Tag Archives: resources

Creating sustainability in health and social care

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The question of the sustainability of funding for health and social care services has been in the spotlight recently. The Conservative Party manifesto contained proposals around making individuals pay for more of their social care costs, to deal with the “challenges of an ageing society”. Meanwhile, figures suggest that NHS Trusts in England overspent by £770m last year despite a focus on efficiency savings.

However, creating and maintaining sustainability in health and social care is much broader than financial sustainability. It means considering other factors, including environmental, training and project management issues. This takes planning, commitment and an understanding of the aims and expectations of staff and senior management.

A research symposium earlier this year (hosted by Healthcare Improvement Scotland and partners) explored these issues further, looking at the evidence underpinning ways to create sustainable health and care systems.

Environmental sustainability

Environmental sustainability is something which all organisations are being asked to address and improve. The issue of climate change has led to a focus on behaviour change and a more sustainable use of resources.

  • Buildings – This includes the planning of new healthcare buildings, as well as adaptations to existing structures to make them more energy-efficient. Alternative building materials and designs have been used in new projects to improve energy efficiency, with some buildings even incorporating wind turbines, solar panels and geothermal capture centres. Reducing waste water and improving temperature regulation through heat capture and insulation techniques are also being adopted. While these may be costly initial spends for many, the long-term cost savings are also significant, as well as ensuring that the buildings meet minimum national requirements for energy efficiency and contribute to emissions reduction targets.
  • Resource, waste and recycling management – In many offices and clinical centres, individuals are encouraged to be personally responsible for their own reduction in waste and improved use of recycling facilities; however, this must also be facilitated at an organisational level. Clearly labelled recycling bins, promoting reduction in of the use of disposable water and coffee cups, and encouraging employees to use less paper when report writing (printing double sided for example, or going paperless where possible) are all simple ways in which environmental sustainability can be promoted in health and social care settings. Innovative techniques such as reusing water in internal plumbing, or creating bespoke recycling facilities to help reduce the amount of clinical waste incinerated, are being developed.
  • Remote monitoring and the use of technology – There have been major advances in the use of remote technology to host meetings, video-conferences, follow up appointments and assessments for those in receipt of reablement care via tele-health. Remote monitoring of patients, as well as the use of tele-health and other digital platforms can allow consultations and routine check-ups to take place without either party having to leave the house or office, thereby reducing vehicle emissions used in transport. In social care, remote meetings and cloud-based reporting can allow front-line social workers to remain out on visits instead of having to return to the office to fill out reports, again reducing vehicle emissions.

Sustainable resource management

In the face of more limited funding, joint working between health and social care is being heralded as a new way of cost saving, making the most of ever-depleting resources in the face of ever-greater demands. Being efficient with resources, through effective planning and management is one of the key ways to ensure resource sustainability in the long term, especially for the NHS and local authority social care teams.

Approaches include:

  • Making full use of the entire health and care ecosystem – This means using the entirety of the health and social care ecosystem, its capacity, expertise, resources and the end-to-end care it can provide. It means engaging carers, GPs, nurses, and pharmacists to improve efficiency, make better use of resources, spread the workload and improve satisfaction levels and outcomes for service users.
  • Using careful and well-managed commissioning models – This means making good decisions about commissioning and outsourcing to make best use of funding and other available resources. It also means allocating to appropriate projects, being mindful of the possible consequences of payment by result frameworks, and getting the best value possible.

Sustainability in practice

The final level of sustainability in relation to health and social care practice involves the sustainable implementation of programmes. This means finding ways to ensure that implementation is carried out in ways that ensure long term success and positive outcomes. It involves understanding context, and the culture of the organisation and makes reference to something discussed previously in our blog on implementation science.

Ensuring sustainability in practice requires multiple efforts including:

  • Making sure that practice becomes embedded into everyday work
  • Sharing best practice
  • Maintaining motivation among your workforce
  • Using robust, local evidence in a way that is clear and concise.

Understanding what kind of evidence leads to sustainable programme implementation is also important: economists prefer cost-based strategies, chief executives want one-page summaries, professionals want examples of other organisational based programmes and what was required to implement effectively, and councillors want case studies based around the positive impact on services users. Case studies can at times actually be the least helpful because even in a failing programme there is usually one example you can use to find positives.

Another issue with evidence is the reluctance to report on issues or challenges, or failed projects, when actually some of the greatest insight can be gained from this. All of the learning that can be gained from failures could be useful when trying to make programmes more resilient so they can be more sustainable.



Final thoughts

The concept of sustainability in health and social care cuts across many areas of organisational management and personal practice and behaviour. Encouraging and participating in sustainable practice can mean anything from being more environmentally friendly by digitising reports, recycling paper or changing to energy saving lightbulbs to promoting sustainability of resources through efficient and effective management, utilising the skills, expertise and resources of the entire health and social care ecosystem.

These approaches to sustainability should not only help health and social care as a profession to be less impactful on the environment but will also allow organisations to save money, improve efficiency and ultimately improve outcomes for patients and service users as a result.

* The 5th Annual Research Symposium: Evidence for sustainability – exploring the current evidence underpinning ways to create sustainable health and care systems was held on 16 March 2017. It was jointly hosted by Healthcare Improvement Scotland, Health Services Research Unit and the Health Economics Research Unit at the University of Aberdeen, and the Nursing, Midwifery and Allied Health Professions Research Unit at the Chief Scientist Office.

If you enjoyed this blog, you may also be interested in other articles on implementation theory and commissioning in health and social care.

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The UK generates more food waste than anywhere else in Europe …what’s being done to tackle the problem?

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Wasted_potatoes

Image: by the lone conspirator [CC BY 2.0, via Wikimedia Commons

October 16 is World Food Day, an annual day of action to raise awareness about the problem of global hunger. It’s also a particularly good day to reflect on the problem of food waste.

Over 800 million people – one in nine worldwide – live with chronic hunger. Yet in the midst of global starvation, huge amounts of food are being discarded by retailers and consumers.

  • Some 40% of all the food produced in the United States is never eaten.
  • In Europe, 100 million tonnes of food is thrown away every year.
  • The UK produces 15 million tonnes of food waste every year, more than any other European country.

The costs of food waste

Apart from the ethical concerns, food waste has significant economic and environmental impacts. Some of these are clear to see, while others are hidden costs.

In 2007 the Waste and Resources Action Programme (WRAP) estimated that wasted food costs each UK household between £250 and £400 a year. This doesn’t include council tax payments contributing to the cost of local authorities’ disposal of food waste, much of which goes to landfill sites, where it generates methane and other greenhouse gases.

Scarce resources are being used in the production of food that will never be consumed. Every product has its own “water footprint” –  the amount of water consumed in its production. In 2011, research by WRAP found that the water footprint of food waste was 6,200 million cubic metres per year.

Love food, hate waste

Addressing the problem of food waste is clearly a colossal challenge. But that’s no reason to give up. Since 2007, WRAP, the registered charity that works with businesses, individuals and communities to help reduce waste, has been running a highly successful Love Food Hate Waste campaign in partnership with retailers, food manufacturers, local government and community groups. Between 2007 and 2012, the campaign helped reduce avoidable food waste by 21%. That’s more than one million tonnes of food saved from landfill (or enough to fill 23 million wheelie bins). The campaign is also estimated to have saved consumers £3.3 billion a year and councils around £85 million.

Local action on food waste

Individual local authorities are also doing their bit to reduce the amount of public money used to dispose of food waste as rubbish. Councils in areas such as Cardiff, West Lothian and Oxford have been providing separate food waste caddies for collection. The food can then be recycled either by composting for fertilisers, or by anaerobic digestion for conversion to biogas to generate electricity, heat or transport fuels. Some local authorities, such as Central Bedfordshire are also encouraging home composting by providing householders with subsidised composting bins for kitchen and garden waste.

Donating food to charities

While the bulk of food wasted annually in the UK comes from households, supermarkets also generate substantial amounts.

In 2013, the British Retail Consortium estimated that seven supermarket chains were responsible for 200,000 tonnes of food wastage. In response, some of the UK’s leading supermarkets such as Sainsbury’s, the Co-op, and Tesco have been working with the FareShare charity to rescue thousands of tonnes of food from landfill for redistribution to vulnerable people across the UK in homeless shelters, women’s refuges and children’s breakfast clubs.

At the moment, these are voluntary schemes, but an initiative by a local councillor in France might ultimately lead to legislation compelling supermarkets across Europe to donate unwanted food to charity.

Earlier this year, Arash Derambarsh persuaded the French parliament to pass a law barring supermarkets from destroying food approaching its best-before date. He is now lobbying the European parliament to follow suit by including an amendment in its new “circular economy” directive.

Consumers also have a role to play, for example by choosing misshapen fruit and vegetables that would be otherwise be destined for the bin, buying just the things we need, and understanding the difference between “best before” and “use by” dates.

Good work has been carried out in raising awareness of, and addressing, food waste. However, given the colossal scale of the problem, further progress will depend on concerted actions by governments, food suppliers, retailers and consumers.

 

The Idox Information Service can give you access to a wealth of further information on waste management; to find out more on how to become a member, contact us.

Follow us on Twitter to see what developments in public and social policy are interesting our research team.


Further reading*

A taste for reducing food waste (in the public sector)

Sector bursts with ideas on boosting bioresources (food waste policy)

Strategies to achieve economic and environmental gains by reducing food waste

The seller of food that the shops cannot sell (food waste)

Waiter! More doggy bags, please (designer doggy bags to reduce restaurant food waste)

*Some resources may only be available to members of the Idox Information Service