The CCC Green Plan: 2022-2027

A sustainability strategy and action plan for The Clatterbridge Cancer Centre NHS Foundation Trust.

Foreword

Climate change has been widely recognised as one of the greatest threats to public health of the 21st century. In looking to the future as a specialist healthcare provider, we understand both the significant threat that climate change presents to the people in our region and our responsibility to take action.

The NHS is leading by example globally and has set an ambitious target to reach net zero carbon emissions by 2040. We have already started work within our Trust to make ourselves more environmentally sustainable and this Green Plan will act as the central strategy to ensure that we are taking a proactive approach and working with our partners to ensure that sustainability is embedded throughout our organisation. 

This plan demonstrates our commitment to supporting the local and national efforts to achieve net zero emissions.

The aim of our Green Plan over the next five years is to drive sustainable changes across the Trust and prepare the organisation for the transition to net zero healthcare over the next two decades. Implementing the actions set out in this plan will enable us to make incremental reductions in our carbon emissions, air pollution and waste over the next five years. The strategy focusses on implementing ambitious and effective actions, such as the redevelopment of CCC-Wirral and promoting efficiency through staff engagement.

As one of three specialist cancer centres in the UK, our mission is to drive improved outcomes and experience through our unique network of specialist cancer care across Cheshire and Merseyside. The strategy considers sustainability holistically and will enable us to drive environmental, economic and social performance to ensure we can provide the highest quality of care now, and in the future.

The aim of our Green Plan over the next 5 years is to drive sustainable changes across our organisation and prepare the organisation for the transition to net zero healthcare over the next two decades.

Liz Bishop – Chief Executive Officer
January 2022

Contents

• The need for sustainable healthcare organisations
• Carbon baseline and pathway analysis
• The road to carbon net zero
• Our commitment to sustainability
• Introducing our sustainable action plan
• Glossary of terms

About this document

This Green Plan sets out the organisational strategy for sustainability at The Clatterbridge Cancer Centre NHS Foundation Trust. The document will act as the central sustainability strategy for the Trust over the next five years.

This strategy has been developed using a structured process in which we have considered local and national drivers, legislative and contractual requirements, and the risks that inaction on addressing sustainability present. To inform the plan and shape our sustainability strategy we have undertaken extensive engagement with senior leaders and colleagues throughout the organisation.

This strategy comprises two sections. The Green Plan document sets out the strategic objectives and targets that we will adopt to drive sustainable development throughout our organisation. Secondly, our Sustainable Action Plan provides a plan of actions that the Trust will implement over the next five years. 

This action plan will act as the framework to guide the implementation of this strategy and will enable the Trust to monitor and report the progress made. In addition to these two sections a separate Carbon Baseline Monitoring Tool underpins the strategy.

The development of the plan has been undertaken throughout late 2021 with approval by the Board in January 2022. The provisions of this plan will therefore start to be implemented in early 2022, with the five year timeframe for this document being 2022-27.

The need for sustainable healthcare organisations

A recent report published by the UN’s Intergovernmental Panel on Climate Change continued to stress the threats that climate change poses to the environment and the implications for human health. The World Health Organisation, British Medical Association, the Royal College of Nursing, and the Royal College of Physicians are just some of the organisations that view climate change as the greatest threat to global health of the 21st century.

The need to act on sustainability is reflected across various items of guidance and legislation to which our Trust and this Green Plan responds.

The net zero transition

In line with the Climate Change Act 2008, the UK has established a mandatory target to reduce carbon emissions to net zero by 2050. The NHS is the UK’s largest public sector employer and contributes to approximately 4-5% of the nation’s carbon emissions. As an organisation the NHS therefore plays a crucial role in supporting this national target.

In 2020, NHS England/Improvement released Delivering A Net Zero
National Healthcare Service. Alongside a range of guidance the plan sets two net zero targets for the NHS in England – to achieve net zero for directly controlled emissions by 2040 (the NHS Carbon Footprint) and net zero for indirectly controlled emissions by 2045 (the NHS Carbon Footprint Plus). 

The figure displayed reveals the scope of these two carbon footprints.

• Achieve net zero by 2040 for the NHS Carbon Footprint (directly controlled emissions)
• Achieve net zero by 2045 for the NHS Carbon Footprint Plus (indirectly controlled emissions)

Actions to drive sustainability in healthcare

The For a Greener NHS Campaign was announced by NHS England in 2020, and provides support to trusts to decarbonise their operations, reduce their impact on the environment, and improve health. The campaign builds upon the work already being carried out within the NHS to improve sustainability.

To become a net zero health service, reduce air pollution, and reduce waste the NHS requires the commitment of all trusts, staff, and partners.

An expert panel has subsequently been formed to map the best path for the NHS to become carbon net zero, the findings of which will be kept under review and used to update this plan as required.

National drivers

National drivers for sustainability in the NHS are established in the following NHS-specific documents:

• NHS Long Term Plan
• NHS Standard Service Contract 2021/22
• NHS Operational Planning and Contracting Guidance
• Delivering a Net Zero National Health Service

The NHS Long Term Plan includes considerations relevant to sustainable development, such as new models of care. The NHS Standard Service Contract highlights several targets and objectives associated with sustainability within the NHS, including the reduction of waste and water usage.
 
The NHS Operational Planning and Contracting Guidance provides advice on the actions required to assist the organisation in achieving the UK’s carbon reduction targets and to improve the NHS’s resilience.

Delivering a Net Zero National Healthcare Service provides details on the modelling and analytics that have been used to determine the NHS carbon footprint and future projections. It also covers the actions that will be implemented by the NHS to reduce emissions, including the immediate actions that must be taken to meet the 2040 carbon net zero target. To ensure that the NHS is on track to meet its long-term commitments and retains the ambition it requires to achieve them, this report will be continuously reviewed.

The documents above establish the following targets:

• For carbon emissions controlled directly by the NHS (the NHS Carbon Footprint), achieve net zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032
• For carbon emissions the NHS can influence (the NHS Carbon Footprint Plus), achieve net zero by 2045, with an ambition to reach 80% reduction by 2036 to 2039
• Deliver a 4% reduction (in carbon emissions) by shifting to lower carbon inhalers
• Deliver a 2% reduction (in carbon emissions) by transforming anaesthetic practices
• Transition to zero-emission vehicles by 2032

Increasing requirements and increasing urgency

Significant progress has been made towards NHS sustainability targets. A 62% reduction in carbon emissions was achieved between 1990 and 2020 through the implementation of a number of strategies.

However, as we near a critical stage for addressing climate change the number and scope of drivers for change are expected to increase. The NHS is continually updating guidance to ensure that it is tackling climate change effectively. The new Net Zero Carbon Hospital Standard, for example, will establish best practice requirements for capital projects and energy efficiency to help meet the net zero targets.

The Trust will continue to engage with the NHS’s sustainability agenda and will monitor legislation and guidance changes as we progress towards net zero.

Local drivers

The authorities across our region are also responding to the increasing pressure to act on climate change. In 2019, Liverpool City Council, Wirral Metropolitan Borough Council, and the Metropolitan Borough of Sefton formally declared a climate emergency. All organisations have also set targets to achieve net zero carbon emissions in their respective constituencies, with a region-wide target of net zero by 2040.

The Trust’s key partner organisations have also established targets to achieve net zero carbon emissions. For example, Liverpool University Hospitals NHS Foundation Trust (LUHFT) aims to reduce its NHS Carbon Footprint by 50% by 2025 from a baseline year of 2007/08.
 
There is a clear commitment to reducing carbon emissions to net zero throughout the region but achieving these targets will require all sectors to make a sustained effort. The Trust will engage in the collaborative approach that will need to be taken to reducing emissions across the region to help achieve the regional 

Our targets

In accordance with national and local drivers, the Trust will adopt the following targets:

Carbon reduction

• We will achieve a 100% reduction of direct carbon dioxide equivalent (CO2e) emissions by 2040. An 80% reduction will be achieved by 2032 at the latest.
• We will achieve a 100% reduction of indirect CO2e emissions by 2045. An 80% reduction will be achieved by 2039 at the latest.

Air pollution

• We will convert 90% of our fleet to low, ultra-low and zero-
• emission vehicles by 2028.
• We will cut air pollution emissions from business mileage and fleet by 20% by March 2024.

Waste

• We will adopt a Zero to Landfill policy.

Carbon baseline and pathway analysis

Addressing our direct and indirect emissions

We have developed our carbon baseline in line with the NHS Carbon Footprint. This footprint includes the emissions which can be directly controlled by the Trust. The following aspects are included in the scope of our baseline:
 

• Fossil fuels
• Electricity
• Fleet travel
• Water
• Anaesthetic gases
• Business travel
• Waste

Performance and direct carbon emission baseline

2020-21 has been used as our carbon baseline year, which is the year against which we will compare all subsequent annual carbon emissions (CO2e). We have calculated our emissions for each aspect by multiplying our consumption data (e.g. kWh for electricity) with the national carbon conversion factors provided by the Department for Business, Energy, and Industrial Strategy (BEIS) for greenhouse gas reporting.

Emissions by year and category

Year	Fossil fuels	Anaesthetic gases	Electricity	Business travel	Fleet	Waste	Water	Total
2018-19	494	5	1771	102	107	0	19	2498
Baseline (2020-21)	1046	4	2257	40	133	29	49	3558
Change	+551	-1	+486	-62	+26	+29	+30	+1061

 

2018-19 is the earliest year that we have reliable data to quantify our emissions. However the Trust’s carbon emissions increased significantly through the opening of Clatterbridge Cancer Centre – Liverpool in June 2020. A baseline year of 2020-21 is more suitable than 2018-19 to reflect the full scope of our emissions.

CCC-Liverpool is highly efficient and has been built to allow us to provide the best possible patient experience. Located centrally for the population we serve, the hospital has also reduced the required travel distance for many of our patients. Being positioned near to the Royal Liverpool University Hospital and the University of Liverpool, means we have onsite access to medical specialties and we are able to provide specialist treatment and carry out pioneering research.

Despite an increase in our overall emissions due to the expansion of our services, the efficiency and location of the new Liverpool centre will help drive a reduction in carbon per patient treated.

The road to carbon net zero

Following our increase in emissions in 2020-21, a continued effort will be required if we are to reduce our emissions to net zero by 2040. This section sets out our trajectory to meet the 2040 target and outlines several local and national scale interventions which may help us to further reduce our emissions.

To guide trusts towards the 2040 net zero target, the NHS has established an interim target for an 80% reduction in scope 1 emissions by 2028 to 2032. These targets are not legally binding but form a national commitment by NHS England/Improvement to encourage NHS organisations to achieve net zero emissions as soon as possible and to ensure that the mandatory national net zero target of 2050 is met.

The carbon emissions that we must reduce to reach these targets are shown in summary below. As shown, the Trust will be required to significantly reduce emissions from 3,358 tCO2e to 712 tCO2e if we are to meet the 80% interim reduction target by 2032.

Target for reducing emissions

Year	Baseline (2020)	2032	2040
Target emission reduction (%)	n/a	80	100
Target emissions (tCO2e)	3558	712	0

The figure provides a visualisation of the Trust’s carbon emissions since 2018-19 and reduction in emissions required from the baseline year of 2020-21 against the NHS targets. We will continue to monitor our emissions against these targets and publish our progress on a yearly basis.

Through the development of our carbon baseline tool, we will now be able to closely monitor CO2e emissions and track our progress against our target trajectory for reaching net zero. The implementation of our Sustainable Action Plan will enable us to make incremental reductions in our carbon emissions over the next five years. It is essential that we take significant action over the next ten years to address our emissions if we are to achieve our next interim target of an 80% emission reduction by 2032. This will require a 237 tonne reduction in CO2e emissions annually over the next 10 years.

Delivering a Net Zero National Healthcare Service provides guidance as to which actions are likely to create the most impactful reductions in carbon emissions. A number of these actions have been included within our Sustainable Action Plan, including: the upgrade of the Clatterbridge Cancer Centre – Wirral site, the encouragement of active travel, and the optimisation of our building management systems (BMSs) on all sites to ensure that our estate is efficient by regulating aspects such as temperature, lighting, and ventilation.

An assessment of the possible reductions that could be delivered by longer-term schemes indicates that interventions could be made to reduce our direct carbon emissions to approximately 31% of our of our baseline emissions, as shown below.

Tonnes of carbon dioxide equivalent (tCO2e) emissions

Total emissions per year: 3,558

Total we will reduce by:

• Active travel – 23
• Upgrade of CCC-Wirral site – 314 
• Upgrade of CCC-Aintree site – 47
• Optimisation of building management system (BMS) – 805
• On-site renewables – 815
• National vehicle efficiency – 75
• Electrification of vehicles – 52 
• National electricity decarbonisation – 324 

To reduce the estimated residual 1,103 tCO2e annual emissions to net zero we will rely on further market innovation and the commercialisation of disruptive technologies (such as conversion of the natural gas grid to hydrogen). We will therefore ensure that we monitor innovation and the development of new technologies and seek out funding opportunities to capitalise on further reductions in emissions. This will be necessary to reduce our need for future carbon offsetting to meet the net zero target.

Several local and national schemes will also be crucial in supporting our transition to net zero carbon emissions.

Local considerations

Wirral redevelopment

Prior to the opening of CCC-Liverpool, CCC-Wirral was the Trust’s main hospital site. The coming years will see the redevelopment of our Wirral site and through this process we will address sustainability through various carbon reduction measures.
Some areas of CCC-Wirral, for example some of the radiotherapy bunkers, are therefore now vacant. We will therefore rationalise our estate as we redevelop the site and thereby reduce our carbon emissions.

We will modernise our remaining estate and make our buildings more energy efficient. The increased installation of new technologies, such as solar panelling on empty roofs, will provide a renewable source of energy from which our services can draw, whilst the optimisation of the site’s BMS will ensure the energy currently being used is not wasted.

Where possible we will increase the green space and biodiversity on the site. This will not only reap the benefits of carbon reduction, but also lead to increased mental wellbeing amongst our staff and patients.

Staff engagement

One of our key strategic priorities is to be a great place to work by attracting, developing, and retaining a highly skilled and motivated workforce to deliver the best quality care. A limiting factor to reducing our emissions to-date has been the absence of programme to involve and engage staff in the sustainability agenda.

Our ambition is to harness the enthusiasm and support of colleagues from across the Trust to drive the implementation of our sustainable actions and reduce emissions. To do this, we will develop and launch a Trust-wide engagement campaign. 

We will use our existing engagement groups and other methods to raise awareness amongst staff of the work already being done to reduce carbon emissions across the Trust and also highlight what can be done on an individual basis. We will increase awareness of sustainability issues across the Trust and encourage and enable staff to make changes in their own working lives, in their wider service areas and away from work.

National considerations

Once all practicable actions to reduce emissions have been implemented the Trust will require national scale actions to reduce our final residual emissions and achieve net zero by 2040. This section will set out the key national schemes that have the potential to reduce CO2e emissions and air pollution over the next three decades and which could help the Trust achieve net zero.

The UK Government’s Ten Point Plan outlines the commitment to achieving net zero by 2050. The Government has also recently published its Net Zero Strategy: Build Back Greener, which establishes specific policies and proposals to ensure the UK economy becomes fully decarbonised by 2050. 

Both documents will act as frameworks to guide the nation’s transition towards a net zero economy and will be supported by £5 billion to trigger a ‘green industrial revolution’ in the UK. The Government has an ambition to support a sustainable recovery from the COVID-19 pandemic through the creation of 250,000 new jobs by 2030 in green energy and zero- carbon technologies including offshore wind farms, nuclear plants, hydrogen power and carbon capture and storage technologies.

Renewable energy

The carbon intensity of electricity consumed in the UK decreases every year due to the increasing percentage of the nation’s energy mix generated from renewable sources. To achieve net zero emissions, the UK must completely decarbonise the national grid.
 
The Government plans to power the whole of the UK with clean electricity by 2035 through an increase to the amount of renewable energy generated by additional offshore wind farms, expected to generate 40 GW of energy. This will be enough to power every home in the country and will be supplemented with carbon capture technology and battery storage so that this renewable energy can meet demand. 

The increasing availability of electricity sourced from renewable energies will significantly reduce our carbon emissions associated with the electricity we import from the national grid, our largest source of emissions.

Emerging technologies and opportunities

The Government’s Net Zero Strategy also details its intention to decarbonise heating through the transition to low-carbon hydrogen. 5GW of low-carbon hydrogen production capacity will be created by 2030 which would be used for heating and would halve fossil fuel related emissions. The conversion of the gas grid to hydrogen has been estimated to reduce UK carbon emissions by 73%.

The transition to hydrogen will be supported by the Net Zero Hydrogen Fund which will provide £240million of capital co- investment by 2024-25. Over the next few years, hydrogen technologies will be trialled on a wide scale, with large village heating trials to be undertaken by 2025 and a potential Hydrogen Town by 2030. Privately funded schemes such as the H21 City Gate Project will also begin converting the gas grid to hydrogen in the short-term.

To prepare for the potential conversion of the gas grid, the Government is consulting on ‘hydrogen ready appliances’ and, subject to the outcomes of the trials, will work to enable up to 20% hydrogen blending in the gas grid by 2023.
Carbon capture will be used in conjunction with hydrogen heating to enable hydrogen to be rolled out across the gas grid at prices that can compete with the costs of natural gas but without emitting carbon. The successful transition from natural gas to hydrogen would enable the Trust to reduce the emissions associated with heating on a large scale. This would go some way to reducing our Trust’s carbon emissions, which gas- fired heating systems are a primary contributor towards.

Further opportunities may present themselves through a series of enabling actions highlighted in the Government’s plans to support the net zero transition. An additional £1.5billion of funding will be made available to support net zero innovation projects, whilst the UK Infrastructure Bank (UKIB) will be used to provide over £40billion of investment for the roll-out and maturity of low carbon technologies. Over the next 20 years, the Trust will continue to monitor new and emerging technologies and funding opportunities which could support the decarbonisation of our operations towards achieving net zero CO2e emissions.

Transport

A fundamental aspect of the Government’s Net Zero Strategy is the potential for active travel and public transport to reduce carbon emissions and air pollution. Due to the positive impacts observed throughout the COVID-19 pandemic on air pollution, the Government aims to continue reducing transport- related emissions through the provision of additional funding for public transport, infrastructure, and active travel schemes.

Investment of £2billion will be provided to allow 50% of town and city-based journeys across the UK to be cycled or walked by 2030. £620million will be made available for zero emission vehicle grants and electric vehicle infrastructure, with a focus on creating more nation-wide charging points.

£350million of a total £1billion from the Automotive Transformation Fund (ATF) will also be allocated to support the electrification of UK vehicles and supply chains. On a local scale, the Trust will seek to influence investment in public and active travel to meet the needs of our staff and patients.

Country-wide rail and bus networks will also be improved through additional funding. More rail lines will be electrified with an ambition to remove all diesel- only trains by 2040 and have a net zero rail network by 2050. Meanwhile, bus and rail networks will be integrated and introduce smart ticketing to make the use of public transport more convenient. The publication of a National Bus Strategy also lays out plans to create 4,000 zero-emission buses and infrastructure which will provide a cheaper, more frequent, and reliable bus network – supported by a £3billion investment into the bus sector.

Alongside public transport changes, the Government will promote active travel, with plans to facilitate safer cycling through the construction of thousands of miles of segregated cycling lanes across England. A dedicated active travel body will track the progress of these schemes and distribute funding accordingly. Encouraging active travel across the country will have many benefits for the Trust, by supporting the reduction our emissions, improving air quality, and improving the health and wellbeing of local people.

The sale of all new petrol and diesel vehicles will be banned from 2030, followed by a ban on hybrid models five years later. This ban has been brought forward by a decade to accelerate the nation’s transition to electric vehicles. The Government has committed to the development of ‘gigafactories’ to produce batteries to accommodate the expected increase in electric vehicle manufacturing and support this transition. The provision of electric vehicle charging points will subsequently be increased.

The shift created by these schemes will assist the Trust in reducing Scope 3 emissions. Scope 3 emissions are difficult for the Trust to quantity and reduce as they lie outside our direct control. The increased provision of public transport methods and active travel schemes will help to reduce staff and patient travel emissions and improve air quality. The transition towards electric vehicles will then assist the Trust in reducing transport emissions including commuting, business travel, and the transportation of products.

Our commitment to sustainability

Our organisation’s inclination to sustainability

The Clatterbridge Cancer Centre has a strong commitment to sustainability and to providing high-quality care in a way which does not negatively impact the environment, achieves positive financial performance, and adds value to our communities. We have previously worked to make our organisation more sustainable through both environmental initiatives and the construction of our modern eco-friendly facilities at CCC- Liverpool. Our commitment to the sustainability agenda is reflected in our organisation’s strategic priorities.

The urgency of acting on climate change

This Green Plan sets out how we will achieve a set of ambitious targets which truly embed sustainability at the heart of our operations. The creation of this new strategy is a recognition of the scale of the urgency and change required to take action on carbon emission reduction and tackle climate change as a core element of achieving better health for patients and communities.

Our strategic priorities

Our environmental obligations align closely with out six strategic priorities to provide examples of how and why sustainability can be successfully integrated within our services:

Be outstanding – delivering high-quality care and a strong operational and financial performance allows sustainability to be addressed in patient-first ways while reducing energy and resource use and wastage.

Be collaborative – driving better outcomes for patients through collaboration with partners offers the opportunity to make progress on sustainability by leveraging their support and encouraging wider changes to the practices of our suppliers.

Be a great place to work – attracting, developing, and retaining a highly-skilled and motivated workforce can be supported by engaging staff in sustainability.

Be research leaders – being research leaders to improve current and future patient outcomes means learning more about the wider environmental determinants of health for our cancer patients.

Be digital – delivering digitally-transformed services which empower staff and patients presents the post-pandemic opportunity to continue agile working arrangements alongside telecare where appropriate.

Be innovative – by being innovative, the Trust can improve patient care through the exploration of sustainable alternative equipment and practices.

Embedding targets within the Trust

Like all NHS trusts, The Clatterbridge Cancer Centre is bound to several legislative and contractual obligations relating to sustainability. We will adopt this series of national targets to guide our progress in reducing carbon emissions and improving our sustainability performance:

• In 2020 we started on the way to purchasing 100% of our electricity requirements from renewable sources
• We will adopt the NHS Single Use Plastics Pledge
• By 2032 we will transition to zero emission vehicles
• By 2032 we will achieve an 80% baseline reduction in our direct carbon emissions
• By 2039 we will achieve an 80% baseline reduction in our indirect carbon emissions
• By 2040 we will achieve net zero carbon emissions in our directly controlled scope
• By 2045 we will achieve net zero carbon emissions in our indirectly controlled scope

Our sustainability objectives

Our commitment to sustainability and the national targets is reflected in twelve sustainability objectives. These objectives, shown below against our wider strategic objectives, have been developed through extensive colleague engagement and will enable us to meet our wider targets and ambitions.
 
We commit to taking a range of actions to achieve these objectives. These are detailed further in our Sustainable Action Plan, the delivery of which will require the support of all staff throughout the organisation.

Be Outstanding

• We will ensure CCC-Liverpool is run efficiently through a re-examination of the BMS.
• We will introduce a waste management, recycling, and compactor system across the Trust.
• We will set ambitious targets for sustainability and waste minimisation across different departments.

Be Collaborative

• We will collaborate with external partners and industry on the implementation of sustainable projects.
• We will reach out to external partners, social enterprises, and industry to realise mutual sustainability opportunities.
• We will pursue contracts with sustainable and ethical service and product suppliers.

Be a Great Place to Work

• We will launch a green travel plan, including making electric bicycles more affordable for our staff.
• We will develop and launch a sustainability champions initiative.
• We will raise awareness amongst staff of how they can address sustainability in their professional lives.

Be Digital

• We will continue to promote agile working arrangements and the use of teleconferencing where appropriate.
• We will go paperless through the digitisation of paper documents and shift to recyclable alternatives where necessary.
• We will engage with furniture re-use applications such as Warp-It.

Be Innovative

• We will find recyclable solutions for consumables, such as bottled cleaning products and chemotherapy pump batteries.
• We will make efficiency upgrades to our estate, including replacing old lighting and air conditioning units with sustainable alternatives.
• We will source staff uniforms made from more sustainable materials and set up a uniform re-use scheme.

Introducing our Sustainable Action Plan

We will deliver the sustainability objectives and meet the targets outlined in this Green Plan through the implementation, monitoring and ongoing refinement of a Sustainable Action Plan. 

The plan contains a total of 97 actions, divided across themes of work in accordance with the Greener NHS programme and the Sustainable Development Assessment Tool (SDAT).

The actions have been developed through staff engagement and a review of best practice amongst NHS Trusts. A summary of the actions and the short- term interventions to be achieved by 2025 follows in this document. The full action plan, comprising actions to be implemented beyond 2025, can be found separately, and will be used by the Trust to monitor progress.

The full Sustainable Action Plan also will be developed to contains detail regarding accountable staff, estimated timescales, and indications of monitoring frequency. Taken together, our actions will collectively support the delivery of our sustainability objectives and national carbon reduction targets.

Sustainable action plan themes

Corporate approach

The commitment and support of the Trust Board will be vital to achieve a reduction in carbon emissions. Our corporate approach to sustainability will involve the inclusion of environmental criteria within procurement processes, collaboration with external partners, and setting ambitious targets across our sites and departments.

Asset management and utilities

As a provider of cancer care services, energy consumption is responsible for most of our carbon footprint and in many cases remains unavoidable. To improve the energy efficiency of our activities, we will focus on pursuing contracts with sustainable suppliers.

Travel and logistics

The Covid-19 pandemic has cast light on the potential to reduce carbon emissions through agile working arrangements. We will continue to support teleconferencing where possible, and develop a green travel plan with an emphasis on new electric vehicle infrastructure and cycling facilities.

Adaptation

Climate change is the biggest environmental threat to health of the 21st century and some of its impacts are inevitable. In acknowledgment of this, we will create a contingency plan to ensure our services remain resilient to extreme climatic phenomena such as heatwaves and flooding.

Capital projects

A core action amongst our capital projects plan centres around the integration of sustainability within Wirral’s redevelopment, involving solar panelling and estate rationalisation measures.

Green space

Green space has positive impacts for both the environment and mental health, a particular area of importance for cancer patients.
 
We will work to incorporate additional biodiversity across our sites and in the redevelopment of CCC-Wirral.

Sustainable use of resources

As a provider of cancer care and chemotherapy, we use a significant number of resources and produce a lot of waste. We will tackle this by pursuing estate efficiency improvements, recycling and the application of circular economy principles, and sustainable solutions for consumable products.

Sustainable care models

We will optimise the delivery of sustainable care models through the use of an on-site chemotherapy product manufacturer, video consultations for outpatients patients where appropriate, and re- examined prescribing processes.

Our people

We will need the support and participation of our staff across all departments to achieve net zero carbon emissions. We will harness existing enthusiasm with the creation of sustainability champions, whilst raising awareness among other staff to gain support on a wider scale.

Carbon and greenhouse gases

Carbon emissions must be reduced from all areas of our organisation to meet net zero targets and ensure that progress is being made on wider environmental concerns like air pollution. We will optimise business travel by enhancing the connectivity of regional services, and run a joined-up procurement service through Health Procurement Liverpool which aims to reduce emissions and share best practice.

Our short term focus on driving incremental improvements

Throughout the years covered by this Green Plan we will pursue several short- term actions to address pressing concerns, and start to create a culture of sustainability amongst staff. Other actions included within our Sustainable Action Plan are long-term in nature and will be implemented from 2025 and beyond.

2022

• We will launch a Trust-wide engagement campaign and Green Travel Plan to encourage participation in sustainable practices and link this to the importance of tackling air pollution for the improvement of cancer care
• We will explore and pursue sustainable, recyclable, and reusable solutions for consumable items such as bottled cleaners, sharps, and chemotherapy pump batteries

2025

• Our Wirral estate will have been rationalised and redeveloped to incorporate net zero features such as rooftop solar panelling

Longer term

Interventions detailed in our sustainable action plan will be carried forward from 2025 and beyond

Implementing our Sustainable Action Plan

In order to ensure the actions within our sustainable action plan are successfully implemented, each intervention will be led by an accountable and dedicated individual.

The nominated leads will lead in the implementation of our Sustainable Action Plan and continue to review our Green Plan over next five years. This will include making regular progress reports to the Trust Board and updating colleagues across the Trust of the progress being made through the most appropriate communication channels.

Board approval and leadership

This Green Plan was formally approved and adopted as the Trust’s sustainability strategy by the Trust Board in January 2022 [tbc]. The delivery of this strategy will be led at Board level by the Director of Strategy who will oversee the implementation of the plan and advocate for sustainability at Board level. The Board lead will ensure that resources and leadership support are made available to aid our transition towards becoming a net zero organisation.

Monitoring, evaluation and continuous improvement

We recognise the urgent requirement for action on climate change and we will monitor our performance against the emissions trajectory that we have outlined in this Green Plan.

We will work to develop key sustainability metrics to ensure that we can continually monitor and report on our progress to our senior leaders and other stakeholders. 

These metrics will align to our organisational strategic ambitions and could include:

• The quantity of CO2 emitted per patient treated
• The absolute carbon emissions of the Trust
• The proportion of sustainable action plan items which have been completed, are in progress, or are outstanding

The information provided by these metrics will provide the basis for regular progress reviews to the Board and to the Greener NHS programme, as well as annual reporting in the progress against our strategic objectives and targets.

Glossary of terms

Air pollution – the presence and introduction into the air of a substance which is harmful to human health

Carbon Intensity – a means of calculating the amount of carbon generated for a specific energy source (e.g. electricity)

Carbon net zero – a state in which an organisation emits no carbon emissions from its activities. Or a state in which all carbon emissions are offset

CO2e (Carbon dioxide equivalent) – a unit used to express total greenhouse gas emissions. There are multiple GHGs, each with a different impact on climate change. CO2e equates all GHGs to the impact of carbon dioxide. CO2e is used to report all GHG emissions

Greenhouse gas (GHG) – a gas that contributes to the greenhouse effect, leading to climate change (for example, carbon dioxide)

kWh – Kilowatt-hour, a unit of measurement for energy usage

Direct emissions – CO2e emissions from sources which are owned or controlled by the Trust

Indirect emissions – CO2e emissions from sources which are not owned or controlled by the Trust, but are generated due to the Trust’s activities (e.g. purchase of electricity, procurement, waste disposal)

Scope 1 emissions – direct emissions from owned or controlled sources (e.g. on-site fuel combustion, company vehicles, anaesthetic gases)

Scope 2 emissions – indirect emissions from the generation of purchased electricity, steam, heating, and cooling

Scope 3 emissions – all other indirect emissions that occur in an organisation’s supply chain (e.g. purchased goods, employee commuting, waste disposal)