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Advertorial: In association with Boehringer Ingelheim

Why we signed up to the ICS Clean Air Framework

We can’t achieve the NHS’s net zero goals without action on air pollution.

By James Dixon

This advertorial was funded, reviewed, and approved by Boehringer Ingelheim Limited UK&IE

A lot has changed in the past ten years. Climate change and sustainability are now top priorities for policymakers – and healthcare is no different. Within the NHS, the appetite for transitioning to net zero is stronger than ever. Greener NHS, NHS England’s climate change programme, is doing a fantastic job of embedding climate emergency action into the work of this country’s largest employer. Today, every NHS Trust has an executive director lead for net zero and a board-approved Green Plan, with sustainability professionals increasingly employed to help deliver these. NHS England has set ambitious targets of reaching net zero by 2040 for all the emissions we can control, and 2045 for all the emissions we can influence, ahead of the UK government’s target of 2050.

Here at Newcastle Hospitals, we declared a climate emergency in 2019 – the first healthcare organisation in the world to do so. With a vision to be a global leader in sustainable healthcare services, we know that the climate emergency is a health emergency. We have set even more ambitious targets of net zero by 2030 for the emissions we control, and 2040 for those we can influence.

As associate director for sustainability at the Trust, I am highly focused on these aims. When I first joined 12 years ago, I was the lone environmentalist in an organisation of 15,000. My role involved looking at waste, recycling and efficiencies. But since then my remit – and our team, now with six other people – has expanded to far broader thinking on sustainability.

Today, I look at the sustainability of our estates – energy, waste, water, the design of our hospitals and green spaces – as well as journeys to and from hospitals, the embodied carbon in our procurement, and implementing clean air principles in our work. We also have a strong focus on our people and patients – how do we empower our staff to deliver more sustainable care, and keep our stakeholders committed, too?

Clean air is one of the three long-term goals in our Climate Emergency Strategy. Poor air quality is a public health issue. Some 30 per cent of preventable deaths due to non-communicable diseases are connected to airborne pollutants. One in three GP practices and one in four hospitals in England are in areas that breach World Health Organisation guidance levels for fine particulate matter (PM2.5), one of the most common and dangerous pollutants.

There is an economic price, too. It is estimated that the social and health impacts of air pollution could cost England £18.6bn by 2035.

And there are many different players in the fight for better air, so any action on air quality needs to involve businesses, policymakers and the wider public. As a result, we helped create, and are early adopters of, the ICS Clean Air Framework. After we declared a climate emergency in 2019, we knew that air pollution was one of the biggest environmental threats to public health. It became clear that action on clean air is as key for population and planetary health as getting to zero carbon and zero waste.

We teamed up with Global Action Plan (GAP) and Boehringer Ingelheim to trial this on an Integrated Care System (ICS) level, building on GAP’s earlier work with Great Ormond Street Hospital. The initiative, and the findings of our pilot study, published in April’s Levers for Change report, represent a commitment to improving air quality at all healthcare access points, not just hospitals.

We had concerns about achieving this. The North East & North Cumbria (NENC) ICS covers a vast geography, from the east to the west coast and from the Scottish border to Yorkshire. It includes 13 local authorities and doesn’t benefit from one single mayoral combined authority or integrated transport system. Coupled with a similar number of NHS provider Trusts, we knew cohesion and capacity would be tough.

We started collaborating with our sustainability leads across NENC and challenged the then ICS management board to prioritise this work. The NENC is a huge patch and there are many different parties and Trusts within that – so we came together to collate best practice. Knowing that the NHS couldn’t do this alone meant bringing together provider Trusts extending into local authorities, businesses and third sector and voluntary organisations.

On the back of this came the North East England Climate Coalition – and with that, the huge ambition to become England’s greenest region. Of course, this has come with its challenges. Given the geographical spread, there’s variation in political priorities – and affiliations – competing interests, and populations with varying challenges.

But it’s been worth it. Public health leaders and local authorities now share our obligation to improve population health. Collaboration is integral to this and aligning the work with acute, mental health, and primary care providers makes the partnership incredibly effective.

We have had many successes, including a significant increase in digital healthcare appointments, education on the health impacts of air pollution, no idling campaigns, and nature-based solutions aligned with green and social prescribing.

If you work with, or are part of, your local ICS you should absolutely consider signing up to the ICS Clean Air Framework, which you can access for free online. You can see how important it is, how easy it is, and you can advocate for your ICS to sign up. Once more ICSs get involved, we will be able to see improvements in clean air nationwide.

In fact, Boehringer Ingelheim and its partners, us included, would really like to see the Greener NHS team make action on clean air a mandatory part of the Green Plans that all ICSs are required to produce. Targeted plans against air pollution across the country would be mutually reinforcing and beneficial. We would see real results in reducing ill health and the burden on services. Despite the NHS’s strong commitments, not all ICSs have an established sustainability lead delivering this work. Change has to be a cohesive effort that is championed from the top, with clear accountability.

The air pollution that we breathe every day is largely undetectable to the human eye, but it is killing us across all stages of life, from the womb to old age. It’s on the rise, and we can’t be complacent. Our NHS staff see the worst of it, and it’s putting a huge strain on an already pressurised health service. This needs to be a priority for all healthcare professionals, local authority leaders and community partners – and this initiative is the perfect place to start.

[See also: Air pollution is the biggest environmental risk to the UK’s health – here’s why]

Job code: NP-GB-103373