Anchors and the green agenda: how anchor work can tackle climate change to improve health
A week before COP26 kicked off in Glasgow, we welcomed more than 100 HALN participants to a conversation about the NHS’s contribution to environmental sustainability.
With climate change having serious direct and indirect consequences on people’s health, integrating a green agenda into anchor work has never been more important.
We heard from three experts:
Dr Katja Behrendt, Senior Net Zero Manager in the Greener NHS team, who provided valuable insight on plans to deliver the world’s first net zero health service
John Ebo, Acting Assistant Director for the Improving Population Health Programme at West Yorkshire & Harrogate Health Care Partnership, who covered the implementation of its environmental sustainability strategy especially in relation to the flood-hit Calder Valley
Tanja Dalle-Muenchmeyer, Air Quality Manager at Guy's and St Thomas' NHS Foundation Trust shared the projects which the Trust has undertaken to tackle air pollution, sharing how these link to its wider objectives as an anchor institution
The event - which you can watch again here - closed with an invitation to the audience to ask further questions. Here’s what you asked, with answers from John and Tanya.
1. How does greening link to health inequalities? For example, how does your team account for the digitally excluded, the heat poor, those who live on streets?
Tanja: As an anchor institution, our long-term sustainability is tied to the wellbeing of the populations we serve. We look beyond the boundaries of our estate to improve the health and wellbeing of our local communities, and that includes addressing health inequalities. In our day-to-day drive to improve air quality, this could mean taking into account not only air pollution levels but also deprivation levels and health inequalities around our community sites when deciding on project locations.
John: I never tire of emphasising that the climate emergency is a health emergency. In reference to anchor institutions and our role in reducing health inequalities, we will only achieve the broader outcomes for all by paying good attention to, and dealing with, greening and sustainability challenges. This is a cross cutting theme - an anchor framework and responsible approach to protecting communities calls for sustainable management of water, energy use, resources, transport emissions, retrofitting our homes and so on.
Our team in improving population health is running a fuel poverty campaign through the winter months. They are working with anchor institutions to enable health and care staff to spot the signs of fuel poverty and signpost help where needed for our populations. Our ‘Adversity, Trauma and Resilience and Prevention’ programme helps us understand the needs of homeless individuals, providing a deeper level assessment, beyond immediate support.
2. How easy has it been to get support at board level for this work?
Tanja: At Guy’s and St Thomas’ NHS Foundation Trust we have clear support for our sustainability and air quality work at board level and are grateful for it. However, it might be useful to recognise that it requires time and change for this high-level support to translate into the day-to-day implementation of our sustainability strategy.
John: For our system, this is absolutely central. Climate change has its own specific strategy as one of 10 overall ambitions for our ICS. It is led by the team in improving population health and bought into by all our senior leaders. We have two senior responsible officers, one comes from health and one from the local authority and public sector - together, they hold the ICS accountable for the work that they are doing on climate change. But it’s not just about leadership at that level, it’s important that this is everybody’s issue and requires everybody’s input. Whilst leadership is important and needs that driver under strategic work, we shouldn’t underestimate the impact of what people can do as individuals.
We hold lunch and learn sessions with staff to connect with this issue at a very personal level. In the Calder Valley flooding example, the local authority has been the hub to draw in a huge amount of organisational influence - Yorkshire water, the Environment Agency and various local organisations to look at this issue in a holistic way.
3. How can we decentralise procurement to support greater levels of local production and investment?
John: It’s important to start with the premise that local leaders know their patch best. The role of procurement should then be making sure that the appropriate investment opportunities are made available to the right location at the right time, and for the right organisation - not the other way round. Now, this might suggest that there are less opportunities for economies of scale but I believe that a better approach might be considering procurement strategies as the enabler, rather than the driver. We need to begin first with the outcomes in mind and then work through what the correct procurement match should be.
Tanja: At Guy's and St Thomas' NHS Foundation Trust, the sourcing team manage over £300m of expenditure across clinical and non-clinical spend categories. We are committed to including social value award criteria in new tenders and to working with our supply chain to make local sourcing possible. We have, for example, recently applied a weighting of 20% for social value criteria to our new stationery contract.
4. How do you effectively partner with local authorities and other partners? How did you involve them to support your projects?
Tanja: We have a strong relationship with local partners, whether that is the local councils, business improvement districts, universities or others. Underpinning these relationships is the recognition that we can only deliver significant change by working together. As a Trust, we might be the biggest employer in both Lambeth and Southwark, but addressing issues such as travel, transport, greening (in terms of corridor development) and other sustainability initiatives will always require a joined-up approach on a local level at least.
From experience, a starting point to these relationships could be the question “How can we contribute?” rather than “How can one of these organisations support our project?”. Playing an active local role by feeding into relevant consultations and joining steering groups, for example, can be a mutually beneficial process with long-term benefits.
John: Our Integrated Care Partnership in West Yorkshire has a singular focus, that is to work collaboratively across Health and Care roles as a system, across a region, to provide “Better Health for Everyone”. It simply means we take a matrix approach to focussing on solutions across our entire region. We call it “distributive leadership”. Take my role as an example - my substantive post is with Leeds City Council in an economic development and place leadership Head of service role.
However, in the past 12 months I have been seconded into the Integrated Care Partnership on a leadership role with responsibility for several key areas: deriving our Anchor Institution vision and mission, supporting delivery of our climate change actions, driving change through the latest health and medical tech, working on the health needs of our older population and representing the ICS at our Economic Recovery Board, led by the Mayor of West Yorkshire.
I report to our Director of Improving Population Health Programme as an overall senior leader, because improving Health equity is the overall outcome. This role structure prioritises interconnectedness, collaboration and influence across Bradford & Craven, Calderdale, Kirklees, Leeds, and Wakefield places. The strength of our anchors mean we are doing good work together, with VCSE colleagues and place leads playing a key role.