Keynote Session: Net Zero / Sustainability
- Ian Hinitt Past President - IHEEM
The role of Clinical Engineering in support of the NHS came into sharp focus during the COVID-19 Pandemic and has shone a light on this essential profession. There is a shortage of Clinical Engineers and an ageing workforce with fewer and fewer recruits. The industry is having to move quickly with an ever increasing portfolio of connected devices and interfaces to the Electronic Patient Record (EPR). These skills are moving Clinical Engineering into greater depth with Trust ICT departments and detailed knowledge of software. The MHRA requires all staff to be appropriately trained.
The investment from the NHS and private sector companies into Apprenticeships for Clinical Engineers is now paramount. The focus into ensuring succession planning; greater ICT skills; the implications to cyber security, knowledge of Net Zero Carbon and other sustainability related issues will mean a shift in the knowledge base of Clinical Engineering. Attracting more recruits and raising the status of the personnel working within it is an import shift post-pandemic. Putting the clinical back into Clinical Engineering; the training of clinical colleagues on key equipment e.g. ventilators; whilst recognising that there multiple levels of opportunity, including attracting young people who have practical skills and can see a route into the profession with support from structured courses.
Raising the profile; paying the appropriate levels for the skills and joint collaboration between the NHS and Private Sector companies that have access to the Apprenticeship Levy, give opportunities help plug the emerging gap in this profession, and provide a long-term career path.
There are a multitude of routes from entry level 2; through to degree level; all with established recognized providers. A number of organisations like RCT IHEEM and IPEM are investing in this approach. The Private Sector are also using Social Values funds to invest in these careers.
The HCPs approach to sustainability, is a collaborative approach to ensure the principles of sustainability and social value are embedded across the Partnership.
• As a social value accelerator site, C&M are keen to harness the positives that came as a result of COVID and build back better, reducing reliance on the healthcare, and wider public services, by putting sustainability principles at the heart of all decision-making processes.
• The aim is to deliver an ethical framework of behaviours, resulting in long term behavioural changes as to how people use and view the NHS, and wider public sector Through working with colleagues across the Partnership we are aiming to ensure behavioural change can occur and people can change the way they currently access NHS (and wider) services and see an increase in community resilience.
• Our Social Value Charter launched in 2019, since then 35 organisations across Cheshire and Merseyside have signed up to the Charter. The Charter describes our local vision and principles for maximising the potential of social value locally, our principles include building on the strengths of people and our communities, enabling people to live a 'valued and dignified life'.
• Working together across sectors to achieve social value outcomes, foster innovation and reduce avoidable inequalities linked to the Marmot Principles: Protecting health and social care services for future generations; Giving a voice to local communities; Social Value will be embedded as core practice, behaviours and the way that we operate.
• The ICS is working with partners and the public to establish an Anchor Institute Charter with an agreed set of principles, anchored in local communities, for organisations across the region to adopt. The charter will be reflective of local needs and determine the organisational behaviour required to deliver them.
The NHS Carbon Footprint (emissions under NHS direct control) needs to be net zero by 2040, with an ambition for an interim 80% reduction by 2028-2032.
Birmingham and Solihull integrated care system (ICS) serves a population of 1.3 million people in the West Midlands region. Within the area there are 5 NHS Trusts, 3 Councils and a multitude of GP Practices. We are committed to developing, understanding, and reducing our environmental impact and ensure we progress towards sustainable healthcare. In 2021 we commissioned AA Projects to produce an Annual Sustainability Report which was the starting point in terms of collating the data from across the organisations which sit within the ICS.
It is acknowledged that each of the 5 Trusts are at different stages of their progress towards Net Zero Carbon, the propose of the report was to set a framework for reporting on the sustainability measures which have been achieved annually. The report establishes a baseline for all organisations and maps the progress to date and highlights areas where information may be missing, or further action is required. There are 21 recommendations which cover the short, medium and long term.
The report will be updated annually updated to show the progress we are making at ICS level in terms of meeting the NHS overall target of Net Zero Carbon by 2040.
The ICS has formed a Green Board and has sustainability representatives from all stakeholder trusts and national property companies. Additionally we have local authority members and ICS programme leads for medicines management, primary care, procurement, people and digital. We have developed a communications strategy and trained exec leads on carbon literacy. We have appointed an Exec Lead to Chair the Board.
There are many reasons why prioritising diversity in NHS apprenticeship schemes can greatly benefit the organisation. The NHS people plan focuses on the importance of diversity and all will be familiar with the proposition that a trust should mirror the community it serves. The more a workforce mirrors the community it serves the better the patient experience of care. Where better to start with this diversity than your apprenticeship schemes.
However although the Equality Act 2010 allows employers to introduce positive action measures to increase representation for disadvantaged and protected groups a lack of understanding about what positive measures actually means in practice is often thwarts their best use.
In this presentation we will look at three forms of positive action with a specific focus on widening the diversity of NHS apprenticeship schemes and how they are actually applied in practice. Reserving places on relevant training courses to assist with applications, interviews or ability to do the job in question, providing mentoring schemes to increase representation of disadvantaged groups at a senior level in the organisation (and yes apprenticeships can apply to senior level posts as well as junior), and the "tie-break" provision as it applies in recruitment.
Feeling confident about what you can do is simply a case of knowing where the legal boundaries lie and how best to use positive action to benefit your apprentices, your organisation and subscribe to the ethos of the NHS people plan. Our presentation will provide the enhanced knowledge that you need in this area.
According to 2017 data, there were approximately 11.8 million people aged 65 and over in the UK, and by 2050 that number could reach 19 million. Hospital admissions are also steadily increasing year-on-year, a good proportion of these represented by elderly people who rely on continuing care.
In parallel to this trend, England's Chief Medical Officer has signalled that the country needs a national strategy to tackle health inequalities for seaside towns. Coastal towns often have older populations with more complex health needs, but historical planning has often underprovided for these areas.
This presentation will explore the changes that can be made to the way that health is managed and delivered to enable health and social care to operate together to support wellbeing, rather than responding to accident and illness. This integrated care model has a strong focus on patient wellness, with less-institutional community spaces and therapeutic environments that provide excellent daylighting, ventilation, views, comfortable acoustics, and access to outside space.
The presentations will explore forward-thinking projects where an integrated model of care has been used to address the complex health needs of coastal towns and discuss the design factors that are critical to their success.
One such project is the redevelopment of Whitby Hospital, which sees the adaptation of an outdated and under-utilised facility to create a health and social care hub, which supports the integrated delivery of primary care, secondary care, and community services.
Another is the pioneering Jean Bishop Integrated Care Centre in Hull, which is the first of a new class of NHS facilities to cater for the needs of an increasingly elderly population without the recourse to hospital admission.
The presentation concludes by looking at the lessons that can be learnt from these examples and how the fundamental principles can be applied across the country.
The objective of the presentation is to inform Healthcare providers of how they can create Sustainable Healthcare Accommodation through the design and build process, utilising modern methods of construction (MMC) for net-zero carbon (NZC) ready buildings.
The presentation details how new healthcare accommodation can achieve NZC, aligned to meet the 2028 NHS government target. In the long term, a broader approach for net-zero whole life carbon will cover all of the emissions associated with the construction, operation, maintenance, and demolition of a building. The methodology provided ensures the embodied emissions associated with products and construction will be measured, reduced, and offset to achieve NZC.
Regarding operational energy, the energy used by the building in operation should be reduced and where possible, any demand is met through renewable energy. Any remaining emissions from operational energy use should be offset to achieve NZC.
A principal step to achieving NZC is Passivhaus - the principles relate well back to MMC due to the ease of incorporating the additional insulation and the naturally higher airtightness of an MMC construction.
Passivhaus buildings achieve a 75% reduction in space heating requirements, compared to standard practice for UK new build (traditional builds). The Passivhaus standard, therefore, gives a robust method to help the industry achieve the 80% carbon reductions that are set as a legislative target for the UK Government.
The overall construction process using MMC provides greater energy efficiency and a reduced carbon footprint when compared to traditional construction, for example, Low U values and exceptional airtightness lead to minimising heat loss.
Currently, operating carbon energy isn't clean which powers the building, so it is imperative to provide the right materials maximising the embodied carbon. As the government targets come into play, it will be more cost-effective to act now rather than retrospectively.
Curtins are proud to have over 30 years' experience in the successful delivery of projects with innovative offsite manufactured structural solutions which are now often referred to as Modern Methods of Construction (MMC) for both Public and Private Sector clients and Manufacturers from early feasibility appraisals through to construction detailing in accordance with Design for Manufacture and Assembly (DfMA) workflows.
We have experience of working on major government pathfinder projects and programmes within healthcare (including New Hospitals Programme and other funding streams), Schools (including the Department for Education Schools MMC Framework), and MOJ (including the current Alliance for Prisons Programme.)
We have worked on numerous award winning MMC projects, including Offsite Awards Project of the Year and Winner of Winners over the past decade.
Our presentation would outline the industry and government drivers behind the requirement for MMC in healthcare and other sectors, how we have integrated MMC delivery with our BSI BIM Level 2 Kitemark accredited Digital Delivery processes, and how this links with other requirements such as reducing embodied carbon. We would provide real life examples from the healthcare sector, and learning from these for discussion with our peers in the audience and to stimulate a debate within the conference.
We have presented over recent years at Education Estates, AUDE, and other significant conferences, and would be delighted to bring this learning to IHEEM 2022.
Recognised by the Top Employers Institute as a Top Employer since 2019 for excellence in employee conditions, we are confident in our dedication to providing the very best working environment for our employees through our progressive 'people-first' HR practices.
In addition, we are gold accredited Investors in People, driving positive outcomes in the workplace. We are engaged and motivated to retain, train, and develop all our staff, from Apprentices to Senior Managers.
To ensure the personal and professional growth of our staff, we launched the TEAM scheme on our Healthcare sites; Training Employees as Managers. The scheme supports employees, to not only access quality training opportunities but also provides that their learning and development within their role is set out in a well-structured format. The scheme can be adapted to any trade, profession or discipline, with topics relevant to each - e.g for site engineers, it is split across six themes; Health & Safety, Meetings, Compliance, Operations & Management, Project Management and Email Etiquette.
Engineers are given the chance to take on more responsibility, gain an understanding of the wider contract and management experience, supported by, and working closely with the management team in real time. This would typically include auditing jobs, conducting site safety tours, compliance tracking, managing minor works and being coached on how to answer difficult emails from the client.
The aim is to give valuable real-life experience to employees, but also to encourage a collaborative team spirit between management and the workforce. The experience and understanding of the wider contract gained, is then discussed and digested within the wider team, creating a clearer understanding of the operation and the requirement of the workforce.
We must give our employees the space and opportunity to reach their full potential and are thrilled to see so many of them flourishing.
This presentation will focus on how 3D volumetric systems help NHS trusts achieve their Net Zero Carbon goals, by utilising quality controlled offsite manufacturing techniques leading to reductions in energy during manufacture, delivery, site installation and beyond.
Premier will show that by focussing on a fabric first approach utilising lean, clean and green technologies, coupled with end-of-life recycling of modules closing the circularity loop, leads to both operational and embodied Net Zero Carbon energy.
By early client engagement at the pre-design stages and by using energy modelling evaluation, we can ensure buildings achieve the energy performance requirements and assist clients during their decision-making processes at every stage of the project to deliver a more comfortable building with Net Zero operational and embodied energy.
We will discuss our key learning points:
Fabric First design principles, how improved thermal insulation properties, enhanced thermal bridging detailing and lower air permeability rates require less heating and cooling, saving energy and carbon.
Lean, Clean and Green principles, how we design and build structures that consume as little energy as possible whilst generating as much as possible from clean, renewable sources
Whole Life Cycle and Circularity principles adopting a cradle to grave and beyond design methodology.
Our robust ISO 14001 certified environmental management system and constantly improving environmental performance through more efficient use of resources and reduction of waste.
Deliveries minimised because products arrive in bulk, rather than individually to disparate sites - up to 83% fewer vehicle movements disruption, congestion and carbon emissions
Materials are received with minimal packaging to save time and waste on site.
Recyclable modules and components and our Zero Waste to landfill policy
Premier's Carbon Reduction Plans helping to reduce the embodied carbon of our products at the manufacturing stage.