Sustainability Enabling Strategy

East of England Ambulance Service

NHS Trust

#WeAreEEAST *

Sustainability Enabling Strategy

April 2020 - 2025

Author: Sam Wood

Head of Sustainability

www.eastamb.nhs.uk

www.eastamb.nhs.uk

Version control

Version Commentary Date of version change

#WeAreEEAST

Author

3 Sept 1 First draft created RG

20

9 Oct 2 Revisions to first Draft RG/SW

20

3

4

5

6

Sustainability Strategy v2

#WeAreEEAST

Purpose The purpose of this Sustainability Strategy is to set out how the Trust will govern, manage and implement its sustainability plans for the 5-year period commencing 2020, and aligns with and supports the Corporate Strategy approved by the Trust’s Board of Directors.

These will complement its commitment towards Sustainable Development and the Trust’s responsibility to engage all our key stakeholders and external partners to realise our vision, goals, and objectives within this Strategy.

This Strategy has been developed in order to identify and plan to reduce the environmental impact of the Trust’s activities and to set clear and unambiguous targets for reductions.

The starting point for developing the Sustainability strategy is identifying the current and future healthcare service needs of the local population, The Trust’s approach to Governance, staff wellbeing, the environmental impact of it’s estate and fleet operations, and the impact and interaction the Trust has with the communities it serves.

A Sustainability strategy cannot, therefore, be developed in isolation. Rather, it is an integral part of the Trust’s service planning.

The updated Sustainability Strategy is designed to ensure that the Trust’s overall vision for Sustainable operations can be delivered:

To set clear and unambiguous targets for reductions in the environmental impact of the Trust’s activities; to support the sustainable delivery of

clinical care within the community served by the Trust, and maintain the social and economic wellbeing its staff, stakeholder and communities

As part of this strategy, a Sustainability Green Plan is identified to implement and achieve the proposed transformations across the sustainable agenda.

This strategy focusses on ensuring the Trust:

• is complaint with sustainability legislation, guidelines, and best practice

• harnesses sustainable approach to enable of improved service delivery.


#WeAreEEAST

• Embraces sustainable technology to enhance its operation, reduce running costs and carbon footprint

• Underpins high performance principles to meet sustainability targets maximise economic efficiencies and wellbeing

• Fosters joint working with other healthcare, emergency and public sector organisations

This strategy aligns with the Trust vision of ‘Outstanding care, exceptional people, every hour of every day’ #WeAreEEAST.

The vision is underpinned by four goals:

• Be an exceptional place to work, volunteer and learn

• Provide outstanding quality of care and performance

• Be excellent collaborators and innovators as system partners

• Be an environmentally and financially sustainable organisation

This strategy aligns with the Corporate Strategy and aims in the following ways:

• Goal 1 – the Trust is investing to create an environment that attracts, retains and nurtures its staff

• Goal 4 – ensuring the estate is sustainable, delivering economic efficiency and environmental Sustainability.

• Goal 4 – the estate delivers value for money and reduced running costs

The Carter Report (Operational productivity and performance in English NHS acute hospitals: unwarranted variations) identified the need to create a set of metrics that could serve as a barometer for hospitals to compare themselves with their peers and provide a baseline for improvement.

The key recommendations in the report which are salient to Sustainability include:

• Operate an efficient service whilst minimising our impact on the environment.

• Manage energy usage and obtain best cost per unit of energy


#WeAreEEAST

• Provide an environment that supports staff and patient’s health & well-being

The launch of the Model Ambulance Service Portal has provided a clear set of consistent metrics against which we are able to benchmark our sustainability with other Ambulance Trusts.

This Strategy is developed in line with the principles of the Carter Report and the recommendations contained within it, and the Model Ambulance Service metrics and operation in respect to Estates services.

The Sustainability strategy is aligned with the NHS Long term Plan 2018, in the follow areas:

• Reduction in waste generated

• Increase in waste being recycled

• Carbon footprint reductions


#WeAreEEAST

Aim (s) There is growing awareness of the world-wide effects of day to day human activities on the environment. The Government expects public authorities to respond positively to environmental issues to improve quality of life.

East of England Ambulance Service NHS Trust (EEAST) is committed to providing quality healthcare. In providing this service, EEAST consumes resources and produces waste material which will in turn have in effect on the environment and ultimately may impact on the health of the people for whom EEAST provides a service.

The Trust Board and Executive Leadership Board therefore acknowledge that they have a Corporate and Social Responsibility to consider the environmental implications of its corporate business strategy and to promote policies and practices that will provide a responsible approach to environmental management within EEAST. For this purpose EEAST has adopted this policy.

Drivers for Change As part of EEAST’s commitment to the environment, this strategy will enable EEAST to set targets by which continuous environmental improvement can be measured.

To fulfil this commitment, this strategy will promote EEAST’s Environmental and Sustainability Policy and encourage joint working with other Trust groups as appropriate to co-ordinate and reinforce EEAST’s strategic objectives.

The strategic direction for sustainability in EEAST is to act as change agent for the Trust’s operations, ensuring key elements such as the estate and fleet will be high performing, contributing to the overall reduction in the carbon footprint of the Trust.

The objectives of this Sustainability strategy are to:

• Maximise the opportunities for sustainable practices - To provide short, medium- and long-term plans to produce a sustainable estate, fleet and operations. Recognising that properties, vehicles and procurement of goods and services are a significant factor in environmental damage and waste, the strategy will systematically seek to optimise estate footprint and fleet size is used to deliver


#WeAreEEAST

the Trust’s services and is transformed through environmentally friendly products.

• Support strategic sustainable initiatives - the Trust will ensure that it provides sustainability through leadership in its operations, to support and encourage cooperation and joined up working with other healthcare system providers, emergency services, public sector organisations, private providers, the military and further education establishments.

• Embed the Trust in the community – as a key employer over six counties in the East of England, the Trust plays a major role in communities - geographical communities, healthcare communities and emergency services communities. The Trust will work with each community stakeholders to ensure a positive contribution to its ongoing sustainability across the three key elements.

• Staff wellbeing and welfare – the Trust will encourage and promote remote and flexible working to increase productivity and effective time management of staff, building on Covid enforced protocols and initiatives such as flexible working, communications, and access to welfare facilities, in line with the IT strategy and the Workforce Strategy.

The Sustainability Strategy aims to use five key components to improve the standard of the estate and its operation:

• People – ensuring we have the best available staff employed in the right roles to deliver the strategy

• Technology – deploying emerging and established technology wherever appropriate to deliver a considered and enduring approach and manage sustainable initiatives.

• Standards –complying with all legislation, NHS standards and guidance, and environmental standards applicable to the Trust’s estate, fleet and operations.

• Data –providing Governance and value though the collection and analysis of data across all aspects of the estate, fleet and Trust services.

• Process – using safe systems and processes to deliver sustainability in a responsive and responsible manner to support Trust objectives.


~ >E o 0 ~ C ·-81E w (I)

Patient Outcomes

(I)

E :.-::I .t!' (I) := (I) ·-

c i 0·-0.Q) (I) ... (I)

0:::

II) (I)

rj ~ · - Q) C -~ =o u Q)

~

Operational efficiency

II:: ~ II) ~

"'O C C Cl> CV ·c - (I) C Q. Q) ~ ~ Q_

#WeAreEEAST

This strategy’s overarching objective is to improve the Trust’s sustainability and contribute to patient safety and deliver the best patient outcomes possible, as well as drive resilience and reliability against regulatory compliance (CQC), through striving to achieve the four pillars of a high-performance ambulance service as defined by the industry:

1. Economic efficiency – to deliver our service at minimal cost to the patient (i.e. the taxpayer)

2. Response time reliability – to reliably attend to our patient within the clinically appropriate time

3. Clinical effectiveness – to provide a service which is reliably equipped to tend to the clinical needs of its patients

4. Patient and staff experience – to provide a high level of satisfaction with our service across patients and staff

Four pillars of a high-performance ambulance service


G #'''t. ALS DEVELOPMENT \ ,1,cil-\

SUSTAINABLE DEVELOPMENT Gl}'"tALS

#WeAreEEAST

Principles underpinning the structure (use if applicable) This Strategy has been aligned to that of the Sustainable Development Assessment Tool (SDAT) to provide assurance and probity in the understanding that it provides a robust framework for understanding our current position and that of our objectives in achieving. The use of this tool ensures our action are linked to, and measured against, the United Nations (UN) Sustainable Development Goals (SDG’s) many of which have a direct link to health (see below).

Sustainable development, in the context of these plans, is based upon three factors;

• Environmental impact; the impact your organisations activities have on the environment including both the positive aspects that can be leveraged and to reduce or eliminate any negative impact.

• Social impact; the impact your organisations activities has on its local communities, and society more broadly, positively utilising its levers to address health and social inequalities.

• Financial impact; the impact your organisation has on how it controls and spends its money, i.e. the contribution sustainable development activities have on your short, medium and long term financial position; the impact your expenditure can have to actively improve the local socio-economics of your communities.


#WeAreEEAST

The diagram below identifies the links between the economic, environmental, and social factors that influence how we operate which forms

Diagram 1 – links between economic, environmental and social factors

NHS and social care organisations serve as anchors in their local communities. They are embedded within their communities and have a significant economic contribution both as an employer and as a purchaser.

A significant proportion of health and social care carbon emissions come from the estimated £52bn of health-based non-pay spend. Improving the impact of health and care delivery on the environment, society and the economy can generate direct financial benefits to organisations as well as impact wider economic improvements, all of which contribute to the wider determinants of health.

Projects and/or programmes which balance the three aspects can have a positive benefit on; the environment, local communities, and the finances of EEAST. Each of these three aspects have been considered within each of the key focus areas.

Behind each of the headings is an extensive sub-set of targets that have been identified by the SDU as evidence of achievement towards the United Nations (UN) Sustainable Development Goals (SDG’s) many of which have a direct link to health.


#WeAreEEAST

Environmental Aspects The following aspects are considered to impact upon EEAST:

• Materials, handling and storage

• Site activities

• Energy usage and efficiency

• Emissions to air

• Water usage and effluent discharges

• Waste generation, segregation and disposal

• Health and Safety

• Purchasing and supplies

• Packaging

• Transport

Environmental Standards EEAST’s environmental activities are supported by a Board of Directors approved policy.

EEAST’s Sustainable Development Strategy is being developed, which will set out targets against key areas and will provide the basis for the Sustainable Development Management Plan.

Sustainable Development Implementation Plan The annual Sustainable Development Management Plan defines EEAST’s environmental Priorities for the year. Objectives and priorities are agreed with each environmental lead and progress monitored through the Sustainable Development Working Group.

Register of Regulations The relevant legislation identified in the Appendix A and their application to EEAST is outlined in a register of regulations and legislation. This will be located at Estates Department and updated when new and relevant regulations and legislations are identified.

Register of Environmental Effects A register of environmental effects will be maintained to provide a comprehensive list of relevant direct and indirect environmental effects arising from the processes and activities undertaken by EEAST.


#WeAreEEAST

Organisation The Risk Management Strategy of EEAST defines the structure within which risk is managed within the organisation. Environmental issues are an integral part of EEAST’s Risk Management system and significant operational risks are put on the Estates Risk Register.

The Sustainable Development Working Group (SDWG) will include those Heads of Services where environmental issues have an impact on the work of those departments.

The SDWG will lead their individual groups in working towards delivery of their environmental objectives, as set out in the Annual Sustainable Development Implementation Plan. The SDWG will ensure the consistent implementation of the Sustainability Development Strategy and Sustainable Development Implementation Plan.

Environmental issues are included in the areas managed under the Sustainable Development Strategy and practical objectives and targets are set out in the Sustainable Development Implementation Plan. Sustainable Development has a broader remit than environment and incorporates aspects from the ‘triple bottom line’ of environment, society and economy.’

The Sustainable Development Working Group is responsible for implementing these objectives and meeting the targets. Environmental target is a 10% reduction in CO2 emissions by 2020 in line with the 2008 Climate Change Act.

Examples of non-environmental targets include areas such as Finance and Procurement where EEAST Trust business cases are required to include carbon life cycle costs, or Networking and Partnerships where the Trust furthers climate change action in any Local Strategic Partnership.

Duties and Responsibilities Responsible staff The responsibilities of individuals and Trust staff are presented below:

The Chief Executive The Chief Executive will assume overall responsibility for ensuring that environmental issues are effectively addressed within EEAST. The Trust must be compliant with national and, where applicable, international environmental legislation.


#WeAreEEAST

Executive Directors Executive directors are responsible for ensuring that the Trust’s Environmental and Sustainability Policy is effectively implemented within their own Directorates. In particular, Directors should ensure that Directorate work stream action plans are developed, implemented and progressed to contribute towards achieving the aims and objectives of the Trust Five Year Business Plan, Integrated Business Plan and Strategic documents with outcomes and achievements regularly monitored and reviewed.

The Interim Head of Infrastructure and Estates Transformation has Board level responsibility for this Policy and environmental matters in general.

Executive Leadership Board The Executive Leadership Board (ELB) approval will be obtained for this document. The Estates and Fleet departments will all contribute and review this document.

All Trust Managers are responsible for contributing towards the development of Directorate environmental work stream action plans, for implementing and delivering agreed environmental actions and for monitoring and reporting progress towards achieving environmental targets.

All Trust Managers should ensure that directly managed staffs are made aware of the Trust Environmental and Sustainability Policy and of the Trust’s commitment towards environmental management. Staff should be encouraged to participate in and fully support environmental initiatives and to put forward suggestions for environmental improvements. In particular

Managers should:

• reinforce the need for staff to minimise energy and utility usage by observing good housekeeping measures

• support staff in undertaking environmental training as appropriate

• assist staff in accessing and implementing environmental guidance

• contribute towards minimising the effect of operational travel by management of logistics and journey efficiencies


#WeAreEEAST

• support staff seeking to make use of environmentally friendly alternative travel opportunities, e.g. walking or cycling to work, car sharing and public transport

• encourage staff to minimise the production of waste and maximise the reuse and recycling of waste material.

Interim Head of Infrastructure and Estates Transformation The responsibility for environmental and carbon management within EEAST and the implementation of this policy has been delegated to the Interim Head of Infrastructure and Estates by the Chief Executive. The Trusts’ responsibility for environmental management consequently resides with the Chief Executive.

The responsibilities identified include that:

• An annual Sustainable Development Report/Carbon Management Plan is presented to EEAST Trust Board

• An Environmental Plan (Sustainable Development Implementation Plan) is prepared and implemented, monitored and reviewed annually

• Environmental issues feature in EEAST Corporate Strategy • Appropriate resources are identified for the control of

environmental risks

Environmental Lead It is the responsibility of the Environmental and Sustainability Manager to update this Strategy and to ensure that consultation with stakeholders and external bodies to collate up to date information on legislative requirements is conducted.

The Environmental and Sustainability Manager, in conjunction with the Head of Estates and Facilities will put together the Environmental and Sustainability Policy and will review it on an annual basis.

All Trust Staff All staff will be expected to comply with and support the EEAST Environmental and Sustainability Policy and with identified practices and procedures. Members of staff are required to support this policy by familiarising themselves with the policy and complying with its requirements.

Staff will be trained on environmental action within their subject area.


#WeAreEEAST

Carbon Champions (interested individuals from across the Trust) are regularly informed on the green issues that affect them and the Trust.

Trust employees have the following responsibilities under this policy:

• to support and participate in implementing agreed environmental action plans

• to become familiar with the Trust Environmental and Sustainability Policy, support the Trust’s commitment towards environmental management in all aspects of their work and put forward suggestions for environmental improvements

• to minimise energy and utility usage by observing good housekeeping measures.

• to assist in minimising the production of waste and maximising the reuse and recycling of waste material


#WeAreEEAST

Objectives

External Drivers for Change Drivers for change can be broadly categorised into five key categories;

• legislative requirements;

• mandatory requirements;

• International guidance;

• UK Guidance;

• Health specific requirements.

Set out below a list of some of the most common/relevant drivers for change for healthcare organisations, within each of these categories.

The environmental and related legislation and other guidelines that apply to EEAST are contained within Appendix A. These requirements will be addressed by EEAST’s commitment to environmental principles as outlined above. This process will provide the framework for this Environmental and Sustainability Policy in support of environmental management requirements.

Legislative; a list of the key legislative drivers [as of March 2018] is detailed below:

• Civil Contingencies Act 2004

• Climate Change Act 2008

• Public Services (Social Values) Act 2012

Mandatory; those mandated within the NHS

• Standard Form Contract requirements for Sustainable Development 2017-19 HM Treasury’s Sustainability Reporting Framework Public Health Outcomes Framework

• International; those driven by International Guidance Intergovernmental Panel on Climate Change (IPCC) AR5 2013

• United Nations (UN) Sustainable Development Goals (SDG’s) 2016

• World Health Organisation (WHO) toward environmentally sustainable health systems in Europe 2016

• World Health Organisation (WHO) Health 2020; European policy for Health and Wellbeing

• The Global Climate and Health Alliance; Mitigation and Co-benefits of Climate Change


#WeAreEEAST

UK guidance; those driven by UK Guidance

• National Policy and Planning Framework 2012

• Department of Environment, Food and Rural Affairs (DEFRA) The Economics of Climate Resilience 2013

• Department for Environment, Food and Rural Affairs (DEFRA) Government Buying Standards for Sustainable Procurement 2016

• The Stern Review 2006; the Economics of Climate Change

• Health Protection Agency (HPA) Health Effects of Climate Change 2012

• The National Adaptation Programme 2013; Making the country resilient to the changing climate

• Department of Environment, Food and Rural Affairs (DEFRA) 25 Year Plan

Health Specific Requirements

• The Marmot Review 2010; Fair Society, Healthy? Lives Five Year Forward View 2014

• Sustainable Development Strategy for the Health and Social Care System 2014-2020

• Adaptation Report for the Healthcare System 2015 The Carter Review 2016

• National Institute for Clinical Excellence (NICE) Physical Activity; walking and cycling 2012

• Health Technical Memoranda (HTM)’s and Health Building Notes (HBN)’s Sustainable Transformation Partnerships (STP) Plans

The detail and requirements set out in each of the above support activity will underpin the delivery of long term financial, environmental and social sustainability within the Trust as well as across the healthcare system and support the NHS wide approach for achieving this.

The objective of implementing the Sustainability Strategy is to have a cohesive plan for each part of the Trust that drives best practice behaviours ensuring the Trust can deliver services without damage to the environment, the communities it operates in, and the economic climate where ever more services are being demanded for less money.

To do this the Trust will:


#WeAreEEAST

• Comply with all relevant legislation and NHS guidelines.

• Adopt best practice where possible and striving to continually improve EEAST’s environmental performance.

• Educate, train and motivate employees to understand and undertake their role in preventing, controlling and reducing EEAST’s environmental impact.

• Embrace Carbon Management techniques in reducing EEAST’s Carbon Emissions.

• Ensure compliance with waste management legislation and recommended best practice in minimising, segregating and recycling waste. EEAST aims to achieve zero landfill and further reduce other waste streams across the organisation.

• Undertake an environmental impact assessment of new developments and adopt a life cycle approach by seeking to balance capital costs and long term running costs.

• Improve the Patient experience within the Built Environment.

• For new processes consider environmental and safety implications before implementation.

• Ensure that where possible suppliers of goods and services to EEAST and contractors demonstrate an acceptable standard of environmental performance.

• Consider environmental costs in resourcing, purchasing, disposal, transport and distribution decisions.

• Monitor progress and producing an Annual Sustainable Development Report.


#WeAreEEAST

Metrics The Sustainability Strategy will follow the guidance and principles of The Carter Report (Operational productivity and performance in English NHS acute hospitals: unwarranted variations). The Carter Report identified the need to create a set of metrics that could serve as a barometer for hospitals to compare themselves with their peers and provide a baseline for improvement.

This will be underpinned by a set of sustainability metrics derived from the various facets from:

NHS Premises Assurance Model (PAM) – To support NHS trusts, the Premises Assurance Model (PAM) was introduced as a software package bespoke to the non-clinical aspect of the healthcare setting. It provides a consistent basis to measure Trust compliance against legislation and guidance and will inform investment decisions to raise standards in the Trust in the most advantageous way.

Estates Returns Information Collection (ERIC) - ERIC collects information relating to the costs of providing and maintaining the Trust Estate including such things as building, maintaining and equipping the fleet, the provision of support services and the consumption and associated costs of utilities.

Model Ambulance – NHS Improvement developed the Model Ambulance and the underlying metrics to identify what good looks like, giving Trusts information on key performance from Board downwards. Whilst NHSI Model Ambulance portal provides over 300 metrics for the operation of an Ambulance Trust’s performance, within this Strategy we are focusing on the Operational component “Sustainability”.

Where appropriate, these metrics will feed the key lines of inquiry required by the Care Quality Commission (CQC).

The CQC monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety. There are standards covering all services and in particular premises and equipment, governance and employing suitably qualified, competent, and experienced Staff.

Trusts are required to be compliant with all of the Fundamental Standards. These are the Standards the Care Quality Commission have put in place to enable them to Regulate the Health and Social Care Act


#WeAreEEAST

2008 (Regulated Activities) Regulations 2014 (Part 3) and the Care Quality Commission (Registration) Regulations 2009. (Part 4).

The Sustainability Strategy will be developed to ensure that the Trust maintains compliance with CQC Regulations.

We will meet the above metrics will enable us to comply with legislation including Fire Safety, Statutory and Non-Statutory Standards - (Including DDA)

In addition, we must comply with relevant legislation including:

• Health and Safety at Work ACT 1974

• Equality Act 2010

• Health Building Notes (HBN) and Health Technical Memoranda (HTM)

• Regulatory Reform (Fire Safety) Order 2005

Our on-going management of the estate and fleet will be guided by using tools such as the six-facet survey, sharing information and best practice through Ambulance Trust benchmarking club.

We will undertake Environmental Impact Assessments (EIA) for all works that may have a material impact on the environment, e.g. new build schemes, energy efficiency measures, etc.

The NHS has been identified as the largest public sector contributor to climate change. As a result the Government has identified that it is critical that the NHS rapidly establishes a programme of action to reduce its carbon emissions and play its part in meeting Government carbon reduction targets. It has also been recognised that energy consumption alone is not responsible for such carbon emissions and that within the NHS carbon footprint of 18 million tonnes CO2 per year, energy is responsible for 22%, travel 18% and procurement 60%.

The Estates Service will use new NHS software “The Sustainable Development Assessment Tool (SDAT)” to ensure that all aspects of environmental impact can be benchmarked and monitored, including:

• Corporate Approach

• Asset management & utilities

• Travel & logistics

• Adaption


l 00

75

50

25

0 I I I I _, - I - ■I Corporate Asset Travel Adaptatioo Capital Green Sustainable Our Sustainable Carbon

A;pproach Management and Prnjects Space & Care i'l!D!j]le use of / GHGs

& Util!lies. Logistics Biodiversity Models. Re~ourc.es

#WeAreEEAST

• Capital Projects

• Green Space & Biodiversity

• Our People

• Sustainable use of resources

• Carbon GHGs

• Sustainable care models

The NHS Environmental Assessment tool (N.E.A.T) will be used on every major project and designs working towards achieving the British Establishment Environmental Assessment Methodology (BREEAM) ratings appropriate to the development.

The above table provides a summary of the Trust’s current score using the Sustainable Development Unit’s (SDU) on line tool which indicates where some work has already taken place, but moreover, where further work is required in support of an operational and corporate focus to achieve an improved score.

Implementation plan Compliance with the Strategy will be monitored by the Sustainable Development Working Group and reported at the Executive Leadership Board


#WeAreEEAST

Minimum requirement to be monitored

Process to be used for monitoring

Responsibl e individual/ committee for carrying out monitorin g

Frequency of monitorin g

Responsibl e individual/ committee for reviewing the results

Responsibl e individual/ committee for developin g an action plan

Responsibl e individual/ committee for monitorin g the action plan

Compliance with Policy and Legislation

Analysis of environmen tal audits

Environme ntal and Sustainabil ity Manager

Yearly Sustainabl e Developm ent Working Group

Environme ntal and Sustainabil ity Manager

Sustainabl e Developm ent Steering Group

The process of review will be both reactive (investigating compliance with this Strategy following an incident) and proactive (assessing compliance in a planned manner). Any lessons learnt will be shared within the organisation via the Trust’s existing communications channels.

Progress on meeting objectives and targets will be regularly reviewed at the Sustainable Development Working Group meetings.


#WeAreEEAST

As the SDMP is aligned to the modules outlined within the SDAT, the plan will have overarching ambitions, methods of measurement and a target for each module.

Element Ambition Indicator Target by 2024/25

Governance Ensure sustainability is included within the decision-making process

Trust policy documents and strategies all reflect upon the importance of sustainability

By 2024/25

Drive continual improvement through our SDWG meetings

Monthly meeting held with all department representatives

Each month

Asset management & utilities

Continually aim to reduce our energy demand across our Estate

Energy intensity (kWh/m2) Reduce by 10%

Cost per m2 (£/m2) Reduce by 10%

Energy generated through renewable sources

15% > by 2024/25

Travel & logistics

Promote alternative more sustainable transport for both our staff & patients and our contractors

Annual fuel cost Reduce by 10%

Annual milage covered by the fleet Reduce by 10%


#WeAreEEAST

% of Fleet either hybrid or electric vehicles

10% > by 2024/25

Install 20 new EV points across the Trust to support our plan to reduce fleet fuel consumption

20 new installs by 2024/25

Adaption

Create a board level approved adaption plan/strategy and ensure the effects of climate change is embedded into our Trust

Review against the SDAT metrics

Capital Projects

Invest in energy efficient technologies that aim to reduce our overall reduce demand

Invest in energy efficient technology that offers a Return on Investment (ROI) of less than 2-3 years

Ensure all new developments are certified to BREEAM good standard as a minimum

Green Space & Biodiversity

Create and provide external spaces that enhances Biodiversity and promote staff health and well-being.



#WeAreEEAST

Our People Engage with all staff with regards to Sustainability and how it plays a key role within the Trust.


Sustainable use of resources

Continually aim to reduce our waste generation and disposal

Create standardised waste streaming

Reduce waste generation, through correct segregation and recycling before disposal

To engage Purchasing and supplies as an integral part of the Trust’s procurement activities

Carbon GHGs Reduce our GHG emissions and impact on the environment

Reduce our Scope 1,2 & 3 emissions in line with carbon footprint targets

Reduce by 10%

Sustainable care models

Provide service that supports care throughout the community



#WeAreEEAST

Priorities The main priority is to implement sustainable initiatives to support delivery of frontline Ambulance services.

Other key priorities for the Sustainability Strategy are:

• Enable the Trust to operate efficiently, whilst being able to adapt to future climatic scenarios.

• Continually support our Green Plan strategy by working with all responsible departments within the Trust

• Support our staff and patients by providing a sustainable Trust that aims to minimise its impact on the environment.

• Provide effective communication to the Trust with regards to Sustainability and aim to engage with all staff and patients

• Ensure all contractors are aligned and support with our Sustainability objectives

Additional priorities include:

• Continued engagement and communications with Emergency services, NHS Property Services, One Public Estates (OPE), Public sector organisations, Private providers, further education, and military organisations to explore wider initiatives for sustainable working such as shared estates portfolios, agile working, and resource sharing

• Support other Trust strategies to deliver their aims

• Identification of a fit for purpose approach ……….

This strategy will continue the existing sustainability programme in conjunction with Estates, Fleet and other Trust departments.


#WeAreEEAST

Ambition The overriding ambition is to provide a sustainable estate, fleet and services which contribute to community and economic sustainability and wellbeing.

In line with the Corporate Strategy, sustainability will contribute to staff welfare, wellbeing and safety of our staff whilst undertaking their various roles.

Through reconfiguration, the efficiency of the estate will improve, reduce its operating cost and through effective use of resources, good management, and environmental improvements will be achieved. These will include reductions in:

• Energy consumption and unit costs

• Water consumption and sewage costs

• Fleet fuel consumption

• Fleet annual milage

• Waste generation

• Carbon emissions

Service review

At regular frequencies, the Estates department will review its operational model to ensure that learnings from the previous period and opportunities identified during Covid-19 operations are fully exploited to improve the standard of the estate, and/or reduce the estate running cost.

A further review will establish if better value and service would be achieved by outsourcing all or part of the estates function.


#WeAreEEAST

Interdependencies This Strategy directly supports and is interdependent with the following key EEAST strategies, policies, and procedures:

• Waste Management Policy

• Lease Car Policy

• EEAST Health and Safety Policy

• Fire Safety Policy

• Procurement Policy

• COSHH Policy

The sustainability strategy is key to supporting all strategies within the Trust as each recognises the need to be delivered effectively whilst minimising its impact on the environment. Sustainability is integrated into all strategies as it not only aims to improve to the local environment but also enhance the working environment for staff and patients. It is essential that this strategy in continually adhered to throughout the decision-making process to allow this strategy to be an effective support to the Trust.

Wider system engagement and dependency To meet the requirements of a more joined up NHS, EEAST has engaged with local and regional One Public Estate (OPE) Groups, the Sustainability and Transformation Partnerships (STP) and Integrated Care Systems (ICS) within the area, the 18 major Hospital with Emergency facilities and the Police and Fire and Rescue Services in all six counties along with Local Authorities and Councils, Universities, military establishments, and private providers of ambulance services.

From this extensive engagement EEAST will refine aspects of its sustainability programme to consider the approach of other organisations, aligning initiatives where possible. EEAST will continue this engagement to inform this strategy in the coming years.

Alongside this we have developed relationships with Local Authorities and gained information from planning around major


#WeAreEEAST

housing, retail, industrial and infrastructure developments to ensure adequate sustainable services can be provided, adjusting the Trust’s approach in light of changing population needs and demographic.

The Sustainability Strategy supports the core elements of delivery of other Trust services through embedded sustainable practice and ethos in all elements of service delivery.


#WeAreEEAST

Concluding comment and Next Steps The Sustainability Strategy is a key tool in the transformation of the Trust. It must look long term to ensure our services respond to changing technology, attitudes, and needs, but also be agile enough to react to immediate demands.

The strategy considers colocation where possible to reduce impact of buildings and energy usage, working with Blue Light services and other public sector organisations in areas such as call centres, , vehicle servicing and maintenance, supplies distribution, and the development of new premises.

Key elements of the strategy are refurbishment of premises to upgrade key systems that will reduce energy and water usage, reduce waste and running costs, alongside the medium-term targets to improve building performance, generate revenues through energy production, and the transformation of the fleet to low emission vehicles.

Long term reductions in overall space, running costs and emissions in the estate and fleet need to be programmed to be an efficient use of resources, and to optimise the sustainable practice within the service as a whole.


#WeAreEEAST

Appendix A – Summary of Environmental Legislation Environmental Protection Act 1990

Environmental Protection (Prescribed Processes and Substances) Regulations 1991 Clean Air Act 1993

Hazardous Waste Regulations 2005

Waste (England and Wales) Regulations 2011

Controlled Waste Regulations 1992

Waste Electrical and Electronic Equipment (WEEE) regulations Control of Pollution Act (COPA) 1974

Environmental Permitting Regulations 2010 (replaced Waste Management Licensing Regulations

Water Industry Act 1991

Water Resources Act 1991

Trade Effluents (Prescribed Processes and Substances) Regulations 1989

Special Waste Regulations 1996 (Amendments 1996 & 1997)

Groundwater Regulations 1998

Ionising Radiations Regulations 1985

Carriage of Dangerous Goods by Road Regulations 1996 Noise and Statutory Nuisance Act 1993 The Anti-Pollution Works Regulations 1999

Health and Safety at Work Act 1974

COSHH Regulations 1999

The Producer Responsibility Obligations (Packaging Waste) Regulations 1997 (plus amendments)

Packaging (Essential Requirements) Regulations 1998

Environmental Protection (Controls on Substances that Deplete the Ozone Layer) Regulations 1996

The Climate Change Levy (April 2001)


#WeAreEEAST

Town and Country Planning (Environmental Impact Assessment) (England and Wales) Regulations 1999

Climate Change Act 2008

Carbon Reduction Commitment under Part 3 of the 2008 Climate Change Act

2012 Social Values Act

Landfill Tax Regulations

CFC Phase-Out Directive

Ozone Depletion Substance Directive

Oil Storage Regulations 2001 and PPG2

Companies Act – greenhouse gas reporting

Animal By-Products Regulations

Notification of cooling towers and condensers

Pesticides Regulations

Batteries and Accumulators Regulations

Wildlife and Countryside act 1981 with the Protected Species and Schedule 9 – invasive species

HSWA/HSE guidance for Legionella

Water Supply and Fittings Regulations

Control of Asbestos Regulations

Environmental Damage Regulations 2009

Scrap Metal Dealers Act

Fluorinated gas regulations

Air conditioning and high voltage switchgear (SE6)

Registration, Evaluation, Authorisation and Restriction of chemicals (REACH) Restriction of Hazardous Substances Directive Energy Performance Building Regulations

End of Life vehicles Regulations


#WeAreEEAST

Trans-frontier Shipment Regulations

Carriage of dangerous goods and use of transportable pressure vessels

COMAH

Radiation/Radioactive sources

BREEAM Assessment for new buildings and retrofit standards

Energy Savings Opportunity Scheme

Petroleum Licensing

PPGs (Storage of diesel)

Manufacture and storage of explosives regulations 2005

Civil Contingencies Act 2004

Public Services (Social Value) Act 2012

HMT Sustainability Reporting Framework


Sustainability Enabling Strategy

Documents