at work what we do at home 9.To take account of the strength of the scientific evidence 10.To align actions with core ethics and values of the health / care system 11.To modernise models of prevention and care in line with other changes 12.To discharge a duty of care to improve population health, and reduce health inequalities now, and in the future

10. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk 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. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Protect and Promote Extreme Events Climate chaos Resource shortages Heatwaves Flooding Lack of biodiversity Pollution Housing Employment Family and friends Healthy sustainable food Clean energy, clean water Integrated transport Safe shared pleasant spaces Resilient communities A legacy of social justice “A life, a community, and a future we all have reason to value”

12. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Leadership support

13. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Actions to improve protect/improve health 1. Cholera: 1854 Broad Street Pump 2. Smoking and tobacco: 1962 3. Sustainable development and climate change: 2012

14. Working across the NHS, Public Health and Social Care system www.sduhealth.org.uk Route map