Greener NHS Webinar.pptx

webinar to support innovators understand about NHS Net Zero. To help understand sustainability

1. Greener NHS What NHS Suppliers and Innovators need to know

2. Unless asked to speak, please stay on mute with video off Ask all questions in the chat bar Only use the chat for questions

3. PPN 06/21 Guidance on adopting and applying 06/21 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1054373/Guidance-on-adopting-and-applying-PPN-06_21-_-Selection-Criteria-Jan22__1_.pdf Technical Standard for completion of Carbon Reduction Plans https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/991625/PPN_0621_Technical_standard_for_the_Completion_of_Carbon_Reduction_Plans__2_.pdf Carbon reduction template https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1053009/PPN-0621-Carbon-Reduction-Plan-Template-Jan22.odt FAQ on PPN06/21 https://www.gov.uk/government/publications/procurement-policy-note-0621-taking-account-of-carbon-reduction-plans-in-the-procurement-of-major-government-contracts/ppn-0621-frequently-asked-questions

4. Greener NHS » Delivering a ‘Net Zero’ National Health Service (england.nhs.uk) https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf https://www.health.org.uk/about-the-health-foundation/get-involved/events/webinar-after-cop26-what-will-it-take-to-get-the-nhs-to-net-zero

5. Environmental Consultants As the NHS embraces Net Zero, we expect there may be an increased number of environmental consultants offering advice. Take care that any such consultant is credible, with a strong track record in this area.

6. Calculating Carbon Footprint – Where to Start? The UK Government provides the MacKay Carbon Calculator: https://www.gov.uk/guidance/carbon-calculator This is a useful tool which can help map out a pathway for a company to reduce their green house emissions across a range of sectors.

7. Useful sources Carbon Trust: SME Carbon Footprint Calculator: https://www.carbontrust.com/resources/sme-carbon-footprint-calculator Carbon footprint: http://www.carbonfootprint.com/ Carbon Footprint: Small Business calculator: https://www.carbonfootprint.com/small_business_calculator.html avieco : https://avieco.com/ Ricardo-AEA: https://ee.ricardo.com/?stage=Live CDP partners: https://www.cdp.net/en Waste Resources Action Programme (WRAP): http://www.wrap.org.uk/ Greenstone: http://www.greenstoneplus.com/services/ Ecometrica : http://ecometrica.com/ Anthesis Group: https://www.anthesisgroup.com/ IEMA: http://www.iema.net/ Verco: http://www.vercoglobal.com/ Loreus : http://www.loreus.com/ WS Group: http://www.wspgroup.com/en/WSP-UK The following list is not exhaustive and is not officially endorsed by government but may prove useful:

8. Essential reading

9. Delivering Health Sustainably NHS Supply Chain Sustainability Strategy Martin Toomey FCIPS – Sustainability Manager

10. Sustainability is a key priority within the NHS and NHS Supply Chain NHS Supply Chain are working closely with NHS E/I to align our plans

11. 2021/2022 Business Plan – Sustainability and Supply chain Resilience

12. NHS Supply Chain Sustainability Goals Human rights & labour standards* ‘NHS Supply Chain are committed to delivering health sustainably’ Ensure basic rights for everyone across entirety of NHS supply chain Response to Intl Issues e.g. Modern Slavery, Child Labour, Forced Labour, Trafficking Support Labour Standards e.g. Health and Safety, Employment terms Targets 360 New suppliers registered on LSAT module 15% Colleague volunteers for charity day 33% SME’s traded by value Waste & Circular Economy Targets 3 Feasible projects undertaken and concluded 50% Office waste recycled Plastic Products & Packaging Reducing use of plastics across NHS supply chain and our supply chain for procured /distributed products Reducing plastics in packaging and single use plastics Understanding the cumulative effect of these on the environment Stretch Targets 350 Single use plastic tonnes reduced Climate Change, Energy & GHG emissions Holistic response to climate change, air pollution, carbon agenda Includes: Energy consumption, fuel usage, carbon footprint, GHG emissions Across NHSSC operations, infrastructure & Fleet. Excludes our suppliers. Stretch Targets 5,100 tonnes CO2 Emissions removed Management of waste across entirety of NHS supply chain Impact of packaging, food waste and other waste across offices and distribution centres etc. Circular economy principle to minimise resource input and further reduce waste *Includes efforts to support the SME strategies of central government and encourage our staff to pursue charitable goals in their local communities

13. Our Suppliers and Supply Chain are a big contributor to Carbon and therefore critical to our success 3.3. Supply chain The NHS Carbon Footprint Plus considers an expanded scope of emissions, covering the products procured from its 80,000 suppliers. While the NHS does not control these emissions directly, it can use its considerable purchasing power to influence change. A summary of the broad range of interventions considered is presented in Figure 9 , for reductions of emissions from medical and non-medical equipment (18%), food and catering (6%), other procurement (18%), commissioned healthcare services outside the NHS (4%) and medicines and pharmaceuticals (20%). Supply Chain Contribution to Carbon Emissions

14. Present day emissions Emissions reduction Residual Interventions to reduce supply chain emissions ​ In the Net Zero report, there are 13 interventions that were identified within the Supply Chain workstream. These form the foundation of the Supply Chain workstream programme plan for the next five years.

15. Building net zero into NHS procurement Jan 2022 NHSE&I will launch the Sustainable Supplier Framework NHS will adopt PPN 06/20 so that all NHS tenders include a minimum 10% net zero and social value weighting April 2024 April 2027 All suppliers* will be required to publicly report emissions and publish a carbon reduction plan aligned to the NHS’ net zero target for their direct emissions, irrespective of contract value April 2028 All suppliers* will be required to publicly report emissions and publish a carbon reduction plan aligned to the NHS’ net zero target, for both their direct and indirect emissions (Scope 1, 2, and 3) April 2030 All suppliers will be required to demonstrate progress in-line with the NHS’ net zero targets, through published progress reports and continued carbon emissions reporting April 2023 NHS will adopt PPN 06/21 so that all contracts above £5m will require suppliers* to publish a carbon reduction plan for their direct emissions as a qualifying criteria April 2022 2045 New requirements will be introduced overseeing the provision of carbon footprinting for individual products supplied to the NHS Net Zero Supply Chain Net Zero NHS *To account for the specific barriers that Small & Medium Enterprises and Voluntary, Community & Social Enterprises encounter, a two-year grace period on the requirements leading up to the 2030 deadline, by which point we expect all suppliers to have matched or exceeded our ambition for net zero.

16. The NHS Supply Chain Sustainability KPI Dashboard Notes: CO2 in month tonnes removed corresponds to delivery of discreet projects Office waste collections on hold

17. Supplier Registration Service Government Portal – Why is it an enhancement? https://supplierregistration.cabinetoffice.gov.uk/ Online Data across Supply Chains with Group Scores and answers with the ability to drill down into the questions and individual scores Suppliers also get a report of the assessments and an improvement plan NHS SC can track and report on improvements over time – both internally and externally, demonstrating our added value The modules provide more detailed information and action plans for improvement NHS SC have invested in the portal to supports us to assess: Labour Standards and Modern Slavery Carbon Reporting Supply Chain Mapping Through these assessments we are able to look at these themes in a consistent way

18. Supplier Registration Service – NHS Supply Chain NHS SC is using a series of Assessments on UK Government Online Portal to collate detailed information from our Suppliers on Modern Day Slavery, Labour Standards, Carbon Waste and Water NHS SC have Risk Assessed all their Procurement Frameworks for key Sustainability Themes and will be using the Portal to engage our Suppliers on this key issues. For more information and to registered as a Buyer visit. https://supplierregistration.cabinetoffice.gov.uk/

19. Social Value Overview NHS SC are already working on implementation of Social Value Issued on June 6, 2020, PPN 06/20 applies to all N HS procurement from April 1 , 2022 and mandates that a minimum weighting of 10% of the total score for the tender evaluation should apply to social value. A higher weighting can be applied if justified. The NHS is adopting this approach as well. Covid-19 Recovery - Helping local communities to manage and recover from the impact of COVID-19 Tackling Economic Inequality - Investing spend in a way that drives an equitable society Fighting Climate Change - Effective stewardship of the environment through net zero delivery Equal Opportunity – Provide equal opportunity and tackle modern slavery Wellbeing – Encourage wellbeing and cohesion Wider Determinants of Health

20. Procurement Policy Note 06/21 – Carbon Reduction Plans https://www.gov.uk/government/publications/ procurement-p olicy-note-0621-taking-account-of-carbon-reduction-plans-in-the-procurement-of-major-government-contracts Suppliers are required to submit plans to reduce Carbon in Contracts over £5 million Confirming the bidding supplier’s commitment to achieving Net Zero by 2050 for their UK operations. Providing the supplier’s current emissions for the sources included in Scope 1 and 2 of the GHG Protocol, and a defined subset of Scope 3 emissions. Providing emissions reporting in CO2e (Carbon Dioxide Equivalent) for the six greenhouse gases covered by the Kyoto Protocol4 Setting out the environmental management measures in effect, including certification schemes or specific carbon reduction measures you have adopted, and that you will be able to apply when performing the contract and that support achieving Net Zero by 2050. Publication of the CRP on the supplier’s website.

21. Thank you Questions? [email protected]

22. Leanvation A decade in surgical gloves. www.leanvation.com @leanvation

23. Leanvation - “I’m terribly sorry to hear that. However, you are still wearing your old gloves. We don’t start the trial in this theatre until tomorrow.” A real encounter with an orthopaedic surgeon. Surgeon - “These gloves are ******* crap! They’re uncomfortable and so slippery that I keep dropping my instruments!”

24. Background Former senior management team of leading global surgical gloves brand Start-up business in 2013, supported by PE and NW Investment Fund Have grown to sell over 40 million gloves in 2020-21 Headquartered in St Helens www.leanvation.com @leanvation

25. Why set up Leanvation?

26. Head of Procurement - Erasmus Hospital, Netherlands “Please don’t come here bringing me even more products to consider. We already have more than we need. Every surgeon has their own preferences, making stock control almost impossible. We have little storage space and gloves take up more than anything else.”

27. Typically, how many SKUs are offered by the leading brands?

28. 160-360

29. Category Traits Dominated by few key players Remains predominantly latex based (>90%) c.f 53% latex-free in US Product development focuses on incremental improvements in competitive claims for marketing advantage

30. Opportunity Innovate to deliver greater value .

31. How do we innovate to add value? Recognise that customers want fewer gloves, not more Strip-out ‘luxury’ additives from formulations (e.g. aloe vera) Use fewer chemicals together with a brand new manufacturing facility to deliver health benefits and efficiencies Substitute expensive chemical formulations for generic alternatives without impacting quality or performance. Focus on delivering multi-functionality by reducing thickness, increasing softness, improving tactile sensitivity, all while retaining strength / performance www.leanvation.com @leanvation

32. Launch Range - 2014 ‘Three gloves, one message, no latex.’ Class-leading fit/feel/comfort without compromising protection Engineered to service specific needs of all surgical specialties, offering a thin, thick and puncture indicating glove variant of the same poly(isoprene) formulation Multi-functionality across surgical specialties made possible by innovation Performance removes need to carry latex variants

33. Feedback Assessment Attribute - Fit Assessment Attribute - Comfort Assessment Attribute - Sensitivity Assessment Attribute - Strength Assessment Attribute - Donning Ease 'Would you be prepared to use Leanvation for all cases?'

34. A recipe for success?

35. 2015. A realisation. Budget pressures dominate Even at reduced pricing v competitors, latex-free gloves present an unacceptable cost pressure in direct comparisons with latex variants www.leanvation.com @leanvation

36. 2016. Change. www.leanvation.com @leanvation Answering market need & opportunity.

37. Our product range approach: keep things simple. 2 different thickness levels 2 different grip levels Puncture indication / double gloving solution 2 alternative fits (finger length & palm width) Chemical resistance Latex range mirrored in latex-free www.leanvation.com @leanvation

38. Leanvation in 2019 www.leanvation.com @leanvation Greater focus on efficiency & cost effectiveness Core message of using innovation to deliver a rationalised product range now offered across both latex and latex-free variants in response to customer demand Continue to offer class-leading fit/feel/comfort and quality without compromising protection Engineered to service specific needs of all surgical specialties Low allergenicity

39. Leanvation Eco Innovation to deliver reduced costs Leverage latest coating technology to reduce donning coating thickness without compromising function Engineer to be crease resistant, allowing greater folding Reduced packaging size and volume (50%) Reduced packaging costs (size, colour, non-corrugated) All without reducing quality www.leanvation.com @leanvation

40. Product Range

41. Clinical Feedback from Alder Hey www.leanvation.com @leanvation

42. Clinical Feedback from Alder Hey www.leanvation.com @leanvation

43. Orthopaedic Surgeon, Aintree NHS Trust “Having worn my current glove for 20 years, I was contemplating penning a letter to the Medical Director, refusing to be forced to change my gloves against my will. I then, yesterday, arrive at the RCS to educate medical students on a course I was leading only to be provided with Leanvation gloves there in London. So I guess I will have to accept that you guys are taking over the world and just accept it.”

44. So, the path ahead is easy then, is it?

45. No.

46. Attitudes to ‘Change’ Remain a Hurdle Serving the NHS with products still currently plays to the strengths of ‘Goliath’ not ‘David’ SME’s can make impact, but continued traction is hampered by attitudes to change when change offers few incentives for individual NHS stakeholders Global enterprise will always attempt to defend it’s position - that’s pure economics! However, agile SME’s can often be more innovative, more quickly, particularly with respect to environmental sustainability www.leanvation.com @leanvation

47. Realising an opportunity…

48. Leanvation Eco Innovation to deliver reduced costs & improved environmental sustainability! Leverage latest coating technology to reduce donning coating thickness without compromising function Engineer to be crease resistant, allowing greater folding Reduced packaging size and volume (50%) Reduced packaging costs (size, colour, non-corrugated) By reducing packaging size by 50%, we can pack 2x quantity in 40’ shipping container Reduces CO2 associated with transit by half Reduces CO2 associated with controlled storage by half Reduces non-recyclable packaging waste by 50% for end-users www.leanvation.com @leanvation

49. A simple way forward?

50. No.

51. NHS Supply Chain Gloves Framework Tender 22-24(26) Significant weighting towards CSR & ES Requires bidders to showcase what plans they have to reduce their carbon footprint over the next decade Leanvation showcase the vast savings in CO2 that have already been realised from development of Leanvation Eco and spin-off products, adoption of EV’s across the business, adoption of clean energy at manufacturing sites Leanvation validate that we are industry leaders for environmental sustainability and have already implemented change to realise an environmentally sustainable business Leanvation preliminarily receive the lowest bidder score for environmental sustainability on account that ES is essentially scored on the basis of not where a business is now in terms of ES, but what increment of change you will deliver in the next decade! www.leanvation.com @leanvation

52. Dialogue is Essential! Supported by the NWC AHSN (Innovation Agency) and Valuematch, Leanvation worked with NHS Supply Chain to look at the detail behind Leanvation’s tender submission NHS Supply Chain subsequently acknowledged that Leanvation had been scored ‘harshly’ on account of having already made huge strides to improve ES across the gloves category NHS Supply Chain acknowledged that Leanvation presented an opportunity to swiftly aid the NHS to attain it’s net zero goals by adoption of Leanvation products www.leanvation.com @leanvation

53. Where do we go from here?

54. More dialogue.

55. Considerations Many NHS Trusts still strive to irradicate latex from operating theatres Cases of latex-allergy remain lowest for over a decade; no reported cases of fatal anaphylaxis in over 5 years Latex-free surgical glove adoption across the NHS remains steady at around 6% Latex-free surgical gloves cost typically 2x the cost of their latex counterparts Latex gloves are produced from a renewable resource with a net positive impact on CO2; the opposite applies to latex-free gloves Should NHS trusts revisit their latex policies in support of the goal to attain net zero by 2040? www.leanvation.com @leanvation

56. Learnings Listen, adapt, challenge and communicate Recognise that common sense does prevail with NHS Supply Chain, although you may have to fight for it! Understand what customers / end users want - using technology to realise ‘simplification’ can typically: Improve environmental sustainability Reduced costs / improve profitability Provide strong competitive advantages that are easy to sell and easy for end users to understand www.leanvation.com @leanvation

57. Greener NHS – What Suppliers…. And Innovators need to know Mike Kenny Acting Co-Director of Enterprise and Growth, Innovation Agency (NWC AHSN) 16 th March 2022

58. Summary Points Climate change is the biggest and most pressing challenge of our generation ; worlds best scientists say we have less than 10 years to fix it The NHS is the largest emitter of CO2 in the UK NHS responsible for 5% emissions in the UK

59. The Opportunity for Innovation Multiple NHS “Digital First” polices & programmes Improving Care Improving Outcomes Bridging Workforce Gaps Saving Money Improving Experience for patients and workforce

60. The Opportunity for Innovation Covid 19 Pandemic Social Distancing Reduced capacity in Primary and Secondary Care Remote Monitoring “stood up” at Scale Virtual Consultation provided at Scale in Primary and Secondary Care Not for everyone, but for many – a better experience A chance to be at home Workforce – better care for more patients within capacity

61. The Opportunity for Innovation AHSNs have been driving such change for years The Pandemic changed behaviours of patients and NHS & Social care staff due to necessity Covid created the “use case” for greater digital provision of care… virtually overnight Digital and Remote is not for everyone - it can and has driven health inequalities So Digital and Remote not the whole “answer” – but has become embedded as part of the way care is delivered right?

62. What Can be the NHS “Call to Action”?

63. With 5% of NHS CO2 emissions due to patient travel – can we really justify this? This Photo by Unknown Author is licensed under CC BY-NC This Photo by Unknown Author is licensed under CC BY-NC

64. The Opportunity For Innovation This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA

65. The Opportunity For Innovation Leanvation started out trying to make the NHS Latex free But have realised a much bigger opportunity through innovative approaches to manufacturing, packaging and raw material use – reducing carbon emission Whilst increasing value This Photo by Unknown Author is licensed under CC BY-NC This Photo by Unknown Author is licensed under CC BY This Photo by Unknown Author is licensed under CC BY-NC-ND This Photo by Unknown Author is licensed under CC BY

66. Thank You Mike Kenny – [email protected] @innovation_mike