Written evidence submitted by the Department
of Health |
1. This submission covers the Department of Health
and its Executive Agency but does not include the Department's
Arms Length Bodies. It does not cover broad sustainable development
issues in the NHS, except where the SDC had a specific support
2. There are a number of areas where we believe
that the mechanisms for ensuring sustainability of operations
are working well in our sector, notably:
- the use of Sustainable Operations on the Government
Estate (SOGE) reporting process and the Key Performance Indicators
that are the output of this process;
- the role of the Centre of Expertise in Sustainable
Procurement (CESP) part of the Efficiency and Reform Group of
the Cabinet Office.) in liaising with Departments and monitoring
- the role SDC has played in a Sustainable Development
Programme in the NHS and in embedding sustainable development
as part of DH policy making
How can mechanisms to ensure the sustainability
of Government operations, procurement and policymaking be improved
and further embedded across Government Departments?
3. Whilst the current mechanisms are working
effectively, we believe that the introduction of single reporting
arrangements with associated monitoring and continuous review,
which includes all aspects of property performance, would be more
efficient. Reporting cycles should be consistent, with a single
system for all building and operations related data collection
for all purposes including Sustainable Development in Government
(SDIG), High Performing Properties (HPP), carbon budgets, Carbon
Reduction Commitment Energy Efficiency Scheme (CRC) and Her Majesty's
Treasury Financial Reporting Manual (HMT FReM)
4. In relation to target setting, there should
be greater recognition of the improvements in sustainability already
undertaken. If not this reduces the ability to meet a target set
across the board. The recent exercise for assessing the percentage
reduction each Department needed to make towards the Prime Minister's
10% carbon emissions reduction exercise is a good example of where
this took place.
5. The use of audits to assess the effectiveness
of procedures could be beneficial in term of raising profile and
awareness of sustainable practices as well as identifying specific
How can governance arrangements for sustainable
development in Government be improved, and how can sustainability
reporting by Government departments be made more transparent and
6. The requirement to meet the 10% reduction
has already made Government Departments more accountable for delivering
on sustainable development. The on-line reporting tool has increased
transparency and the publication of Departments progress against
the 10% target on the data.gov.uk website makes us more accountable.
7. There will come a point where the scope for
delivering further savings will diminish. However, the remit is
being widened to include Arms Length Bodies. This will mean that
Government Departments will be accountable for sustainable development
activities across more of their estate.
8. The requirement for all government bodies
to make a statement about sustainable development costs and usage
in their annual accounts should be extended. Sustainability should
be included in the Government wide Permanent Secretary's Annual
Statement of Internal Control
9. Sustainability should also be included in
the new governance arrangements for Department Boards and this
needs to filter through and feature in Departments other governance
Was the SDC successful in fulfilling its remit?
Which aspects of its work have reached a natural end, or are otherwise
of less importance, and which remain of particular continuing
10. From a Departmental perspective, the SDC
was successful in fulfilling its remit. It provided the Department
with invaluable help and advice during the development of the
Department's Sustainable Development Action Plan (SDAP).
11. We also feel that they fulfilled their role
as a watchdog of government in terms of appraising the effectiveness
of delivering sustainable development through the SOGE annual
exercise and reporting. As this role is now provided by the CESP
team, it is clear that this work has reached a natural end.
12. The Department does feel that it is important
that there needs to provision of awareness of the concept of sustainable
development with key sectors such as the NHS and increasing awareness
of the issues it raises. There should also be a function that
is able to encourage, stimulate and share good practise not just
across government but also the wider community.
13. In relation to the NHS Sustainable Development
Unit, the SDC played an important role in providing analysis and
data to underpin the publication of its landmark Saving Carbon,
Improving Health carbon reduction strategy for the NHS. This
analysis built on their previous experience with the education
sector. It revealed extensive carbon emissions arising through
NHS supply chain and travel, as well as building energy.
14. Under contract to the Department, the SDC
have embedded staff to work closely with our policy makers to
promote the use of carbon and greenhouse gas emissions (GHG) as
a consideration in policy design and appraisal, with a view to
avoiding "lock-in" to high-carbon policy, and helping
the NHS begin stabilising and then reducing its overall GHG burden.
15. From autumn 2008, the SDC's health team took
a more active role in helping to integrate sustainable development
in DH policy, assisting with general advice and awareness raising
on sustainability, and also providing more targeted support for
individual policy teams (eg healthy food, commissioning, policy
support, health inequalities, pharmaceuticals and social care).
- Systems review of how DH's policy machinery lends
itself to incorporation of sustainable development as a priority,
leading to a report for the SD team and the appointment of an
analyst to act as the central source of information and support
for analysts with regard to GHGs and sustainable development.
- Provision of evidence to the Marmot Review, leading
to greater understanding of the interaction between health inequalities
and sustainable development.
- Reframing climate change and other environmental
problems as critical to future public health, not solely issues
of NHS estates management.
- Policy pilots on World Class Commissioning and
the Healthier Food Mark, raising the profile of sustainable development
in these important policy initiatives.
- Participation in committees and working groups
such as the GES's Social Impacts Working Group and the sustainable
social care programme steering group.
- Provision of research and support to the Public
Health White Paper Team.
16. The provision of sustainable development
input into policy decisions remains important and the Department
will need to find alternative ways of delivering this, now that
funding has been withdrawn from the SDC.
In formulating a future architecture for sustainable
development in Government, how can it take on board wider developments
and initiatives (e.g. to develop "sustainability reporting"
in departments' accounts) and the contributions that other bodies
might make (eg Centre of Expertise in Sustainable Procurement)?
17. The key to taking on broader initiatives
and development is to ensure that there is a common platform for
data requirements and reporting and that definitions are understood
across the government community. CESP have adopted a more proactive
role in terms of data collection and verification. The key is
to minimise the requests for data, i.e. data is collected once
and then it can feed the many requests for data. This will free
up resources to actually implement and drive new initiatives and
18. From an NHS perspective it has been recognised
that the NHS cannot achieve ambitious targets for carbon reductions
in isolation, but rather in association with its partners, suppliers
and contractors. The Department's Procurement, Investment and
Commercial Division is working with the CESP to identify appropriate
19. NHS organisations are legally autonomous
and are therefore subject to legislative requirements such as
the EU Energy Trading Scheme (EU ETS) and the Carbon Reduction
Commitment Energy Efficiency Scheme (CRC) as a means of reducing
energy and carbon by a cap and trade approach.
What procedures specifically initiated in the
department have been most successful in improving sustainable
development? Why have these worked well? Which procedures have
not worked and why?
20. The Department first published a Sustainable
Development Action Plan in March 2006, focusing on the key contributions
set out in Securing the Future, delivering UK Sustainable Development
Strategy, March 2005:
- the NHS as a corporate citizen;
- food and health in the context of sustainable
food and farming;
- transport and health;
- healthy, sustainable communities; and
- health impact in partnership in the regions.
21. Good progress was made on these areas and
others, including the establishment of a good governance structure
and good performance in sustainable operations. These five key
contributions continue to shape our response, but within a far
more wide-reaching SDAP for 2007-08. Details of progress made
was published in the Sustainable Development Action Plan 2007-08
Progress report. We are now taking delivery of SD into a new phase,
guided by a new strategy and with an increased emphasis on policy,
which is where we feel we can have the most significant impact.
22. The Department produced its Sustainable Development
Strategy "Taking the Long Term View" in 2008.
Within this document, DH's overall aim is to improve health and
well-being for all. We want our approach to this task to be consistent
with the principles underpinning sustainable development. This
means that we need to understand the decisions we are making today
on the future: we need to explore how the future might be different
so that we do what we can to influence it for the better and adapt
23. This document also referenced the five principles
for sustainable development:
- Living within environmental limits.
- Ensuring a strong, healthy and just society.
- Achieving a sustainable economy.
- Promoting good governance.
- Using sound science responsibly.
24. The Sustainable Development Action Plan process
itself has helped to drive forward our SD agenda and enabled us
to identify colleagues across the Department to take a leading
role for each of the nine opportunities. The programme infrastructure
we put in place to support and monitor delivery of the SDAP has
been very helpful. This includes managing the SDAP as a programme
of work; putting in place a programme board and a steering group;
using the DH project management approach; monitoring and reporting
25. The DH produced its Climate Change Plan in
spring 2010. In this document, the Department set out its initial
priorities and intentions, which articulate how they will contribute
to reductions in carbon and how and where their efforts will be
directed in terms of adapting to climate change. Through the actions
set out in the Climate Change Plan the department is confident
that the health and social care sector can play its part in reducing
carbon and that we can make the transition to delivering health
and well-being for all in a low carbon future.
26. The Department has established a Green Champions
network, members of staff (currently about sixty strong), who
have volunteered to help raise staff awareness and increase staff
engagement of Sustainable and Efficiency issues. The network runs
seasonal missions to highlight specific topics, for example Green
travel and leisure and the forthcoming missions, which compliments
the PM's energy efficiency competition, will be on reducing your
personal carbon at work and at home.
27. The move to a managed print service and the
rollout of Dynamic Desktop (Ultra Thin Client) puts us in a good
position. Facilities managers have been working to help meet the
target since the PM set the challenge in May by making changes
to cooling and lighting for example.
28. We have struggled to introduce an Energy
Management System (EMS). This has been down to the lack of drive
from our Facilities Management suppliers, as this didn't form
part of the contract. It also proved difficult to get sign up
to some of the polices which are an integral part of the EMS.
We have just awarded a new contract for provision of our Facilities
Management and the contract includes the requirement to deliver
an EMS system.
To what extent are civil servants in your
department made accountable for working more "sustainably"?
29. The department currently records details
of its rail and taxi expenditure based on unit headcount, by directorate
on a quarterly basis. As from Quarter 2, 2010-11 these statements
will include an estimated CO2 equivalent. This data
will be published on the DH intranet enabling staff to monitor
what progress the department and individual directorates are making
in reducing their carbon footprint.
30. The department also makes transparent its
printing costs and these are now re-charged to individual directorates.
Transport costs are also devolved down to the individual cost
centres. Sustainable Development and DH's Carbon footprint are
both measures that are reported in the quarterly Corporate Scorecard.
31. DH staff have been made aware of the cross
Government competition, which commenced on 30 September, with
the display of the league table showing the performance of each
Department's headquarters energy consumption, being published
on the DH intranet. All staff are being encouraged to make a personal
contribution to saving energy and are encourage to make a pledge
on our discussion database.
What would help Department of Health engage more
effectively with the bodies set up by Government to deliver sustainable
32. Engagement with bodies such as CESP and the
Central Management Carbon Management Programme have been working
effectively. We need to continue to work with these bodies to
share good practices and learn from some of the more innovative
ideas and how they can be implemented. While there are sustainable
development workshops where good practice can be shared, it would
also be helpful to have discussion forum or shared website where
ideas and issues can be raised and help provided by the Government
Sustainable Development community.
33. It is important that the bodies we deal
with continue to have the expertise and experience to help us
meet our targets and that they have knowledge of our business,
which would help us to adapt initiatives accordingly.
34. Some appreciation that not all those involved
with the sustainable development agenda are London based and consideration
could therefore be given to more sustainable approaches to holding
meetings and workshops so all can be involved.
35. We do receive numerous requests for data,
from different parts of the organisation for similar data items,
often with very tight timescales. It would be extremely helpful
if requests for data could be streamlined and collected centrally
and then made available more widely. Along with more realistic
timescales, this would reduce the pressure on our limited resources
and ensure consistency of data quality.
How has the Sustainable Development Commission
(SDC) contributed towards improving the sustainability of your
Department? How much money has Department of Health saved, over
what period, by implementing measures recommended by the SDC?
36. The data collection and reporting process
established by SDC has enabled us see a level of KPIs that is
consistent across Government and the traffic light and five star
rating proved invaluable. This was only used by the core Department
and our Executive Agency.
37. With investment from DH, the SDC's Good Corporate
Citizenship Assessment Model (GCC) was launched in February 2006,
followed up by a strong programme of advocacy via publications,
events and working in depth with NHS organisations. It quickly
established itself as the leading sustainability benchmarking
and learning tool, and by September 2010 (in its second version)
over 80% of all NHS Trusts were registered as users
(exceeding the 2010-11 target after only six months).
38. The impact of the GCC was studied in 2010,
with recommendations offered to DH and NHS. SDC have advised us
that without more extensive research, it is impossible to quantify
the impact of potentially thousands of actions inspired by the
GCC in hundreds of NHS organisations nationally. However, based
on feedback, case studies and levels of interest in the GCC, it
is likely to have had significant impact.
To what extent does the SDC's Sustainable Development
in Government (SDiG) reporting process provide an effective means
of monitoring the Department's performance?
39. This is a very effective way of monitoring
our performance and is the main vehicle by which we do so.
How does the Department verify the data it submits
on Sustainable Operations on the Government Estate (SOGE) targets?
How might the submission and verification procedure be improved
under the new SDiG process?
40. We work in tandem with CESP for both data
collection and verification of the data, which is a continual
process within a set timeframe. Verification is done using actual
invoices and utilising our FM supplier for the data and feedback
on the outputs from the CESP team.
41. We currently initiate an annual internal
audit of our property benchmarking data. We could extend the audit
remit to cover the SOGE data. This will provide us with an independent
assessment that we are handling and reporting our data correctly
13 October 2010