Sustainability in HealthTech: the Importance, the Challenges and the Solutions
Sustainability’s Importance in Healthcare
Sustainability is an area of ever-increasing significance to our lives as humanity approaches a turning point in the fight against climate change. We are past the debate of academic consensus. The international scientific community has declared that human influence has unequivocally warmed the planet through anthropogenic greenhouse gas emissions. Despite this understanding and the success of the 2015 Paris Agreement, where 196 countries committed to hold global warming below 1.5°C, experts are in total agreement that insufficient action is being taken to deliver these pledges.
With evidence and expectation mounting, in October 2020 the NHS's then chief executive, Lord Simon Stevens, set out a bold ambition to become the world's first carbon net zero nation health system by 2045. Considerable progress has since been made in reducing the NHS’s Carbon Footprint to meet these goals. The system's Footprint has reduced by 62% on 1990 levels by 2020, nearly double the requirement set out by the Climate Change Act.
That being said, a significant challenge remains. The health service itself accounts for 5% of the UK's GHG emissions[1], when including carbon generated by associated activities such as food and patient transport. The mitigation of these emissions will be a mammoth task – for context the NHS’s footprint is roughly equivalent to the emissions profile for Croatia[2].
The Role of HealthTech
Assessing emissions holistically, the NHS has outlined that one of its greatest areas of opportunity, and challenge, in emissions reductions, lies in the supply chain. Estimates suggest that 60% of NHS emissions are linked to its supply chain2.
The HealthTech industry has an important role to play as a key part of the NHS’s supply chain, and therefore, will also be a significant player in the decarbonisation challenge. Whilst there are many challenges and concerns with the impacts this may have on HealthTech suppliers, there is a clear enthusiasm and motivation to ensure that this agenda has effective and tangible results. HealthTech vendors that produce a well-evidenced message and strategy on sustainability will create a valuable market differentiator and be better positioned to take advantage of economic, social, environmental and regulatory changes that may arise. However, one would be remiss to claim that these significant business benefits are simple to take advantage of in the HealthTech sector.
Sustainability is not a simple topic for the HealthTech industry. Therefore, Arup has partnered with ABHI to develop a Sustainability Framework for Action. The framework aims to offer technical support and an action plan to its members, to breakdown and traverse the complex subject of sustainability. The report will be published in full on Monday 25th April, but the remainder of this blog will give a preliminary summary of its contents.
Sustainability Framework for Action
To develop the evidence base, a series of research, engagement, data gathering activities took place. These aimed to create an understanding of the current maturity within the sector, the greatest challenges and concerns, and the upcoming requirements from both the NHS but also the wider legislative and economic trends. This approach enabled us to focus the framework on material topics that are crucial to ABHI members and provide tailored guidance and actions.
The Framework
Reflecting upon these findings, the framework proposes a series of time-dependent actions that aim to provide a structure to focus actions, investment and drive performance, as well as engage internal and external stakeholders. Actions are set across a timeline to 2028 and are categorised as either ‘must do’ or ‘should do’ to aid with prioritisation. The framework also includes sections that are specifically aimed at SMEs, as these organisations face different challenges due to size, resources and scale of production. The framework’s suggested actions are categorised into four key initiatives that are detailed over four chapters:
- NHS England tender compliance with environmental requirements
The ambitions and requirements of the NHS's 'Decarbonisation Plan', 'Supplier Roadmap’ and 'Social Value Model' are broken down and clarified with the facilitation of case studies, to ultimately provide steps for member compliance. Tips are also provided for the application of ‘NHS Carbon Reduction Plans’ and the Sustainable Healthcare Coalition's 'Care Pathway Carbon Calculator' to help members understand and mitigate the environmental impact of their products or services. In the associated appendices there are templates that show the Carbon Reduction forms that will need to be completed. Additionally, specific capacity building advice is given for SMEs to help them address these new asks.
- Consistency across healthcare systems across the UK's four nations and further afield
Due to the sometimes fragmented nature of the UK’s NHS Trusts, there was a concern within the member group that the environmental requirements from each would be different. Whilst it is too early to confirm the exact tender requirements, this chapter aims to summarise the current maturity of these Trusts and create a more transparent view of the environmental journey they are on. The differing environmental requirements across the UK's four health administrations are therefore clarified alongside associated deadlines. This is supplemented by information on healthcare systems outside of the UK, notably regarding the EU and Norway.
- Sustainability strategy development
This chapter provides guidance and tools to help members create, or improve, their sustainability strategies. The chapter walks members through the process to develop a strong and comprehensive strategy. Each stage contains descriptions of what needs to be undertaken. This is accompanied by clear templates in the appendices which can be picked up and implemented by members. The process involves research and data gathering, conducting a materiality assessment, developing environmental KPIs and metrics, developing strategic objectives and monitoring and reporting. A number of tools to assist with these actions are then detailed and illustrated, including Top Down vs Bottom Up carbon footprinting calculations and guidance on conducting Life Cycle Assessments.
- Circularity principles in HealthTech
The concept of circularity and its associated benefits are clarified, including relevant regulations for the industry. Steps are subsequently presented on how members could integrate and monitor circularity within their organisations and case studies supplement this by showcasing examples of circularity in practice.
The Ask from ABHI Members
In addition to the technical areas of guidance, the framework also wanted to support ABHI members to communicate back to the NHS, what it is they feel they need to progress in this journey. Therefore, with the hope of establishing a two-way dialogue across the healthcare sector around the issue of sustainability, this report also presents 'The Ask' from ABHI members based on their feedback.
The request of certain engagement support from the NHS is made along five topics: engagement, clarity and guidance, timelines, compliance requirements, and SME capacity. Each of these individual asks for the NHS are complemented by the suggestion of potential solutions.
The need for shared industry infrastructure is also argued, to ensure that organisations receive consistent advice and guidance. It is suggested that the subsequent creation an industry-wide 'shared voice' would foster industry dialogue and mutual-understanding, thereby creating a concerted effort within the sector to move towards a more sustainable future.
Florence Mansfield, Climate Change Consultant & Jamie Atkinson, Graduate Climate Change Specialist, Arup
The ABHI Sustainability Framework for Action report is due to be published on Monday 25th April.
[1] Greener NHS campaign to tackle climate ‘health emergency’, NHS England
[2] Delivering a ‘Net Zero’ National Health Service, NHS