The green shoots of recovery

by Sandra Easton

19 January 2018

Is your organisation making progress with the environmental sustainability agenda? Or have environmental issues taken a back seat to the real financial and service performance pressures facing the NHS?

That’s what the HFMA wants to understand – and that’s why we hope you will take part in a short survey examining environmental sustainability in health and care.

There’s a good argument that pursuing sustainability goals – social, economic and environmental – is fully aligned with meeting service and access targets and could help organisations in their financial recovery plans. That starts with the very obvious opportunities – replacing halogen light bulbs with energy efficient alternatives, for example. Upfront investment leading to clear cost savings – it is easy to understand and the payback is direct.

But there is also a good argument for more involved policies, where the impact is less direct and could have a longer return. New models of care that improve the well-being of the population could reduce demand on the carbon-consuming health service. Organisations need to balance up the different carbon footprint impacts – increasing proactive support in the community could increase miles covered by staff in cars. But if this leads to reduced acute admissions, there could be a triple payback in terms of better outcomes for patients, lower costs (by reducing acute capacity) and less impact on the environment overall (given the significant carbon footprint of stays in hospital).

So sustainability can help the financial bottom line. But accepting this logic and pursuing it in the face of such a demanding wider agenda and real pressure to hit financial targets is undeniably difficult. Organisations may feel they don’t have the funds to pump prime sustainability initiatives or the head space to see them through.

And how effective are governance and reporting arrangements – the necessary structures that ensure business cases reflect system wide goals as well as organisational ones and the reporting mechanisms to ensure these are delivered in an accountable way?

These are the aspects we are keen to explore in particular in the HFMA survey. Do your organisations understand their obligations in terms of environmental sustainability and do they comply with these requirements? Do you have strong board support for sustainability? Are environmental credentials embedded across the organisation or does progress depend on a small number of champions? What tools are you using to support the achievement of sustainability goals?

The NHS Sustainability Development Unit believes there is much greater understanding among NHS bodies about their obligations than there was a few years ago. These requirements – set out in the various accounting and reporting manuals or included in standard contract terms – were summarised in an HFMA briefing last year (Reporting on environmental sustainability), which will be updated for 2017/19 shortly.

Most organisations are also implementing sustainable development management plans. And annual reporting of environmental performance is both more widespread and improving in quality and depth.

But we now want to get the finance function’s view – or more accurately we want to refresh that view. This will in fact re-run a survey we first undertook in 2015 and reported two years ago this month. Is sustainability now business as usual? Or is the attention elsewhere currently and the NHS has more to do to get this agenda fully embedded?

Please complete our short survey which should take no more than five minutes to give us your views.