Managing a sustainable, low carbon supply chain in the English National Health Service: The views of senior managers.

Objectives:In an effort to reduce costs and respond to climate change, health care providers (Trusts) in England have started to change how they purchase goods and services. Many factors, both internal and external, affect the supply chain. Our aim was to identify those factors, so as to maintain future supply and business continuity in health and social care.Methods:Qualitative interviews with 20 senior managers from private and public sector health service providers and social care providers in south west England. Interviews were recorded, transcribed and thematically analysed.Results:There were four areas of concern: contradictions with government legislation which caused confusion about how best to deliver sustainable solutions; procurement was unclear and created multiple approaches to purchasing bulk items at low cost; internal organizational systems needed to be reconsidered to embed sustainability; and embedding sustainability requires a review of organizational systems. There are examples of sustainability solutions throughout the National Health Service (NHS) but the response continues to be patchy. More research is needed into why some Trusts and some staff do not recognize the benefits of a core approach or find the systems unable to respond.Conclusions:The NHS is one of the major purchasers of goods and services in England and is therefore in an excellent position to encourage sustainable resource management, manufacturing, use and disposal

How do people conceptualise the reuse of medicines? An interview study

Objectives: To capture people’s beliefs about medicines reuse and to map the determinants of intentions to reuse medicines in the future. Methods: Participants were recruited through an advert placed in the university’s community newsletter reaching 15,000 households. Adults wishing to participate were interviewed using opportunistic sampling, with recruitment continuing until data saturation. Participants were interviewed face-to-face by two researchers using a semi-structured interview schedule based on the Theory of Planned Behaviour (TPB). Interview transcripts were analysed by thematic analysis with the themes classified according to the TPB. The University’s research ethics committee approval was obtained. Key findings: Nineteen participants were interviewed. The potential economic and environmental benefits of medicines reuse were juxtaposed with stability and safety worries. Participants trusted pharmacists to quality-assure returned medicines, but wondered if they had the time and storage space to dedicate to medicines reuse. Environmentalists were seen as the main proponents of medicines reuse with drug manufacturers, some taxpayers, and parents seen as the main opponents. The physical characteristics of reused medicines, and quality assurance and logistics of reuse processes were seen to enable / obstruct engagement in medicines reuse. A working definition of medicines reuse as a behaviour was developed. Conclusions: People could potentially agree to reuse medicines if their concerns are addressed and the process is well defined and managed. This is a qualitative study with a small number of participants meaning the results may not be generalizable. The themes generated will enable a structured questionnaire to be developed for quantifying broader views

Environmental aspects of health care in the Grampian NHS region and the place of telehealth

Detailed information about the composition of the carbon footprint of the NHS in the Grampian health region, and in Scotland generally, is not available at present. Based on the limited information available, our best guess is that travel emissions in Grampian are substantial, perhaps 49,000 tonnes CO2 per year. This is equivalent to 233 million km of car travel per year. A well-established telemedicine network in the Grampian region, which saves over 2000 patient journeys a year from community hospitals, avoids about 260,000 km travel per year, or about 59 tonnes CO2 per year. Therefore using telehealth as it has been used historically (primarily to facilitate hospital-to-hospital interactions) seems unlikely to have a major environmental impact – although of course there may be other good reasons for persevering with conventional telehealth. On the other hand, telehealth might be useful in reducing staff travel and to a lesser extent, visitor travel. It looks particularly promising for reducing outpatient travel, where substantial carbon savings might be made by reconfiguring the way that certain services are provided

Voting on sustainable transport: communication and governance challenges in Greater Manchester's ‘congestion charge’ referendum

In December 2008, the Greater Manchester electorate voted to reject a £3 billion package of transport measures that would have included investment in the conurbation's bus, tram and rail networks and walking and cycling infrastructure, together with, and partially funded by, the introduction of a congestion charge. The proposals followed a successful bid to the UK Government Transport Innovation Fund (TIF). High levels of car use present challenges to cities, and the TIF bid can be seen as an attempt to address these by promoting and facilitating a modal shift. The paper reflects on the debates surrounding the proposals, which led to a referendum. In particular, it explores the challenges of communicating complex, controversial plans in a fragmented and contested political arena

NHS England Carbon Emissions Carbon Footprinting Report

This document is summarised in 'NHS [England Carbon Emissions Carbon Footprinting Report] Executive Summary'.The National Health Service has produced 'National Health Service England Carbon Reduction Strategy', as part of a broader sustainable development agenda. To support this process, the Sustainable Development Commission in conjunction with the Stockholm Environment Institute, has completed an updated carbon foot printing study covering all National Health Service England Estates and activities.Publisher PDFupdated versio

NHS [England Carbon Emissions Carbon Footprinting Report] Executive Summary

This is a summary of 'NHS England Carbon Emissions Carbon Footprinting Report'.The National Health Service has produced 'National Health Service England Carbon Reduction Strategy', as part of a broader sustainable development agenda. To support this process, the Sustainable Development Commission in conjunction with the Stockholm Environment Institute, has completed an updated carbon foot printing study covering all National Health Service England Estates and activities.Publisher PD