Quality and Outcomes Policy

Quality and Outcomes Policy

Room 6A

Skipton House

80 London Road,

London

SE1 6LH

16thSeptember 2010

Dear Sir/Madam,

Re: NHS Sustainable Development Unit response to the Department of Health consultation on the NHS White Paper: Liberating the NHS: Transparency in outcomes – a framework for the NHS.

The NHS Sustainable Development Unit (SDU) welcomes the opportunity to respond to the NHS White Paper “Liberating the NHS: Transparency in outcomes – a framework for the NHS”. This response is in letter form to better convey overarching principles that the Sustainable Development Unit (SDU) would like to make.

The NHS SDU provides leadership, expert support, and technical guidance across the NHS and health system in relation to sustainability. The unit is keen to ensure that a joined up approach to economic, social and environmental sustainability are core to the health reforms and the QIPP agenda. Sustainability is an integral part of excellence in management and the health system requires clarity about the metrics, governance, and reporting mechanisms to maximise opportunities that will deliver savings and improve health outcomes through linked environmental, social and financial considerations.

The Climate Change Act sets a legal requirement to achieve carbon reductions of 34% by 2020 and 80% by 2050. Work carried out by the NHS Sustainable Development Unit (SDU) for England indicates that the NHS would need to achieve a 10% reduction on 2007 levels by 2015 to be in a position to meet the legal imperative. The act also highlights the requirement for climate change adaptation plans to be in place based on projected climate impacts relating to weather, specific illness, commodity price rises, increased migration and social impacts e.g. increased inequalities.

The case for sustainability in healthcare is clear. There is sound evidence that many components of sustainability achieve cost reductions and immediate health gains. It ensures the development of a sustainable system which reduces inappropriate demand, reduces waste and incentivises a more effective use of services and products[1].

A sustainable service is a quality service and as the Outcome Framework is a catalyst for driving up quality, we feel that sustainability and carbon reduction should be specifically included as outcomes. It is important that we manage and monitor the use of resources in a way to build, rather than undermine, operative resilience for the future delivery of high-quality healthcare.

At present some standard carbon reduction information is collected through the ERIC returns and should be maintained in some form, in order to monitor the trends across the NHS. Sustainable Development metrics in the future may also include measuring inequalities of access to healthcare and would take in to account the adaptation requirements to climate change The SDU would welcome the opportunity to work with the DH to ensure that the outcome framework for the NHS contains the most suitable sustainable development metrics and measures

In summarythe NHS SDUstronglyrecommends thatthe DH considersand truly embeds an integrated approach to social, economical and environmentalsustainability intofuture NHS structures and functions. It is our duty of care forthe health of current and future generations.

Please do not hesitate to contact the unit for any further clarifications or questions in relation to this response. Thanking you for the opportunity to respond to the White Paper

Yours Faithfully,

Sonia Roschnik Hannah Greensmith

Operational Director Project Manager

NHS SDU NHS SDU

[1] Decision making in the NHS using Marginal Abatement Cost Curves: Save Money by Saving Carbon, 2010. Cambridge: NHS Sustainable Development Unit.