How to Prepare your Trust for New NHSE Green Plan Guidance

In October 2020, the Greener NHS unveiled its strategy titled ‘Delivering a Net Zero National Health Service.’ The report emphasized the dire consequences of unchecked climate change on healthcare, linking environmental degradation to an increase in major diseases such as heart conditions, asthma, and cancer. It outlined a roadmap for the NHS to achieve net zero carbon emissions by 2040 for the emissions within its direct control, and by 2045 for those emissions it can indirectly influence. NHS England has pledged to reach net-zero carbon emissions by 2040 for its Carbon Footprint and by 2045 for its Carbon Footprint Plus, aiming for an 80% reduction by 2032 and 2039 respectively, using 1990 as the baseline year.

The 2021/22 NHS Standard Contract mandated that trusts develop a Green Plan outlining their methods for emission reduction, aligning with national trajectories. These Green Plans are intended to articulate an NHS Trust’s commitment to sustainability, resilience, and carbon emission reduction, consistent with national objectives. Subsequently, the Greener NHS provided guidance for trusts on creating a Green Plan [1]. Updated in June 2021, this guidance is valid until the conclusion of the current financial year, which is January 2025 for trusts. All trusts had to publish a Green Plan by 14^th January 2022.

Current Green Plan Themes

• Workforce and system leadership.
• Sustainable models of care.
• Digital transformation.
• Travel and transport.
• Estates and facilities.
• Medicines.
• Supply chain and procurement.
• Food and nutrition.
• Adaptation.

The Green Plan strategies were proposed to be implemented over a three-year period. Consequently, Trusts that established a 3–4-year strategy will find that their Green Plans have either expired or are nearing the conclusion of their effective period, with the end of this financial year, 24/25, marking the official completion of the cycle.

NHS England are now asking Trusts to prepare to update and re-publish their Green Plans, as new guidance is expected in the autumn of 2024/25 to support NHS organisations.

Expected Strategic Requirements

• The NHS have released their net zero travel and transport strategy which sets a roadmap for decarbonising transport which needs to be linked in to the commitments and interventions included within a Trust’s Green Plan
• Estates net zero carbon delivery plan
• NHS net zero building standard, including heat decarbonisation.
• Net zero supplier roadmap
• Inclusion of workforce upskilling opportunities on Greener NHS training hub
• Desflurane decommissioning and clinical use
• Reducing emissions from piped nitrous
• High quality low carbon respiratory care
• National overprescribing review

Climate Change Adaptation

A key section of the guidance will be on the inclusion of climate change adaptation. Guidance will focus on what needs to be done, and what realistically can be done. All Trusts will need to expand this adaptation section in their Green Plans.

Reflecting on Net Zero Progress

Trusts will need to ensure they reflect on the progress they have made and ensure their targets are aligned to national NHS net zero ambitions. The guidance will also require organisations to consider how they are/can contribute to best practice.

TCFD Reporting

Trusts are now also expected to report on their alignment with TCFD recommendations, starting with phase 1 – the involvement of senior leadership and board in sustainability. These can be included in Green Plan updates.

Engaging Stakeholders

The Green Plan refresh will also provide an opportunity for organisations to engage stakeholders locally and increase buy-in to Green Plan strategies across the health system, for example Primary Care.

Fulfilling Legislative Duties

New Green Plans must demonstrate that the organisations are fulfilling their legislative duties towards and emissions and environmental targets. Plans will need to prioritise interventions that improve patient care and population health and support efficient use of NHS resources – aligning with system priorities in terms of saving money as well as the environment.

SMART Targets

Refreshed plans need to set out strategic objectives and a summary of SMART actions for each emission reduction area. These must be Board-approved and publicly available. The emphasis on the renewal of Green Plans is on a refresh, rather than a whole scale re-write. They should be set for a minimum of three years, and no more than 5. Annual reviews should be undertaken to monitor progress.

NHSE have also run engagement exercises with Trusts and ICB sustainability leads throughout the summer to prepare for the Green Plan refreshes and discuss plans – an interactive workshop and also an opportunity for written feedback.

The new guidance is expected in the autumn of 2024. However, this may extend beyond that time. There may, therefore, only be a few months available to complete the work, making it crucial for your organisation to begin preparations immediately.

Even those Trusts who have committed to a 5+ year strategy will need to make amends in line with new guidance and priorities. Timescale will need to be re-aligned to cover at least the duration of the updated guidance.

WRM have been developing a combination of Sustainable Development Management Plans (SDMPs) and Green Plans for numerous Trusts over the last decade. In the latest Green Plan for York and Scarborough Teaching Hospitals, we identified that the Trust’s old Green Plan followed the sustainability framework previously published by the NHS’s Sustainable Development Unit which is now defunct. We held interviews with catering and digital teams to ensure the decarbonisation of food and IT could be included in line with new NHSE requirements.

Get in touch with WRM today to find out how we can support your Trust with our sustainability strategy and Green Plan experts.