UCLH declares a climate and health emergency

UCLH is making a firm commitment to reduce its impact on the environment, with a 10-point plan to reach net zero carbon dioxide emissions by 2031. To galvanise action, UCLH has declared a climate and health emergency. This builds on progress made since the UCLH Green Plan was put in place in 2020. 

The Green Plan has seen investment of more than £2.5m in a programme that includes:

  • installing low energy lights
  • switching to sustainable electricity and recycled paper
  • reducing patient journeys by 50 per cent
  • reducing the use of the most harmful anaesthetic gas by 90 per cent
  • encouraging staff to take part in climate action schemes.

We are dedicated to treating and supporting our patients and staff within the constraints of our natural resources, increasing our readiness for changing times and climate, and strengthening our links with the local community.

We aim to embed sustainable development principles in every facet of our activities, focusing on:

  • Our corporate approach
  • Our patients and staff
  • Sustainable use of resources
  • Our progress towards net zero carbon emissions.

See below for more information on the steps we are taking to reduce climate change.

1 – UCLH will only use renewable electricity

2 – UCLH will install solar panels throughout our 12 hospitals. On just one hospital roof we could put in enough solar PV to generate 300,000 kWh per year, enough to power 70 homes. 

3 – UCLH will cut its carbon emissions from energy use by 80% by 2025 and invest over £2.5m in low energy LED lights across its hospitals. LED lights use just a quarter of the energy of our previous lights and last much longer. 

4 – UCLH will halve the amount of patient travel, totalling over 14 million miles of travel saved each year. We will provide over 500k appointments virtually this year to deliver this, 50% of outpatient appointments. 

5 – UCLH will ban the worst greenhouse gases in anaesthetics, stopping use of Desflurane by 2022 and moving to majority intravenous anaesthetics. (An eight-hour operation using Desflurane is the equivalent of 4,206 miles in an average car.)

6 – UCLH will cut single use plastics and incineration of clinical waste, including by introducing re-usable PPE in wards at UCLH.  

7 – Buying Green.  We will give 10% weighting to sustainability in our procurement.

8 – Shifting to 100% recycled paper and cutting printing.  UCLH will cut its paper use and is shifting to using recycled paper this year.  This will save 100s of trees each year and over 11 tonnes of CO2. 

9 – We will pledge for one of our hospitals to move to be among the first Net Zero Hospitals in the UK. 

10 – UCLH is setting a clear ambition to be Net Zero Carbon by 2031.

Our electricity is now sourced completely from renewables; we will continue to install solar panels on more of our hospital buildings. Installing solar panels on just one site could generate enough electricity to power the equivalent of 70 homes. We have invested over £2 million in low-energy LED lights this year across our hospitals: these use just a quarter of the energy of our previous lights, and last much longer. This is enabling UCLH to save more than 1,200 tonnes of CO2 per year.

UCLH has declared a climate emergency and is committed to cutting carbon emissions by 80 per cent by 2025. With anaesthetic gases contributing around five per cent of the carbon footprint across all acute NHS organisations, and well over two per cent across the whole of the NHS, a natural place to focus has been on our operating theatres. A cohort of theatre staff has come together to create the UCLH Green Theatre Group to tackle this problem, among others which can support UCLH’s climate action plan.

The team have outlined a local action plan to reduce carbon emissions in our hospitals, including a review of our use of anaesthesia, minimising our reliance on single use materials, improving waste management, reducing electricity and an education programme to encourage personal responsibility for action on climate change. While climate action is the driver for the work, improvements to patient and staff experience remain central to any activity.

“The climate crisis means we all have to reduce our carbon emissions to zero. Every action counts and the time to act is now”, said consultant anaesthetist and Green Theatre Team member, Damon Kamming.

The team’s starting point was to reduce reliance on the anaesthetic gas Desflurane, which has the highest carbon emissions of all anaesthetic gases This has historically been a commonly used anaesthetic gas at UCLH, but it releases a lot of greenhouse gases and is actually one of the most environmentally harmful. To provide some context, one hour’s use of Desflurane emits the same carbon emissions as travelling 230 miles in a petrol car and is 2,500 times more damaging to the environment than carbon dioxide. If everyone in our hospitals stopped using Desflurane, its carbon emission contribution from anaesthesia would decrease from five per cent of the total to just 0.5 per cent.

UCLH is now committed to eliminating the use of Desflurane across its sites by the end of 2021. The team have made some relatively simple changes in the meantime, such as removing Desflurane from our theatres and storing them in pharmacy cupboards instead. Staff are then prompted to use Sevoflurane, a less environmentally damaging gas, instead.

The team is also promoting the use of Propofol Total Intravenous Anaesthesia (TIVA), which has a greenhouse gas impact of 10,000 times lower than Desflurane. They have already purchased 138 new pumps to allow anaesthesia to be administered this way more often. The benefits of TIVA are far-reaching: patients also report a better experience, since intravenous anaesthesia reportedly leads to less nausea and vomiting.

“The key is to make it easy for staff to do the right thing and harder to make choices that are bad for the planet”, said Damon. “This small change is 'win-win', because we also have the chance to make things better for patients as well as the environment.”

Other changes are also in the pipeline. The Green Theatre Group is now investigating methods of reducing, capturing and disposing of nitrous oxide emissions (a gas most commonly used for pain relief in A&E, maternity and dentistry). Nitrous oxide has 300 times the warming potential of carbon dioxide and crucially stays in the atmosphere for 116 years, so this is another area with the potential to make a significant impact on UCLH’s carbon footprint.

There is also a project looking at installation of a kit that changes the way UCLH disposes of surgical fluid. This both cuts out the need for single-use plastics for storage, and reduces the amount of manual handling required of staff for disposal. 

Additional changes are smaller, but no less valuable. Currently UCLH is incinerating over 1,000 tons of clinical waste a year at a cost of £1 million. A focus on the correct disposal of clinical waste across the department has the potential to dramatically increase the amount of waste that can recycled, which offers the potential to reduce both costs and carbon emissions.

“The climate crisis is here and this is a once in a lifetime opportunity to innovate and collaborate with a shared purpose to make it easy to do the right thing for patients, staff and the planet”, said Damon. “There are so many ways we can make a difference.”

Removing environmentally harmful anaesthetic gases from our operating theatres

We are introducing safe, reusable personal protective equipment (PPE), including reusable masks and gowns.

Removing non-infectious clinical waste

Incinerating waste can release harmful pollutants into the air. Tiger waste bags have been brought in to reduce the amount of incinerated clinical waste. The tiger bags are for non-infectious waste such as sanitary pads, nappies and incontinence pads. Previously, this was disposed with clinical waste which is incinerated, but by separating the waste in this fashion we can decrease the amount of burnt waste. The sacks were introduced in January 2021, and this has already seen the amount of clinical waste cut by 20 per cent.

We are also aiming to reduce the amount of waste water we produce.

Our approach to reducing waste

 

Feedback from the Carbon Trust has provided a good framework for us to use our resources efficiently, as well as for cutting costs. We have revised our Waste Policy to measure our success against waste targets more accurately.

We now have a secure area to store surplus furniture and equipment for re-use across UCLH. We aim to challenge a ‘disposable culture’ by encouraging staff to donate unwanted furniture. Staff are encouraged to enquire what items are in the store before buying new ones to reduce waste, save money and keep our carbon footprint to a minimum.

We have identified an aid agency that needs medical equipment; this means we send less waste to landfill, reducing waste costs and making a contribution to those in need of medical aid overseas.

To help us reduce our waste, we:

  • diverted 100 per cent of our recycled waste from landfill
  • increased recycling facilities at our hospitals
  • introduced monthly waste audits to highlight areas for improvement
  • increased battery recycling facilities on all sites
  • adopted a kg waste/patient metric for measuring waste targets. 

With support from Global Action Plan and Camden Council, UCLH is working to improve air quality by holding workshops with staff to promote green travel, such as using public transport; and walking or cycling rather than driving.

Our suppliers are also beginning the transition to electric vehicles.

The COVID pandemic has shown that virtual appointments work well in many situations, and patient feedback has been positive. Video and telephone clinics have halved patient travel rates, saving more than 14 million miles of travel in 2021. UCLH is actively looking at continuing its video clinics and our ambition is to maintain a level of 50 per cent of appointments taking place virtually.

“Being able to cut down the number of face-to-face appointments can be really helpful for our patients, who appreciate being able to take far less time out of their day. It's a valuable tool to be able to offer, so patients can choose what's right for them.”

Dr Toby Hillman, Consultant in Respiratory Medicine

Virtual appointments: reducing the need for patient travel

With support from Global Action Plan and Camden Council, UCLH is working to improve air quality by holding workshops with staff to promote green travel, such as using public transport and walking or cycling rather than driving.

Initiatives include our recent pedometer challenge which had a specific focus on promoting green and active travel amongst our staff. UCLH has also set up a bike user group to promote cycling. The group holds regular free bike check sessions and highlights safe cycling storage facilities.

UCLH will be regularly surveying staff to ensure more are cycling, walking, or using public transport and fewer are relying on private cars for their commute. UCLH has signed up to two programmes that reward staff for taking part in green initiatives. 

UCLH’s service partner Mitie is supporting the vision to improve recycling by installing new equipment, changing their waste management contractor, increasing communication about correct waste streams and organising joint waste road shows.

This has caused better recycling rates, with a dramatic increase of mixed recycling from 38 per cent to 49 per cent in three months last year. Our general domestic waste over the same period has also decreased significantly and we have achieved ‘zero to landfill’ status in the last financial year. UCLH is well on course to hit its current recycling target of 80 per cent by 2025.

Previously, UCLH was using 7,000 boxes of paper a year; switching to recycled paper is saving 272 trees per year.

UCLH is cutting down the amount of plastic used at its hospitals, including encouraging patients and staff to replace the use of polystyrene cups with reusable ones.

Two wards are leading the way. Previously, the team at University College Hospital was ordering 2,000 polystyrene cups per month, but the order has now been replaced by 1,000 paper cups, with the ambition to further decrease this.

The Intensive Therapy Unit (ITU) at the National Hospital for Neurology and Neurosurgery is also supporting the campaign with ‘Plastic-free Wednesdays’, when polystyrene cups and cutlery are made difficult to find, to encourage staff to locate reusable alternatives. The ward is now planning to almost completely eliminate the use of plastic cups and cutlery.

We're committed to ‘buying green’ and have made sustainability a formal part of our procurement decision making, with a 10% weighting in favour of suppliers who operate sustainably.

In line with the NHS' own carbon reduction target of achieving net zero emissions by 2040, UCLH issued its Green Plan in 2020. Having declared a Climate and Health Emergency in 2021, we are now aiming to go further and achieve this target by 2031. 
 
The UCLH Sustainability Steering Group is responsible to the UCLH Board for meeting these challenges. The group consists of senior managers and clinicians from pharmacy, radiography, procurement, information systems, and estates and facilities management. Its work is constantly evolving, and it remains responsive to new challenges.

Working with the community

We are an advisory board member of the Camden Climate Change Alliance. We are working with local businesses, public sector organisations, and local Business Improvement Districts to minimise adverse effects on biodiversity from our necessary operations and to ensure that all members of staff are aware of their responsibilities towards protecting biodiversity. We will continue with this collaboration to achieve common goals. 

Working with the NHS

We are working with colleagues across the NHS to reduce the impact and cost of energy, waste, water and transport. As a member of the Shelford Group of NHS trusts, we are collectively working towards sustainable procurement.

We have aligned our strategy with the UN Sustainable Development Goals, which serve as a blueprint to achieve a better and more sustainable future for all and provide a powerful aspiration for improving our world. Together, we can make a real impact.

Our climate action approach is defined by policies for sustainable development, carbon, and waste management that are endorsed by the UCLH Board. These integrate the latest requirements and guidance from the NHS Sustainable Development Unit. 

In line with the NHS Standard Contract, the UCLH Green Plan outlines our strategy towards a 'net zero' UCLH. It takes into consideration the NHS Long Term Plan's commitments, together with the NHS' own ambition to achieve environmental sustainability.

Our sustainable development assessment currently includes ten measures. We are working to update this in line with emerging national guidance, and to ensure that we have accurate measurement and reporting  in place to guide UCLH's future climate action.