All NHS ICS Green Plans are required to be published in early 2022 upon the finalised transition of Clinical Commissioning Groups to Integrated Care Systems. An ICS Green Plan is different to an organisation-level Green Plan in that it brings together a series of Trust-specific Green Plans. This resulting ‘umbrella’ document should not merely be a summary of the sustainability strategies of the trusts involved. Instead, ICS Green Plans should focus on areas where the partners involved can, under the direction of an ICS Board, collaborate on and find mutual opportunities between their respective sustainability priorities and interventions. These shared interests may lie in the likes of procurement, training, or the evaluation of clinical pathways, but should also focus on benefits that aren’t necessarily related to carbon reduction, for example joint cost-saving or the inclusion of social value aspects.
Joined Up Care Derbyshire (JUCD), Derby and Derbyshire’s ICS, approached WRM to develop their ICS Green Plan. JUCD were clear that their Green Plan should provide the Derbyshire system with oversight and accountability for the achievement of carbon reduction targets against both the NHS Carbon Footprint and the NHS Carbon Footprint Plus, as well as monitoring progress against expected trajectories. The Green Plan should also support the delivery of JUCD’s objectives on health improvements, patient care, addressing health inequality, and building a resilient healthcare system.
WRM began the project by undertaking a review of existing sustainability across the ICS. This involved the collation of and investigation into the ICS’s Trust-level Green Plans to understand the environmental impacts of and actions which were formed by each Trust to address carbon reduction. Over 200 individual actions were identified and analysed using a matrix tool to uncover common themes and opportunities between Trusts which demonstrated potential for collective implementation. The resulting interventions were not exhaustive in agglomerating the actions committed to at an individual level – rather, where Trusts committed to actions which diverged from the interests of others, WRM excluded the actions unless they reasonably contributed towards system-level priorities. Conversely, WRM ensured that where system level priorities were address by most of the Trusts, the associated interventions were still included despite being new for some JUCD’s organisations. In this way, WRM adopted a comprehensive approach in the development of the ICS Green Plan.
WRM then developed a series of strategic sustainability objectives, with a number of resulting interventions developed through an assessment of their deliverability. This included a consideration of the roles required to coordinate the interventions at a system-wide level and the organisations best placed to adopt these roles, and the benefits that each intervention may present. A risk assessment of each intervention and the generation of associated mitigation measures was also undertaken.
A key part of the Green Plan’s development involved working collaboratively with JUCD stakeholders to understand the system’s sustainability progress and priorities. WRM facilitated a workshop with senior leaders and colleagues from across JUCD, in which discussions were held over the merits of the interventions being jointly delivered. The workshop concluded with the establishment of consensus amongst partners on the interventions to be pursued and the ICS-wide strategic objectives to be expressed. To ensure the strategy reflects the priorities of wider regional actors, WRM also held discussions with key partners such as Derbyshire County Council and Derby City Council.
WRM’s development of JUCD’s ICS Green Plan has produced a nuanced sustainability strategy which reflects the ICS’s plans, policies, and priorities including but not limited to health inequalities. Through a separate Sustainable Action Plan of relevant interventions, the document also provides JUCD with a series of timescales and associated Leads by which their progress on sustainability can be monitored and tracked.
JUCD have received an ICS Green Plan which delivered on all their requirements. The Green Plan will be submitted to Derbyshire’s Integrated Care Board for approval, after which the actions established in the document will be implemented. The implementation of this Green Plan will allow the ICS to make cost savings and increase efficiency across the Trusts’ action areas whilst streamlining their progress on achieving the NHS’s net-zero targets.