Green Plan - summary

The UN’s Intergovernmental Panel on Climate Change (IPCC) has warned that global warming and its environmental impact are widespread, rapid and intensifying. This has huge implications for the environment and human health. 

Organisations including the World Health Organisation, British Medical Association, Royal College of Nursing and Royal College of Physicians view climate change as the greatest threat of the 21st century to global health. The impacts range from food production to water availability, extreme weather events (e.g. flooding and droughts) and disease prevalence.  

The UK Government set a mandatory target to achieve net zero carbon by 2050 (Climate Change Act 2008). Local bodies including Liverpool City Region Combined Authority, Liverpool City Council, Sefton Council and Wirral Council have declared climate emergencies.  

As an anchor institution in our local communities and a leading specialist healthcare provider, we have a responsibility to do all we can to minimise climate change by reducing our carbon emissions. 

The NHS nationally also expects this of us and has set ambitious targets that all NHS organisations need to achieve.

Climate change and the need for greener ways of working has climbed higher and higher on the policy agenda in recent years, including within the NHS. Nationally, the NHS aims to achieve net zero carbon several years earlier than the target set by the UK Government. 

There is now a wealth of guidance and policies that set clear expectations for every NHS organisation as well as for the NHS as a whole, highlighting the importance of us addressing our impact on the environment. 

Read more about this on the Greener NHS website (NHS England) 

We deliver cancer care at sites across Cheshire and Merseyside including in other hospitals and patients’ homes/workplaces and we are part of the wider health and care system. Working together with our partner organisations will be key to delivering net zero health services. 

The Clatterbridge Cancer Centre

• Clatterbridge Cancer Centre – Aintree
• Clatterbridge Cancer Centre – Liverpool
• Clatterbridge Cancer Centre – Wirral
• Clatterbridge clinics in other hospitals
• Clatterbridge in the Community (treatment at home or at work)

Site partners

• Blackburne House café
• Clatterbridge Diagnostics 
• Clatterbridge Private Clinic 
• ISS
• Maggie’s Wirral
• PharmaC
• PropCare            
• RVS
• Suppliers
• VINCI            
• Volunteers
• Wirral University Teaching Hospital

NHS partners

• NHS England / Improvement
• Cheshire and Merseyside Health and Care Partnership
• Other NHS trusts 
• Ambulance trusts 
• NHS Blood and Transplant
• Primary care 

Other partners

• Local authorities (incl Liverpool and Wirral)
• Liverpool City Region Combined Authority
• Liverpool Health Partners
• Merseytravel
• Voluntary and community sector
• Universities and other academic partners
• Research partners 
• Deanery and other education / training providers

We have set ourselves the following targets.

Carbon reduction

Directly controlled

• 80% reduction in direct carbon dioxide equivalent (CO2e) emissions by 2032
• 100% reduction by 2040

Indirectly controlled 

• 80% reduction in direct carbon dioxide equivalent (CO2e) emissions by 2039
• 100% reduction by 2045

Air pollution

• 20% reduction in air pollution emissions from business mileage and fleet by March 2024
• 90% of our fleet will be low, ultra-low and zero emission vehicles by 2028

Waste

• Zero waste to landfill policy

We have already taken a number of steps to reduce carbon emissions, adopt sustainable working practices and deliver social value.

Saving energy

• LED lighting on all 3 sites (CCC-Aintree, CCC-Liverpool, CCC-Wirral)    
• Motion-controlled lighting on all 3 sites
• Additional pipe and hot water insulation at CCC-Wirral
• 100% renewable electricity at CCC-Liverpool
• Photovoltaic arrays at CCC-Liverpool
• 50% CHP-powered hot water at CCC-Wirral
• Natural ventilation at CCC-Aintree, reducing need for mechanical cooling
• Heat recovery on ventilation systems at CCC-Liverpool and CCC-Aintree

Sustainable care

Reducing patient journeys through:

• Clatterbridge in the Community – treatment at home or work
• Networked model with care provided close to home 

Water

• 75% automatic taps across all 3 sites 
• Leak detection on CCC-Liverpool and CCC-Aintree water systems

Waste

• Paperlite working / electronic patient record (EPR)
• Recyclable packaging and cutlery in Blackburne House café  

Travel

• Hybrid working
• Virtual clinics (phone and video consultations)
• ‘Cycle to work’ scheme
• Active travel initiatives including bike lockers and showers
• Public transport incentives for CCC-Liverpool
• Electric vehicle (EV) charging points on some sites 

Environment

• Air filtration providing excellent indoor air quality at CCC-Liverpool
• Temperature control at CCC-Liverpool
• Replanting and landscaping of spaces at CCC-Wirral
• Plants on terraces and in offices at CCC-Liverpool and The Spine
• Winter Garden at CCC-Liverpool
• Working with NHS Forest
   

Our flagship new Clatterbridge Cancer Centre – Liverpool was designed with sustainability at its core:

• BREEAM Excellent
• Modern methods of construction
• High-performance façade minimising heat loss 
• Dynamic control systems for energy efficiency (50% above Department of Health and Social Care guideline targets)
• Photovoltaic (PV) panels 
• 30% electricity generated on site by low and zero carbon systems
•  Combined Heat and Power (CHP) unit and PV panels
• Connected to site-wide district heating network
• 23.6% reduction in regulated CO2 emissions

Social value has also been fundamental:

• Use of local workforce and supply chain reduced the travel impact of construction
• Social enterprise Blackburne House runs our hospital café, using local suppliers and reinvesting profits into training & employment for local women
• Ongoing training, education and employment opportunities for local people

Energy efficiency and sustainability will continue to improve as we optimise the building management system. Data from independent sensors throughout the hospital monitor how the system is performing throughout the year (e.g. measuring any heat loss). We can then adjust the building management system to make it even more efficient. 

We plan to follow the same approach as we upgrade and refurbish CCC-Wirral:

• Design and build an efficient building
• Use performance data to make it even more efficient after it opens

We have calculated our baseline carbon footprint from the emissions we can directly control (NHS Carbon Footprint). This includes:

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

We will seek to quantify indirectly controlled emissions (e.g. those relating to our supply chain, staff commuting and patient/carer journeys) over the next few years so we can achieve the NHS Carbon Footprint Plus target by 2045.     

Our baseline carbon footprint

We are using 2020/21 as our baseline year as this was when Clatterbridge Cancer Centre – Liverpool opened. Using 2020/21 means the baseline accurately reflects our current estate and the locations where we operate.  

We have calculated our emissions using the Government’s national carbon conversion factors. 

Our baseline carbon footprint (2020/21)

(Tonnes per year)

• Fossil fuels – 1,046
• Anaesthetic gases – 4
• Electricity – 2,257
• Business travel – 40*
• Fleet – 133
• Waste – 29
• Water – 49
• Total – 3,558

*Business travel was unusually low in 2020/21 due to the COVID-19 pandemic

We have 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

Our commitment to sustainability is reflected in our strategic priorities. Creating a Greener CCC aligns closely to all six of our strategic priorities: 

• Be Outstanding
• Be Collaborative
• Be a Great Place to Work
• Be Research Leaders
• Be Digital
• Be Innovative

Be Outstanding

Relationship with a Greener CCC:

Adopting a patient-focused approach to sustainability means we can deliver high-quality care and strong operational and financial performance (e.g. energy efficiency and less waste)

We will:

• Use performance data to optimise CCC-Liverpool’s building management system for efficiency, then use similar data available for other sites
• Introduce a waste management, recycling and compactor system across the Trust
• Set ambitious departmental targets for sustainability and minimising waste

Be Collaborative

Relationship with a Greener CCC:

By working with partners we can gain support for a Greener CCC and encourage good practice in our supply chain

We will:

• Work with partners and industry to implement sustainable projects
• Reach out to partners, social enterprises and industry on mutually beneficial green opportunities
• Do business with sustainable and ethical suppliers of goods and services

Be a Great Place to Work

Relationship with a Greener CCC:

Engaging staff in sustainability – something we know many of them care about – will help us attract and retain highly-skilled and motivated people

We will:

• Launch a green travel plan, including incentives to encourage people to choose public transport, active travel and car sharing 
• Develop a network of sustainability advocates
• Raise awareness and support staff in adopting greener working practices

Be Research Leaders

Relationship with a Greener CCC:

Better understanding of environmental impacts on health is key to our role as research leaders at the forefront of cancer care

We will:

• Work with partners to look for more sustainable ways of delivering cancer care
• Look at ways of carrying out research in a more sustainable way
• Adopt emerging technology (e.g. potential use of AI to improve building management systems) 

Be Digital

Relationship with a Greener CCC:

Delivering digitally-transformed services will empower patients and staff and help achieve a Greener CCC

We will:

• Continue to promote agile and hybrid working (incl MS Teams) and appropriate use of virtual clinics (e.g. phone and video consultations)
• Go paperless by digitising documents wherever possible and using recyclable alternatives where needed
• Engage with digital services and apps that help people to be green (including reduce, re-use, recycle), cycle and walking routes, public transport, car sharing and so on

Be Innovative

Relationship with a Greener CCC:

We can explore new and more sustainable working practices and equipment, improving patient care

We will:

• Upgrade our estate for energy-efficiency (e.g. installing greener lighting and air conditioning units)
• Find recyclable solutions for consumables (e.g. chemotherapy pump batteries, sharps and cleaning products)
• Source staff uniforms made from sustainable materials and create a ‘swap shop’ for re-using uniforms when staff change roles

The next phase of our estates strategy will be investment in CCC-Wirral to significantly enhance facilities for patients and staff. Sustainability and energy-efficiency will be key elements as we develop the site over the coming years. 

Green space will also be core with many benefits for mental health and wellbeing, which is particularly important in cancer care. 

As we develop CCC-Wirral over coming years…

By:

• Making the most of the beautiful rural setting
• Improving biodiversity and green spaces
• Creating sustainable / active travel options
• Using space more efficiently 
• Harnessing low and zero carbon technologies

We will:

• Improve patient and staff experience
• Promote healthier alternatives
• Create a greater sense of wellbeing for patients and staff
• Reduce carbon emissions
• Make better use of resources and reduce waste

We already know lots of ways we can reduce our emissions based on current systems and technology. This could reduce our emissions by an estimated 69%. Achieving net zero, however, will also depend on the development of market innovations and national changes to new systems and technologies. For example, decarbonising the National Grid and converting the natural gas grid to hydrogen.

Our Green Plan 2022-2027 sets out the actions we can deliver, based on current technologies. As new innovations emerge, we will update this plan with actions to eliminate the remaining emissions.

We estimate that we can reduce directly controlled emissions by up to 69% (2,455 tonnes a year) in the following ways.

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 

Market innovations and national / regional developments between now and 2040 will help us reduce the remaining 31% (1,103 tonnes a year) to achieve net zero.

For the first few years (2022-2025), our Green Plan focuses on some rapid changes and creating a culture of sustainability. From 2025, it focuses on longer-term interventions. 

Completed

2020 

We began our journey towards purchasing 100% of our electricity from renewable sources.

Near future

2022 

We will launch an engagement campaign and Green Travel Plan to encourage staff and volunteers to get involved in sustainable practices. We will highlight how tackling air pollution could lead to better cancer outcomes.

We will explore sustainable, recyclable and reusable solutions for consumable items such as chemotherapy pump batteries, sharps and cleaning products.

By 2025

We will have invested in redeveloping CCC-Wirral to include net zero features such as solar panelling.

Long term

By 2032

We will transition to zero emission vehicles. 

We will achieve an 80% reduction in directly controlled emissions.

By 2039

We will achieve an 80% reduction in indirectly controlled emissions.

By 2040

We will achieve net zero for directly controlled emissions.

By 2045    

We will achieve net zero for indirectly controlled emissions.

We have a detailed action plan for the next five years. The actions are grouped into 10 themes. 

Adaptation

• Contingency plans for resilience to extreme weather events

Asset management and utilities

• Green / renewable energy 
• Energy efficiency

Capital projects

• Redeveloping CCC-Wirral in a net zero way (e.g. solar panels and more efficient use of space)

Carbon and greenhouse gases

• Greener business travel
• Reducing travel (e.g. hybrid / digital working)
• Joined-up procurement and sharing best practice via Health Procurement Liverpool 

Corporate approach

• Commitment from Board
• Green criteria in procurement
• Partnership working
• Setting ambitious targets for sites / departments

Green space and biodiversity

• Enhanced green space and biodiversity on all sites, especially CCC-Wirral
• This will improve patient and staff wellbeing

Our people

• Harnessing existing staff enthusiasm 
• New network of green advocates
• Raising awareness across the Trust

Sustainable care models

• Optimising sustainability wherever possible
• On-site manufacture of cancer treatments (e.g. chemotherapy)
• Virtual clinics where appropriate
• Reviewing prescribing processes

Sustainable use of resources

• Enhanced estates efficiency
• Recycle, re-use and circular economy
• Sustainable solutions for consumables

Travel and logistics

• Agile and hybrid working
• MS Teams / videoconferencing
• Green travel plan including electric vehicle infrastructure and cycling

Delivering

The commitments in this plan will be delivered by a Sustainability Action Group. This multi-disciplinary group will contain the nominated leads for each theme outlined in the plan. The group will be chaired by the Director of Strategy, who is the Trust’s Board-level lead for net zero carbon. 

The Sustainability Action Group will report to the Trust’s senior leadership team through the Trust Executive Group. The group will also provide assurance to the Trust Board on progress against delivery of the Green Plan through the Performance Committee, which is chaired by a Non-Executive Director.  

Monitoring

We will develop metrics to ensure we can regularly monitor and report on our progress. These metrics could include:

• Quantity of CO2 emitted per patient treated
• Total carbon emissions
• Proportion of actions which are on track, completed or outstanding

We will also continue to report our progress nationally as required by the Greener NHS programme. 

Reporting

We will report progress through:

• Regular communications for staff and stakeholders
• Board reports
• Annual Report

Climate change is a real and growing health threat. Its consequences include increased risk of cancer. As a leading provider of cancer care, we are duty-bound to do all we can to reduce this threat by adopting greener, more sustainable ways of working.

The scale and pace of change required is challenging and success partly depends on innovations in other sectors (e.g. energy and transport) but we are absolutely committed to making real and sustainable changes. 

Our Green Plan explains how we intend to do this. Achieving it will need everyone’s engagement but together we can make a real difference, benefiting the environment and the communities we serve. 

Air pollution – Contamination by any chemical, physical or biological agent that modifies air’s natural characteristics 

Agile and hybrid working – Working in a way that reduces the need to travel into a main site as much e.g. IT access off-site, virtual meetings, working from home some days

Building management system (BMS) – Computer-based system that manages functions like a building’s temperature, lighting, fire alarms and lifts. It can help the building run more efficiently

Carbon dioxide equivalent emissions (CO2e) – A measure used to compare emissions from various greenhouse gases based on their global warming potential 

Combined heat and power (CHP) – A highly-efficient process that captures and uses heat produced as a by-product of electricity generation. Producing heat and power together in this way can reduce carbon emissions by up to 30%

Directly controlled emissions – Emissions produced by sources that an organisation directly owns or controls itself. Also known as Scope 1 emissions

Fleet – Vehicles that an organisation owns or leases 

Heat recovery – A process in which any warmth in stale air that is being mechanically removed (usually via a ventilation system) is extracted & recycled by feeding it back into the fresh air coming in 

Indirectly controlled emissions – Emissions produced by sources that an organisation does not directly own or control itself 

LED – Light-emitting diode, a more energy-efficient type of light bulb or tube

MS Teams – Microsoft Teams is technology that allows virtual meetings 

Net zero – When the amount of greenhouse gases produced is the same as the amount of greenhouse gases absorbed is zero (i.e. no net increase in carbon emissions) 

Photovoltaic (PV) – Directly converting light into electricity via semi-conducting materials like silicon

Scope 1 emissions – Emissions produced by sources that an organisation directly owns or controls itself

Scope 2 emissions – Indirect emissions from the generation of purchased energy e.g. electricity, steam, heating and cooling

Scope 3 emissions – All other indirect emissions from producing and transporting goods and services, including the organisation’s full supply chain