NHS Fife Sustainability Strategy 2012 - 2015

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Nov 9, 2013 (3 years and 9 months ago)

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4
July 2011





NHS Fife Sustainability Strategy 201
2

-

2015









Contents



Context

Introduction

1.

Climate Change

2.

Energy Management

3.

Water Management

4.

Waste Management

5.

Transport

and Travel

6.

Carbon Management

7.

Procurement

8.

Biodiversity

9.

Construction

10.

Staff Training & Aw
areness

11.

Corporate Governance

12.

References

13.

Action Plan




1

Context


This strategy document has been developed to comply with the mandatory requirements of
HDL(2006)21
:

Environmental Management Policy for NHS Scotland

(1)

and

CEL1
5
(2009): Sustainable Developme
nt
Strategy for NHS Scotland
(2)
.

The need to protect, promote and improve the quality of our environment
is compelling and
has become
increasingly important in recent years. Many of the natural resources that we rely upon (clean air, water and
food) are
under threat from pollution, overuse and poor management. We often take these resources for
granted

and

the threat from climate change requires that we take action now.

The purpose of this document is to ensure that the operations of NHS Fife do not have
a detrimental effect
on the health of the general population of Fife. NHS Fife has a duty of care as a health provider to minimise
the impact of its operations and this strategy document will be
come

part of an overall sustainability
management process to
ensure this happens.

This strategy is specific to the management of NHS Fife and
is concerned with things that NHS Fife can control and influence.

Environmental management is concerned mainly with the reduction of greenhouse gases
and there are UK

Governm
ent
targets, Scottish Government targets and NHS Scotland targets established for the reduction of
CO
2

emissions.

Other environmental impacts such as land management and biodiversity also impact on the
environment and these will also be considered in this

strategy.

The Climate Change (Scotland) Act 2009

(
3
)

creates a statutory framework
for

greenhouse gas
emissions

reduction
s in
Scotland

by setting an interim 42 per cent
reduction

target
for

2020 and an 80 per cent
reduction

target
for

2050. These
reductio
n
s are based on a 1990 baseline.

The

NHS Scotland HEAT Target

(
4
)

is to reduce energy
-
based carbon emissions and to continue a
reduction in energy consumption to contribute to the greenhouse gas emissions reduction targets set in the
Climate Change (Scotla
nd) Act 2009.

The specific
targets

for

NHS
Scotland

are to reduce
CO
2

emissions

for

oil, gas, butane and propane usage
based on a national average year
-
on
-
year
reduction

of 3% by 2014/15 as a milestone to the elimination of
the use of fossil fuels by 2050;
and to continue to reduce energy consumption based on a national average
year
-
on
-
year energy efficiency target of 1% by 2014/15 as a milestone to achieving an overall improvement
by 2050 of 30% on the comparative per
for
mance as at 2009/10. In
for
mation on
per
for
mance against these
targets

is being established.

Where no National Government, local or NHS Scotland targets exist for a particular environmental factor,
NHS Fife will set a target based on current practice and best estimating techniques. The targe
ts will not
necessarily be a reduction in CO
2

emissions but will look to improve upon existing measures that improve
environmental performance. Where necessary, guidance will be sought from Health Facilities Scotland.


2

Introduction


The Scottish Governmen
t’s strategy document,
Choosing Our Future: Scotland’s Sustainable
Development Strategy

(
5
)

provides a framework that individuals and organisations can adopt to help meet
sustainable development
objectives.
It requires an integrated approach that brings t
ogether environment,
economic and social factors.

With regards to sustainable development, e
nvironmental management forms part of the Scottish
Government’s objectives

and i
t details 4
environmental
priorities that
require

to be addressed
;



Sustainable consu
mption and production
: achieving more with less. This includes reducing
the inefficient use of resources, looking at the impact of products and materials across their
whole lifecycle and encouraging people to think about the social and environmental
conseq
uences of their purchasing choices.



Climate change and energy
: securing a profound change in the way we generate and use
energy, and reducing greenhouse gas emissions.



Natural resource protection and environmental enhancement
: protecting our natural
resour
ces, building a better understanding of environmental limits, and improving the quality of
the environment.



Sustainable communities
: creating communities that embody the principles of sustainable
development locally.

NHS Fife is
committed to meeting these
objectives
across a
wide
range of environmental impacts
.
These
impacts are discussed further within this
strategy;

however, other factors also need to be considered.
Ensuring the delivery of clinical services
will always be the highest
priority and NHS F
ife must
also
balance
financial, legal and business responsibilities alongside environmental
factors.

The NHS in Scotland document
HDL(2006)21 Environmental Management Policy for NHS Scotland

details
in more specific terms the actions that should be taken
by NHS Scotland Health Boards to
manage
environmental aspects within a healthcare setting. This strategy will therefore identify the key operational
areas that NHS Fife will
undertake to improve upon. It will also identify specific objectives for these a
reas
and performance indicators that will enable improvements to be measured.

CEL15 (2009): Sustainable Development Strategy for NHS Scotland
sets a clear framework that is designed
to guide and stimulate a fundamental shift in culture and behaviour within

NHS

Scotland. That shift will
enable NHS

Scotland to maximise its role as a ‘good corporate citizen’, contributing to addressing national
and global sustainability challenges. The strategy pulls together key strands of policy, and the opportunities
to de
liver those policy objectives that will make NHS

Scotland more sustainable in its delivery of healthcare
services.

A new NHS Scotland Sustainability Strategy is currently under development and this strategy will
be reviewed once details of the NHS Scotlan
d document are available.

All NHS Fife staff have a personal responsibility for the environmental impact of their actions. Within

NHS
Fife,

formal responsibility
for environmental matters rests with the Director of Estates and Facilities. The
NHS Fife En
vironment Group meets on a monthly basis to review current performance towards targets and
ensure the objectives and actions detailed in this strategy
will be
achieved.


3

1)

Climate Change


The Scottish Government has stated that climate change is one of the m
ost serious threats facing the world
and it will have far reaching effects on the Scottish economy, its people and its environment. The Climate
Change (Scotland) Act was passed by the Scottish Parliament in June 2009 and received Royal Assent in
August 20
09. It created a framework to reduce greenhouse gas emissions and encourage the transition to a
low carbon economy through increasing sustainable growth. In addition to setting challenging targets, one of
the most important aspects for NHS Fife was the d
uties placed on public bodies. Part 4 of the Act requires
that a public body must, in exercising its functions, act,



In the way best calculated to contribute to delivery of the Act’s emissions reductions targets,



In the way best calculated to deliver any
statutory adaptation programme, and,



In a way that it considers most sustainable.

NHS Fife recognises that it must comply with these requirements and is determined that it will play its part in
meeting this challenge. One of the major aims for this strate
gy will be the development of an action plan that
defines the actions that are required to adapt to the impacts of climate change and any future impacts, and
also to mitigate the causes of climate change.

The terms adaptation and mitigation are becoming in
creasingly common when climate change is mentioned.
The following definitions are given as an indication only.



Adaptation


actions or adjustments taken by an organisation in response to actual or potential
impacts of predicted climate change, which reduc
es harm or takes advantage of beneficial
opportunities.



Mitigation


activities which seek to lessen the human effects of climate change by reducing the
quantity of greenhouse gases released to the atmosphere.

In meeting the requirements of Part 4 of the C
limate Change (Scotland) Act, NHS Fife will adopt best
practice measures when considering any activities or actions that reduce or lessen the impact and effect of
climate change.

Actions that NHS Fife could consider as a way of introducing climate change a
genda into the organisation is
the use of a climate change risk assessment process for new service developments and carbon accounting
for departments. A climate change risk assessment could cover issues such as increasing/decreasing
energy and water use,
clinical waste/domestic waste production, impacts on staff/patient travel and
transport, local environmental impacts, etc. This would not be a replacement for any formal Environmental
Impact Assessment of Strategic Environmental Assessment that may be req
uired as part of a planning
process but rather a simple measure for internal reporting that gives assurance that climate change is being
considered. Carbon accounting is a process whereby the quantity of emissions associated with a service or
department c
ould be calculated in terms of tonnes of CO
2
. Reduction measures undertaken by the service
or department would be allocated to them and performance reported. These developments will be discussed
in the next 12 months by NHS Fife and considered for implem
entation.


Specific Objectives



Consider adopting best practice for adaptation or mitigation measures
.



Development of a climate change risk assessment process.



Consider
the use of carbon accounting to measure improvements in environmental performance
.


Key
Performance Indicators



Increasing operational efficiency of NHS Fife buildings and services
.



Adoption of climate change risk assessment process
.



Introduction of carbon accounting
.


4

2)

Energy Management


The emphasis on reducing CO
2

emissions from the consumpt
ion of energy is increasing and the
Government has implemented and is implementing various measures to assist organisations in this
endeavour.
The introduction of the Climate Change Levy imposed a tax on the consumption of electricity
and fossil fuels. T
he EU emissions Trading Scheme introduced the concept of carbon trading for large
energy intensive organisations. More recently, the Energy Performance of Buildings Directive required
certain buildings to display Energy Performance Certificates and new ca
rbon trading scheme, the CRC
Energy Efficiency Scheme, will require organisations to participate if they meet certain qualifying criteria.
NHS Fife meets
these criteria

and will be a participant.

While legislation can provide a certain impetus for organis
ations to reduce energy consumption,
specific
targets have also been established by the Scottish Government and NHS Scotland.

The Scottish Government emissions reductions targets are challenging and require,



A reduction in CO
2

emissions of 42% by 2020 base
d on 1990 emissions levels, and



A reduction
i
n CO
2

emissions of 80% by 2050 based on 1990 emissions levels.

The NHS in Scotland has had energy reduction targets since 1985

and Health Facilities

Scotland

publish an
annual environment report detailing the pe
rformance of NHS Boards.
The 2008/09 report showed an
absolute reduction of nearly 42% since the base year of 1985/86.


Energy reduction targets for future years
will be included in the HEAT targets.

NHS Fife has a good
track
record of reducing consumptio
n of energy in its buildings.
The reduction in
consumption
from 2009/10
compared to 2000/01 is more than 16%, however, the cost for this energy
compared to the same year has risen by more than 106%.
In 2009/10 just over 103 GWh (103,000,000
kWh)
units of

energy
was consumed by NHS Fife sites at a cost of more than £3.75 million.

Investment in energy saving projects has increased over the last few years and projects such as high
efficiency lighting installations, speed controls for motors, replacement ga
s boilers
, etc.
have been
completed
.
These projects will continue to be undertaken and where appropriate funding will be source
d

from the NHS Scotland Central Energy Efficiency Fund (CEEF) or the Capital Grant Scheme. Low or no cost
projects will also be

implemented with the major emphasis on raising staff awareness.



Specific Objectives



Reduce energy consumption while continuing to maintain the operations of NHS Fife.



Consider the introduction of low/zero carbon renewable technologies.



Utilise
Encode

(
6
)

benchmark figures as a performance indicator for NHS Fife buildings.



Identify and reduce energy waste by improving thermal insulation of buildings
.



Raise staff awareness of energy issues through the introduction of an awareness campaign.

Key Performance
Indicators



Meet and exceed HEAT Targets th
at are in force at current time, 2010/11 to 2014/15 targets are

o

A 3% annual reduction in
CO
2

emissions from
the consumption of fossil fuels compared to
2009/10, and

o

An overall 1% annual energy reduction compared to

2009/10.



Increase % of buildings supplied by renewable energy.



Encode benchmarks

o

Existing buildings


Gj per 100m
3
,

o

New buildings


Gj per 100m
3
.



Capital investment in energy saving projects


CEEF or Grant Scheme.


5

3)

Water

Management


Water is a precious n
atural resource and while it does not have the impact on CO
2

emissions that energy
consumption has
,

it is essential in daily life
. Nationally
,

Scottish Water supplies around
2.5 billion litres of
water

per
day

to it’s customers in Scotland and there is co
nsiderable effort made in ensuring we are all
supplied with clean drinking water that meets
the requirements of the
Water (Scotland) Act 1980

(
7
)

and
Water Supply (Water Quality) (Scotland) Regulations 2001

(
8
)
. Reducing water waste
,

which will in turn
re
duce the carbon emissions for Scottish
W
ater
,

must be a priority for us all to ensure
its

continued supply.

There are no specific targets for the reduction of water in NHS Scotland Health Boards. Since the
introduction of energy targets

in HDL (2000) 19,
NHS Fife has also applied the 2% reduction in water
consumption to all its properties. In the absence of NHS Scotland targets NHS Fife will continue to apply
whichever HEAT energy efficiency target is in place to water savings.

Demand for water within NHS

Fife has been increasing over the last few years due mainly to infection
control, hand
-
washing, cleanliness issues, but actual consumption of this resource has reduced as a result of
the introduction of water saving devices, etc. In addition the major re
duction in water consumption has been
as a result of water leakage detection and repairs being carried out at hospital sites.

In 2000/01, NHS Fife consumed
377,
45
5 m
3

of water at a cost of
more than
£
500,000
. At peak consumption
in 2005/06, 424,257 m
3

of
water was consumed at a cost of more than £
750,000
. Due to the improved
infrastructure and network of pipes supplying water round NHS Fife sites, the consumption of water reduced
to
292,280

m
3

in 2009/10, a reduction from the 2000/01 base year of nearly 2
3%.
Similar to other utilities
costs have also increased for water supplies and expenditure in 2009/10 was around £700,000.
This
represents an increase over the 2000/01 costs of more than 20%.

Costs and consumptions of water are however not the only conc
ern with this utility. Included within the costs
for water services are the disposal costs for removing dirty water from sites and cleaning it before it re
-
enters
the water cycle. Pollution of land, rivers, streams, etc. is a major concern and NHS Fife h
as a duty of care to
ensure it does not knowingly cause water pollution.










Specific Objectives



Reduce consumption of water through improvements in infrastructure and network.



Consider implementation of water reduction projects where feasible.



Minimi
se pollution of water services.

Key Performance Indicators



Consumption of water in NHS Fife sites per m
2

GIA.



Number of occasions NHS Fife is cited by SEPA for
water
pollution offences.



6

4)

Waste Management


The disposal of waste is a major concern to the gl
obal and local environment. Thousands of tonnes of
rubbish are produced each year and there is limited capacity in landfill sites to accommodate this waste. In
addition,
as
waste
degrades
in landfill sites
it
emits greenhouse gases that are more intensiv
e than the
burning of fossil fuels or the consumption of electricity.

The effective and proper management, segregation, disposal and recycling (where available and
appropriate) of clinical and domestic waste is the primary aim for NHS Fife.

To ensure this

happens, NHS
Fife will comply with the guidance set out in
Scottish Health Technical Note 3, NHS Scotland Waste
Management Guidance
(
9
)
. This document is intended to assist NHS Scotland bodies in meeting their
waste management requirements by reflecting
current legal and policy requirement
s, procedures and best
practice
.

Health Facilities Scotland on an annual basis require the quantity and cost to dispose of the waste generated
to be reported by each Health Board and in 2009/10 NHS Fife disposed of 970 t
onnes of clinical waste and
an estimated 3175 tonnes of domestic waste. The cost involved in disposal of this waste
was estimated at
more than £600,000 and this figure will continue to rise in the future. It is more than likely that estimated
figures wil
l become unacceptable when reporting waste disposal quantities and costs and it will therefore
become increasingly important to ensure that accurate is available. Working in partnership with Fife Council,
efforts to ensure that accurate data is available
for domestic waste will be pursued in 2011/12.

The ability to accurately define quantities and costs is vital if performance is to be monitored and reported

and more significantly if efforts to reduce and recycle waste are to be shown as being successful
.

Areas of
good practice within NHS Fife will be encouraged and if practicable extended throughout the organisation.
One method of identifying good practice and providing evidence of compliance with the guidance document
is to carry out waste audits. Effo
rts to increase the number of waste audits undertaken within NHS Fife sites
will be implemented.










Specific Objectives



Implement guidance contained within SHTN 3 throughout NHS Fife.



Increase the quantity of waste recycling within

NHS Fife.



Improve
the method and accuracy of domestic waste disposed of
.



Increase the number of waste audits being undertaken in NHS Fife sites
.


Key Performance Indicators



Quantity of clinical waste being disposed of by NHS Fife per annum
.



Quantity of domestic waste being
disposed of by NHS Fife per annum
.



7

5)

Transport

and Travel


Transport and travel is a major contributor to greenhouse gas emissions and accounts for more than 25% of
all CO
2

emissions in the UK. The
report published by Health Facilities Scotland,
Carbon Fo
otprint of NHS
Scotland (1990
-
2004)
(
10
)

suggests that transport emissions from NHS Scotland activities account for around
24% of the total NHS Scotland emissions and have remained relatively stable over that period. These
figures represent the emissions
from staff commuting, visitor travel, patient travel and business miles
travelled by NHS staff and vehicles. Figures for NHS Fife are reported in the annual NHS Fife Environment
Report, however, they are to a certain degree estimated and do not include pa
tient and visitor travel figures.
Efforts will be undertaken to increase the accuracy of the figures that NHS Fife currently report.

Despite transport emissions appearing to have remained relatively constant over the period reported in the
NHS Scotland Ca
rbon Footprint report, it is an element that has seen an increasing trend in terms of miles
travelled and expenditure on travel by NHS Fife. There is therefore a need to develop new or review existing
business and fleet travel policies to ensure they incl
ude the need to reduce travel and incentivise the use of
alternative, more sustainable means of travel. The use of alternative fuel vehicles in the NHS Fife fleet
transport should be investigated and if appropriate a vehicle assessed.

Staff commuting is a
nother significant area of emissions for NHS Fife. A considerable amount of work has
already been undertaken to promote and encourage walking, cycling and the use of public transport by NHS
Fife employees to get to work, such as,



Cycle to Work


secure bi
cycle shelters have been installed at a number of hospital sites to
encourage employees to cycle to work,



Fiscal incentives


these have previously been available to NHS Fife employees but are currently
under review by HMRC, and



Tripshare Fife


promotes c
ar sharing by NHS Fife employees to reduce commuting miles
.

Effective travel plans supported by robust travel survey information is a good starting point for any
transport/travel policy. Surveys have been carried out at various hospital sites and informed

the
development of travel plans for these sites in conjunction with local authorities, public transport operators,
local community representatives, etc. There will be a need to review this information and update the data
that was used as a basis for the
travel plans to ensure they remain effective.

In addition, the promotion of
health benefits if appropriate journeys are undertaken by walking or cycling should be addressed in travel
policies.


S
pecific Objectives



Improve method of collecting mileage and
consumption data for NHS Fife fleet vehicles
.



Develop transport
policy

for NHS Fife transport fleet vehicles
.



Improve method of calculating number of business miles travelled by NHS Fife employees
.



Develop and implement travel plans for appropriate sites
.



Carry out travel surveys for hospital sites
.



Develop policies and procedures to encourage staff to travel to place of work using public transport or
other means
.


Key Performance Indicators



Accurate reports available

for NHS Fife fleet vehicles
.



Approved
t
ransport
policy

approved and being implemented
.



A
vailability of
business mileage
data

being used in reports
.



Implementation of travel plans
.



Availability of survey information
.



Implementation of
staff travel
policies and procedures
.


8

6)

Carbon Management


The

carbon footprint of any organisation encompasses many aspects of its activities and operations.
The
report published by Health Facilities Scotland,
Carbon Footprint of NHS Scotland (1990
-
2004)

provided an
estimate of the areas where the burden of carbon
emissions arise from within NHS Scotland. The report
identified that the source of more than half of the carbon emissions come from aspects of procurement, i.e.
pharmaceuticals, medical equipment, paper products and business services, etc. The remainder
of the
carbon emissions arise from building energy consumption and travel and transport.

Carbon emissions fall into 3 categories,



Scope 1


direct emissions from sources that are owned or controlled by NHS Fife, i.e.
fossil fuel
boilers, NHS Fife fleet veh
icles, etc.



Scope 2


indirect emissions from the generation of purchased electricity
consumed by NHS Fife.



Scope 3


indirect emissions and are a consequence of the activities of NHS Fife but are not owned
or controlled by NHS Fife.

NHS Fife publishes det
ails of carbon emissions in an annual Environment Report. The report covers a
number of the aspects of a carbon footprint but not all that is considered to give a complete picture. Scope 1
emissions are reported and given that the consumption of fossil f
uels in buildings is measured, these figures
are accurate. Transport and travel figures are to a large extent estimated
, mainly business travel mileage
.
Scope 2 emissions are measured through electricity meters and
the calculated emissions from this data

can
be considered accurate. A small number of Scope 3 emissions are measured/estimated such as waste
disposal

and

staff commuting
,

but a significant proportion of these emissions are not reported.

Based on the
data in the Carbon Footprint report, an est
imate of the total carbon footprint will be calculated for NHS Fife.

One of the methods
the European Union and the UK
Government is
using

to reduce
carbon emissions from
energy use in buildings are

the introduction of
carbon
trading schemes. These schemes

in effect require
organisations to purchase allowances
, at a £ per tonne of CO
2

rate, equal to

the quantity of carbon
emissions
they generate from energy consumption. A scheme for very large consumers was introduced in
2005 and more recently the Carbon R
eduction Commitment Energy Efficiency Scheme has
come into force
for energy intensive organisations. NHS Fife is a participant in this scheme and will be required to purchase
allowances for the emissions it generates from building energy use.

NHS Fife was

also a participant in the 2008 Carbon Management Programme organised by the Carbon
Trust. As part of that programme, a Carbon Management Plan was developed and
NHS Fife set
a
challenging target
to reduce

CO
2

emissions
from a 2006/07 baseline by at least
30%
by
2013/
2014
. The
development of the plan identified a number of emissions reduction projects and these will be implemented
where practicable.




Specific Objectives



Reduce carbon emissions
from a 2006/07 baseline by at least 30% by 2013/2014.



Calcula
te estimate of full carbon footprint for NHS Fife.



Participate in the Carbon Reduction Commitment Energy Efficiency Scheme.


Key Performance Indicators



Encode benchmarks

o

Existing buildings


kg per m
2
,

o

New buildings


kg per m
2
.



Achieve highest possible po
sition in Carbon Reduction Commitment Energy Efficiency Scheme league
table.


9

7)

Procurement


NHS Fife is fully aware of its purchasing responsibilities in achieving best value for money and adopting
sound sustainable procurement activities. While there is n
o universal definition of sustainable procurement,
a useful working definition can be used, e.g.

a process whereby an organisations meet their need for
goods, services, works and utilities in a way that achieves value for money on a whole life basis in
te
rms of generating benefits to society and the economy, whilst minimising damage to the
environment”
. Benefits can therefore be achieved by what is purchased and also by how it is purchased.

The Scottish Government has developed a
Sustainable Procurement A
ction Plan for Scotland

(
11
)

and
this identifies that the public sector must lead by example in the drive for sustainable procurement. Within
NHS Scotland’s standard conditions of contract there are clauses in relation to equality and diversity,
environme
nt and sustainable procurement clauses are being added. All local tenders utilise these terms and
conditions
that include the

following
aspects;



Legislation


all public bodies are required to comply with EU Treaty, EU, UK and Scottish
Government procurem
ent legislation.



Specification


it is much easier and more cost
-
effective to build sustainability into the procurement
process at this stage, when requirements are being drawn up, than later in the process.



Selection of Tenderers


selection criteria must

focus on the suppliers’ economic/financial standing
and their technical ability relating to the performance of the contract rather than the suppliers’
general policies relating to the environment, etc.



Contract Award


2 options are available, Lowest Pric
e and Most Economically Advantageous
Tender (MEAT). MEAT is most likely to be used as this relates more closely to value for money.



Contract Management


after contract award, organisations may work co
-
operatively with suppliers
to reduce their environmen
tal impact and that of their supply chain.

Balancing commitments to value for money and sustainable procurement can however sometimes lead to
contradictory outcomes. The need to relate purchasing factors to the subject matter of the contract means
that op
portunities for incorporating social issues into public procurement are more limited than for example
environmental issues.

Incorporating economic issues can also be limited as preference cannot be given to
any sector of suppliers such as local suppliers
to the detriment of others. While it may prove to be
challenging, finding solutions that lead toward sustainable economic growth should be a core value for all
public sector organisations.






Specific Objectives



Develop NHS Fife Procurement & Logistics
Sustainable Procurement Action Plan.



Engage and participate with local partners to encourage and promote compliance with sustainable
procurement objectives.



Develop responsible procurement risk assessment guidance.


Key Performance Indicators



Availability
of NHS Fife Procurement & Logistics Sustainable Procurement Action Plan.



NHS Fife representatives attending appropriate partnership environmental groups.



Number of risk assessments carried out.



10

8)

Biodiversity


Biodiversity is a term commonly used as a shor
t version of Biological Diversity and means the variety of plant
and animal life in a particular habitat or indeed the world.
It encompasses the total variety of all living things
and is the life support system for our planet. It provides us with food, m
edicines and other materials, adds
colour and beauty to our surroundings and plays an important part in our culture and traditions.

The
Nature Conservation (Scotland) Act 2004

(
12
)

came into force on the 29
th

November 2004 and placed
a duty on all public b
odies to further the conservation of biodiversity. Public bodies now have a legal
obligation to further the conservation and enhancement of biodiversity in the course of carrying out their
functions. It places the onus on the organisation to take direct
responsibility for the impacts that their policies
and operations may have on the natural environment.

NHS Fife is committed to raise awareness and support the conservation and expansion of biodiversity at
sites where appropriate improvements can be implem
ented. The first step in this is to identify
NHS Fife

sites
that can be developed and carry out audits that provide a baseline for

the promotion of biodiversity
.
Greenspace audits have not been

undertaken before for any NHS Fife site and it is likely tha
t external
assistance will be required. The Fife Coast and Countryside Trust
has provided invaluable advice and
will
be consulted
on the best method of carrying out
audits and
surveys.

The improvement in biodiversity of NHS Fife sites will require a chang
e in the understanding of grounds and
gardens maintenance. Existing contracts with service providers tend to follow an approach that keeps
grounds and gardens tidy and well tended.
On larger hospital sites especially, the need to mow grassed
areas will b
ecome reduced to encourage
wildflower plant species to grow.

There are no specific targets for the improvement of biodiversity in the NHS and it is difficult to determine
what would be realistic without first knowing what exists on health service sites. T
he aim for NHS Fife in the
short term is therefore to
determine where we are at hospital sites with regards to biodiversity and develop
local action plans for the hospital sites that provide the greatest opportunities.









Specific Objectives



Carry out

Greenspace audits and surveys

at sites where the development of biodiversity is to be
implemented.



Develop where appropriate
,

or for recognised areas, Local Biodiversity Action Plans (LBAP).



Review current status of grounds and gardens maintenance contrac
ts with service providers.


Key Performance Indicators



Number of Greenspace audits and surveys carried out.



Number of local biodiversity action plans developed.



Increase in number and type of plant and animal species.



11

9)

Construction


New construction proje
cts or refurbishments to any property can present opportunities to demonstrate
commitment to improving sustainability and environmental performance. These opportunities can take many
forms within the design of the project and/or location of the new premis
es. The major benefits for any
building can be maximised during the design phase, but retrofit options can also provide considerable
improvements. Assistance on the applicability of new and renewable technologies can be obtained from the
Carbon Trust who

provide organisations with
specialist support to help cut carbon emissions, save energy
and commercialise low carbon technologies. NHS Fife will continue to use the services of the Carbon Trust
when developing designs, specifications, etc. for new build
and refurbishments of buildings.

It will take a long time for the impact of new construction and refurbishment projects to be felt, however, they
will make a significant contribution to meeting climate change targets. The replacement or upgrading of
inef
ficient buildings should always consider improvements to energy efficiency, reducing waste and
integrating with local services. A policy to ensure that sustainability issues are always considered in the
design stage of any new project will be developed.

A

measure for a new or substantially refurbished buildings’ environmental performance can be assessed
prior to work commencing by undertaking a
Building Research Establishment Environmental
Assessment Model

(13)
.
The assessment considers a number of factor
s of sustainability and environmental
performance and is carried out at the planning/design stage and provides designers, planners, building users
with an indication of the likely environmental performance of the building before it is built. NHS Fife will

undertake BREEAM assessments for appropriate major projects and endeavour to attain “Excellent” rating
for new builds and “Very Good” rating for refurbishments.

Building Standards will also play an important part in ensuring buildings become more efficien
t. These
standards will be changed in future years and likely place requirements on builders/designers to use
renewable energy sources and sustainable materials. As previously discussed in the procurement section of
this strategy, the balance between val
ue for money and sustainability is also relevant for construction
projects, however, meeting challenging climate change targets will not be achieved by the continued use of
conventional energy sources. NHS Fife will ensure that renewable energy sources ar
e always considered as
an option in any new building or refurbishment project.








Sp
ecific Objectives



Develop a sustainability policy for inclusion in specifications and contracts when procuring construction
projects.



Implement BREEAM principles for ne
w and refurbishment projects.



Building performance to be monitored after commissioning.


Key Performance Indicators



Availability of sustainability policy for inclusion in specifications and contracts.



Number of "excellent" ratings for new builds and "very
good" ratings for refurbishment projects.



New build and refurbishment projects to meet good practice benchmarks in Encode.



12

10)

Staff Training and Awareness


NHS Fife staff
will have a significant impact
in the success of this strategy and

could
help to deliv
er real and
quantifiable reductions in carbon emissions, energy consumption and expenditure. An awareness of all the
issues concerning sustainability and climate change is fundamental and NHS Fife is committed to providing
the appropriate training that wi
ll give staff a basic understanding of these aspects. Work has already begun
to deliver awareness raising sessions for Environmental Awareness Representatives and further courses will
be provided.

Prior to the start of the awareness campaign, an environme
ntal awareness survey was undertaken that
provided a number of indicators where staff had particular concerns. The survey data was used to inform
the awareness campaign and ensure that the appropriate messages were being delivered in the campaign.
Where
possible, the survey will be repeated to determine if these messages have been delivered and
understood by NHS Fife staff.

In addition to the awareness raising sessions, a range of publicity material will also be developed. Initially
this will focus on
aspects that are known and quantified, such as energy consumption, waste management,
travel to work options, etc. The intention of this material would be to provide feedback to staff on the results
of actions undertaken by them and NHS Fife in reducing ca
rbon emissions.

NHS Fife is not alone in dealing with the issues of sustainability and climate change within the local
environment. As part of the Single Outcome Agreement there is an opportunity to deliver a comprehensive
and consistent message across a
wider population alongside local council and education partners. A Fife
Partnership Environment Group has been created which comprises representatives from Fife Council, NHS
Fife, St Andrews University, local colleges, etc. and this group has established
a number of task groups that
will deal with specific issues. It is hoped that a common message across these organisations can be
applied
that will achieve a bigger impact on reducing carbon emissions.












Specific Objectives



Implementation of Envir
onmental Awareness Training Programme.



Develop a range of publicity material to inform and educate staff regarding sustainability issues.



Participation in Fife Partnership Environmental Group.


Key Performance Indicators



Increase numbers of Environmental A
wareness Representatives.



Number of Environmental Awareness training sessions held each year.


13

11)

Corporate Governance


Development of this strategy will provide NHS Fife with a platform to deliver Corporate Social Responsibility
duties as well as meeting req
uirements set out in HDL (2006)21,CEL 15(2009) and
CEL 14 (2010)
:
S
ustainable Development: Good Corporate Citizenship Assessment model for NHS Scotland
(14)
. It
will also provide local partners with an understanding of the approach NHS Fife will take
towa
rds
sustainability issues.

Implementation of this strategy presents major challenges to NHS
Fife;

however,
there are a number of
activities that are already in place that will help in meeting these challenges.

The NHS Fife Environment
Group meets on a mon
thly basis and one of the tasks for this group will be to implement this strategy and
action plan once it has been approved. In addition, Mr John Wilson, Chief Executive, Operational Division,
has been appointed as the NHS Fife Sustainability Champion and

Mr Mark Valentine has been appointed as
the Environmental Management Representative for NHS Fife.

These appointments are a mandatory requirement of HDL (2006) 21 as is the requirement to implement an
environmental management system (EMS). Corporate Green
code is the preferred choice of EMS for the
NHS in Scotland as it has been specifically developed for use in the NHS.
It is a tool for managing the
environmental impacts of large estates and provides a framework for
the development and implementation of
a

corporate EMS and tools to help maintain a corporate EMS. Queen Margaret Hospital has been chosen
as a pilot site for the implementation of Corporate Greencode in NHS Fife.

CEL 14 (2010) introduces another important tool for assessing an organizations su
stainable development
performance. The
Good Corporate Citizenship Assessment Model

(15)

is a tool to help NHS organisations
and individuals within Boards to think about how they can contribute to sustainable development.

It focuses
on 6 priority areas i.
e. Travel, Procurement, Community Engagement, Facilities Management, Buildings and
Workforce. It also takes a long term view of improvements to sustainable development by making NHS
organisations think about developing activities to become more sustainabl
e. NHS Fife will address these
initiatives and use them to promote all aspects of sustainable development and environmental performance
throughout the organisation.








Sp
ecific Objectives



Develop and gain approval for NHS Fife Sustainability Strategy.



Develop and gain approval for NHS Fife Sustainability Action Plan 2011/12.



Development of Good Corporate Citizen Assessment Model within NHS Fife as a requirement of
CEL14(2010)
.



Implementation of Greencode Environmental Management System at pilot site.


Key Performance Indicators



NHS Fife Sustainability Strategy and action plan approved and being implemented.



Appointment of Board Sustainability Champion and Environmental Management Representative.



Availability of reports from Good Corporate Citizen Assess
ment Model.



Availability of reports from Greencode Environmental Management System
.



14

12)


References


1)

HDL(2006)21
:

Environmental Management Policy for NHS Scotland


Health Facilities Scotland

ht
tp://www.sehd.scot.nhs.uk/mels/hdl2006_21.pdf

2)

CEL 15 (2009): Sustainable Development Strategy for NHS Scotland

http://www.pcpd.scot.nhs.uk/PDFs/CEL2009_15.pdf

3)

Climate Change (Scotland) Act 2
009


Scottish Government

http://www.scotland.gov.uk/Topics/Environment/climatechange/scotlands
-
action/climatechangeact

4)

HEAT Targets


Scottish G
overnment

http://www.scotland.gov.uk/Topics/Health/NHS
-
Scotland/17273/targets

5)


Choosing our future: Scotland’s Sustainable Development Strategy


Scottish Government

http://www.scotland.gov.uk/Publications/2005/12/1493902/39032

6)

SHTM 07
-
02:
En
CO
2
de


making energy work in healthcare

http://www.hfs.scot.nhs.uk/publications/encode
-
scotland
-
2006.pdf

7)

The Water (Scotland) Act 1980

http://www.opsi.gov.uk/RevisedStatutes/Acts/ukpga/198
0/cukpga_19800045_en_1

8)

The Water Supply (Water Quality) (Scotland) Regulations 2001

http://www.scotland
-
legislation.hmso.gov.uk/legislation/scotland/ssi20
01/20010207.htm

9)

Scottish Health Technical Note 3: NHS Scotland Waste Management Guidance

http://www.hfs.scot.nhs.uk/publications/encode
-
scotland
-
2006.pdf

10)

Carbon Footprint of

NHS Scotland (1990
-
2004)

http://www.hfs.scot.nhs.uk/online
-
services/publications/environment/environment
-
reports/

11)

Sustainable Procurement Action Plan

for Scotland

http://www.scotland.gov.uk/Publications/2009/10/sspap

12)

The Nature Conservation (Scotland) Act 2004

http://www.opsi.gov.uk/legislation/scotland/acts2004/20040006.htm

13)

Building Research Establishment Environmental Assessment Model

http://www.breeam.org

14)

S
ustainable Development: Good Corporate Citizenship Asse
ssment model for NHS Scotland

http://www.sehd.scot.nhs.uk/mels/CEL2010_14.pdf

15)

Good Corporate Citizenship Assessment model for NHS Scotland

http://www.corporatecitizen.scot.nhs.uk/



15

13)

Action Plan


DRAFT


J
ul
y 2011



Ref.
Actions / Priorities
Outcome / Target
Sustainable Consumption
Climate Change and Energy
Natural Resource Protection
and Enhancement
Sustainable Communities
Timescale
Owner
Status
1.
Climate Change
1.1
Consider adopting best practice for adaptation
or mitigation measures
Increasing operational efficiency of NHS Fife
buildings and services


Ongoing
EEM

1.2
Development of a climate change risk
assessment process
Adoption of climate change risk assessment
process

March 2012
EEM

1.3
Consider the use of carbon accounting to
measure improvements in environmental
performance
Introduction of carbon accounting


March 2012
EEM

2.
Energy Management
2.1
Reduce energy consumption in all NHS Fife
buildings
NHS Scotland HEAT Target requires a 1% reduction
in consumption of energy per annum


March 2011 and
annually
EEM

2.2
Improve thermal energy performance of NHS Fife
buildings
Progress towards Encode benchmarks


March 2011 and
annually
EEM

2.3
Discuss with suppliers and contract negotiators the
purchase of green electricity
Monitor contracts and where practicable take
advantage of green electricity supplies


March 2011 and
annually
EEM

3.
Water Management
3.1
Reduce consumption of water through
improvements in supply network
EMaRT returns to HFS to be monitored


March 2011 and
annually
EEM

3.2
Implement measures to minimise the occurrence of
pollution in water services
Number of citations from SEPA for water pollution
offences


Ongoing
HoE


Good;

Satisfactory;
X
Unfavourable; ↑ Improving; ↓ Worsening; ? Insufficient information; = No information
EEM - Energy and Environment Manager; HoE - Head of Estates; TM - Transport Manager; TPC - Travel Planning Co-ordinator
HoP - Head of Procurement; CPHM - Consultant in Public Health Medicine; HCPP - Head of Capital Planning & Property Services





16

Action Plan


DRAFT


J
ul
y 2011

(contd.)


Ref.
Actions / Priorities
Outcome / Target
Sustainable Consumption
Climate Change and Energy
Natural Resource Protection
and Enhancement
Sustainable Communities
Timescale
Owner
Status
4.
Waste Management
4.1
Reduce amount of waste arisings in clinical waste
stream
EMaRT returns to HFS to be monitored


Ongoing
HoE

4.2
Reduce amount of domestic waste being sent to
landfill
EMaRT returns to HFS to be monitored


Ongoing
HoE

4.3
Increase amount of recycling
EMaRT returns to HFS to be monitored


Ongoing
HoE

4.4
Improve method of calculating domestic waste
arisings
Discuss with waste collector and implement solution

December 2011
HoE

4.5
Carry out waste audits within a number of NHS Fife
properties
Results from audits

December 2011
HoE

5
Transport and Travel
5.1
Improve method of collecting mileage and
consumption data for NHS Fife fleet vehicles
Accurate reports to be made available


September 2011
TM

5.2
Develop transport policy for NHS Fife transport fleet
vehicles
Approved policy approved and in place

September 2011
TM

5.3
Improve method of calculating number of business
miles travelled by NHS Fife employees
Discuss with Finance colleagues availability of data



Ongoing
TPC

5.4
Develop and implement travel plans for appropriate
sites
Implementation of travel plans



Ongoing
TPC

5.5
Carry out travel surveys for hospital sites
Availability of survey information



Ongoing
TPC

5.6
Develop policies and procedures to encourage staff
to travel to place of work using public transport or
other means
Implementation of policies and procedures



December 2011
TPC


Good;

Satisfactory;
X
Unfavourable; ↑ Improving; ↓ Worsening; ? Insufficient information; = No information
EEM - Energy and Environment Manager; HoE - Head of Estates; TM - Transport Manager; TPC - Travel Planning Co-ordinator
HoP - Head of Procurement; CPHM - Consultant in Public Health Medecine; HCPP - Head of Capital Planning & Property Services


17

Action Plan


DRAFT


J
ul
y 2011

(contd.)


Ref.
Actions / Priorities
Outcome / Target
Sustainable Consumption
Climate Change and Energy
Natural Resource Protection
and Enhancement
Sustainable Communities
Timescale
Owner
Status
7.
Carbon Management
7.1
Reduce carbon emissions from the consumption of
energy in NHS Fife buildings
NHS Scotland HEAT Target requires a 3% reduction
in CO2 emissions per annum


March 2011 and
annually
EEM

7.2
NHS Fife to register as a participant in CRC Energy
Efficiency Scheme
Successful registration of NHS Fife with CRC
Energy Efficiency Scheme


September 2010
EEM

8.
Procurement
8.1
Develop NHS Fife Procurement & Logistics
Sustainable Procurement Action Plan
Availability of Action Plan


March 2011
HoP

8.2
Engage and participate with local partners to
encourage and promote compliance with
NHS Fife representatives attending appropriate
partnership environmental groups

March 2011
HoP

8.3
Develop responsible procurement risk assessment
guidance
No. of risk assessments carried out

Ongoing
HoP

9.
Biodiversity
9.1
Consider carrying out greenspace audits and
surveys at pilot sites
Availability of audit/survey information


September 2011
CPHM

9.2
Identify the amount of land that could be made
available for improvements in biodiversity
Availability of plans showing areas


September 2011
EEM

9.3
Develop an NHS Fife Biodiversity Action Plan and
where practicable Local BAP's
Action plans being developed


March 2012
CPHM

9.4
Review current status of grounds and gardens
maintenance contracts
Determine expenditure of current service provision


December 2011
EEM


Good;

Satisfactory;
X
Unfavourable; ↑ Improving; ↓ Worsening; ? Insufficient information; = No information
EEM - Energy and Environment Manager; HoE - Head of Estates; TM - Transport Manager; TPC - Travel Planning Co-ordinator
HoP - Head of Procurement; CPHM - Consultant in Public Health Medecine; HCPP - Head of Capital Planning & Property Services





18

Action Plan


DRAFT


J
ul
y 2011

(contd.)


Ref.
Actions / Priorities
Outcome / Target
Sustainable Consumption
Climate Change and Energy
Natural Resource Protection
and Enhancement
Sustainable Communities
Timescale
Owner
Status
10.
Construction
10.1
Develop a sustainability policy for the for inclusion in
specifications and contracts when procuring
construction projects
Availability of policy



Ongoing
HCPPS

10.2
Implement BREEAM principles for new and
refurbishment projects
Number of "excellent" ratings for new builds and
"very good" ratings for refurbishment projects



Ongoing
HCPPS

10.3
New build and refurbishment projects to meet good
practice benchmarks in Encode
Building performance to be monitored after
commissioning



Ongoing
HCPPS

11.
Community & Staff Awareness
11.1
Introduction of Environmental Awareness Training
for NHS Fife staff
Implementation of Environmental Awareness
Programme




March 2011
EEM

11.2
Develop links with local partners through Single
Outcome Agreement
Participation of NHS Fife in partnership groups


Ongoing
All

12.
Corporate Governance
12.1
Develop and gain approval for NHS Fife
Sustainability Strategy 2012/15
Approved strategy in place




March 2011
EEM

12.2
Develop and gain approval for Sustainability Action
Plan - 2012/15
Action plan being implemented




March 2011
EEM

12.3
CEL14(2010) requirement that NHS Boards use
GCCAM
Reports available from GCCAM




March 2012
EEM

12.4
Implementation of Greencode at pilot site
Availability of reports from Greencode EMS




October 2011
EEM

12.5
Review policies that support Sustainability Strategy
No. of policies that have been reviewed or
undergoing review/development




December 2011
EEM


Good;

Satisfactory;
X
Unfavourable; ↑ Improving; ↓ Worsening; ? Insufficient information; = No information
EEM - Energy and Environment Manager; HoE - Head of Estates; TM - Transport Manager; TPC - Travel Planning Co-ordinator
HoP - Head of Procurement; CPHM - Consultant in Public Health Medicine; HCPP - Head of Capital Planning & Property Services