There is a lot of talk about government policy on sustainability. But how it applies to GP commissioning consortia in this era of change is less clear.
The NHS is committed to reducing carbon emissions by 80 per cent by 2050, in line with targets imposed in the Climate Change Act 2008. To achieve this, the NHS Sustainable Development Unit (NHSSDU), devised a carbon reduction strategy for England in 2009.
Then along came a change of government and a new vision for the structure of the NHS.
Abolishing SHAs and PCTs makes a highly strategic agenda, such as sustainability, harder to administer and enforce.
Because of this, the NHSSDU recently launched a Route Map for Sustainable Health. This looks forward to 2050, and provides a common framework for action to bring together a mass of differing organisations and professionals.
At the conference in February 2011 accompanying its launch, it was clear that the aim is to ensure that GPs and consortia look at sustainability as a means of achieving other ends.
The idea is that sustainability needs to become embedded in every decision GPs make, both clinical and when commissioning services. Sustainability is not just about switching to energy efficient light bulbs, for example, it is about achieving financial targets.
NHS deputy chief executive for England David Flory set out an example at the conference: he linked the policy to care for more patients suffering from long-term conditions (LTCs) closer to home in community environments with reduced carbon emissions and potential financial savings.
'Developing services for patients with LTCs is a fantastic example of a sustainable investment in how the NHS develops its services,' he said.
Moving information instead of people around is a key goal of sustainability, for example, using video-conferencing and telemedicine to replace face-to-face consultations. Through the new BT N3 connection (www.n3.nhs.uk) consultants can also study complex data, such as angiograms, without leaving their offices.
So far, with BT N3 an estimated 5,500 hours of consultant time and 10,000 hours of general NHS time, along with untold carbon emissions from less cars on the road, have been saved.
Sourcing services and products locally is another key goal. In Nottingham, hospitals have ensured all their food is sourced locally. This has stimulated the local economy, improved food quality and brought about associated health benefits.
The hope is that examples like this show that sustainability is compatible with commissioning by consortia as well as with day-to-day clinical decision-making in surgeries. NHSSDU says it does not want to dictate to GPs but sees its role as one of leadership to ensure the 2050 targets are met.
At present however, what will happen if consortia fail to take sustainability into account in their commissioning decisions is unclear.
- Andrew Cooper is a Surrey-based commercial property and energy consultant
- Route Map for Sustainable Health www.sdu.nhs.uk