LPFT Green Plan 2022 - 2040

Green Plan Contents

1: Foreword

Climate change, its effects on the environment, and the health and wellbeing of the global population is now recognised on a global scale.  The UK and Lincolnshire are not immune from the health harms and impacts of climate change.  As a coastal county some areas of Lincolnshire are at serious threat of flooding from future rising sea levels as a result of climate change, so it really is close to home.

Responsibility for tackling climate change and reducing carbon emissions cannot be achieved by Government or governing bodies alone, and everyone needs to play their part and contribute, no matter how small their contribution.

Across the NHS in Lincolnshire, and with our county and district council partners, we are steadfast in our resolve to really making a difference and achieving our collective Net Zero Carbon targets and ambitions.  We are working together and recognise the benefits and opportunities that a Greener NHS can have on health inequalities, improving social value and our roles as anchor partners.  We have adopted Lincolnshire County Council’s three guiding principles:

•    Don’t waste anything.
•    Consider wider opportunities.
•    Take responsibility and pride.

Here at Lincolnshire Partnership NHS Foundation Trust, Lincolnshire Community Health Services NHS Trust (LCHS) and United Lincolnshire Hospitals NHS Trust (ULHT), we are fully committed to playing our part in tackling climate change, not only to benefit the environment globally, but also to contribute to, promote and support, the health and wellbeing of the local community which we serve. 

With the energy and commitment of all departments and individual members of staff within the Trust, we will endeavor to look at every aspect of our business and the services we provide, taking a holistic approach to reducing every aspect of our environmental footprint, whilst working hard towards to providing sustainable high-quality services for present and future generations.

2: Executive summary

Carbon reduction targets

The future capital investment required to reach carbon reduction targets: Circa £23,500,000

3: Introduction

Who we are and what we do?

Lincolnshire Partnership NHS Foundation Trust (LPFT) were established on 1 October 2007 under the National Health Service Act 2006, and it was the first NHS mental health organisation to become a foundation trust in the East Midlands. LPFT is based across 45 sites and has 11 inpatient wards in the county, supporting 50,000 service users in 2020-21. Lincolnshire is a large rural county covering 2646 square miles, with a Lincolnshire population of 755,000 and a Northeast Lincolnshire population of 160,000. These services are provided by 2,700 members of staff across many disciplines of mental health, learning disability and social care, who provide the best possible care and support.

The Trust provides specialist health service for people living in Lincolnshire with mental health problems, learning disabilities or autism, and a range of specialist mental health services to some areas outside the county boundary. 

The work of the Trust is increasingly community-based. It provides a wide variety of mental health, learning disability and social care services in close partnership with colleagues in local councils, clinical commissioning groups, charitable and voluntary organisations, as well as with service users, carers, and their representatives. The Trust always aims to provide people with alternatives to admission and where appropriate, to provide treatment, care, and support outside a formal hospital setting.

LPFT Vision

Supporting sustainability through the provision of effective and efficient health and social care in partnership with local communities.

This vision is derived from, and supported by, the Trust’s Quality and Estates Strategies, notably in respect of working in partnership with others, providing care closer to home, increasing the efficiency of services, through transformational change, and rationalising the Trust’s estate. LPFT is actively involved in the wider Strategic Transformation Partnership (STP) programme, progressing partnership working initiatives with LCHS/ULHT.  It is a member of Lincolnshire’s Climate Change Commission and part of the Health Estates Facilities Management Association (HEFMA) sustainability working group.

LPFT is committed to developing and implementing strategies to become more sustainable and reduce carbon emissions, in order to meet the NHS Net Zero commitment, with our Chief Transformation Officer, Chris Higgins, as Executive Lead.

4: Drivers for change

In 2019, global carbon emissions from fossil fuels and industry reached a high of 36.44 billion metric tonnes, with the four warmest years on record having occurred since 2015, and a predicted temperature rise of 1.5°C over the next two decades.  The changing climate is leading to more frequent heatwaves and extreme weather events such as flooding, including the potential spread of infectious diseases to the UK.  Almost 900 people were killed by last summer’s heatwaves; additionally, nearly 18 million patients visit a GP practice in an area that exceeds the World Health Organisation’s (WHO) air pollution limit.

Without action, temperatures will increase; water levels will continue to rise creating increased flooding risk, alongside increased risk and spread of infectious diseases. 

The NHS has been taking action to reduce its impact on climate change; however, it recognises more can be done. The NHS contributes to 4% of England’s total carbon footprint. The NHS’s challenge is not simply to reduce this impact, but also to become adaptive and resilient to the climate challenge, to ensure it remains capable of delivering patient care. 

The NHS began tackling its carbon footprint in 2008, against a baseline from 1990, in line with the Climate Change Act (2008); this data has been used to create the trajectory for NHS Net Zero. Reported as the NHS Carbon Footprint, the data must also include emissions from The Greenhouse Gas Protocol (GHGP).

• GHGP Scope 1 – Direct Emissions from owned or directly controlled sources, on site.
• GHGP Scope 2 – Indirect Emissions from the generation of purchased energy, mostly electric.
• GHGP Scope 3 – All other indirect emissions that occur in producing and transporting goods and services, including the full supply chain.
• The NHS Carbon Footprint Plus includes these three GHGP scopes, in addition to the emissions from patients, visitors and staff who travel to and from the NHS services and medicines used at home.

4.1  Legislation 

The UK, under its obligations of the Paris Climate Change Agreement, set out targets for the reduction of carbon emissions under the requirements of the Climate Change Act (2008) and further updated these requirements within the Climate Change Act 2008 (2050 Target Amendment) Order (2019). 

The NHS targets are more ambitious, with the net zero targets set as follows:

• For the emissions we control directly (the NHS Carbon Footprint), net zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032.
• For the emissions we can influence (our NHS Carbon Footprint Plus), net zero by 2045, with an ambition to reach an 80% reduction by 2036 to 2039.

5: Carbon emissions and the LPFT carbon footprint

5.1 Carbon Emissions

Carbon is produced as the result of burning fossil fuels such as: gas, coal, and oil. As depicted in the picture, industrial chimneys emitting fumes into the atmosphere, which has carbon embedded in the fumes.

5.2 LPFT Carbon Footprint

Based on energy and Trust business travel data, collated for the financial year 2019/20 for areas covered by the NHS carbon Footprint Scopes 1,2 and 3, LPFT emitted 5,349 tonnes of carbon into the atmosphere. This is the same as making 58 round trip flights from East Midlands Airport to Alicante in Spain.

The challenge, carbon reduction targets and progress

The first major carbon reduction milestone set by NHS England, is to reduce our overall 2019/2020 baseline year carbon footprint by 80%. This equates to reducing our carbon emissions by 4,279 tonnes over the 12 year period.

To reach the 80% target for the reduction in our carbon footprint for energy, the Trust will need to have reduced its carbon emissions by 1,614 tonnes by 2032.

To reach the 80% target for the reduction in our carbon footprint for business mileage, the Trust will need to have reduced its carbon emissions by 2,665 tonnes by 2032.

To meet the target of an 80% reduction in carbon emissions we can control by 2028/2032, and Net Zero by 2040, is a big challenge and will require a lot of capital investment, and a change in the Trust and staff behaviors. As we work towards and get closer to these targets, the opportunities, and areas where we can reduce carbon emissions, will reduce, and become harder to find.  Where NHS Trusts find it difficult to fully achieve the decarbonisation targets, any carbon emissions that cannot be reduced or removed, can be offset by buying carbon credits. The cost of carbon credits is expected to be £30 - £60 per tonne of carbon by 2030.

5.3 What is carbon offsetting and carbon credits?

A carbon offset broadly refers to a reduction in Green House Gas emissions – or an increase in carbon storage (e.g., through land restoration or the planting of trees) – that is used to compensate for emissions that occur elsewhere. Purchasing offsets should be a last resort, after other measures to reduce or avoid emissions have been explored.

A carbon credit represents either the permanent removal of a tonne of CO2e from the atmosphere, or the avoidance of one tonne of CO2e being emitted in the first place, through changes in land use or energy generation. One of the most common forms of carbon offsetting in the UK is the creation of new woodland areas, the annual carbon emissions removed by the newly created woodland, offsets the equivalent amount of carbon  generated somewhere else.  Businesses and organisations can either create their own new woodland area to directly offset carbon emissions, or one of the most popular and easiest ways, is to purchase carbon credits, whereby another business or organisation creates a new woodland area, and then sells the carbon removed from the atmosphere to other businesses and organisations in the form of carbon credits.

As mentioned above, once all avenues to reduce carbon emissions have been fully explored and acted upon, where it is not feasible or financially practicable to eradicate some emissions, carbon offsetting can help organisations to fully meet Net Zero expectations, but this comes at a price. If the Trust decided not to invest anymore time and money in reducing our carbon footprint to Net Zero, and used carbon offsetting instead, not only would this be morally wrong, as demonstrated in the graph below, it would be extremely costly to the Trust.

The graph below demonstrates the following:

Red bars = Annual carbon emissions if we do nothing, based on an annual increase in carbon emissions of 5%. This is based on the average increase in staff and services provided by the Trust over the last six years.

Green bars = Annual carbon emissions if we continue to invest in sustainability.

6: Pathway to sustainability

LPFT will take an organisation wide approach to sustainability, working towards building healthier, resilient, more sustainable communities.  This will be achieved by reducing carbon emissions, providing, and promoting sustainable healthcare, whilst supporting and promoting healthier lifestyles for Trust staff, patients, and the wider community, whilst working in partnership with local authorities, partners and other NHS organisations, and suppliers.

To help us work towards meeting our objectives and targets, LPFT will be concentrating on sustainability in the following areas of focus:

•    Work Force and System Leadership.
•    Sustainable Models of Care.
•    Digital Transformation.
•    Travel and Transport.
•    Estates and Facilities.
•    Medicines.
•    Supply Chain and Procurement.
•    Food and Nutrition.
•    Biodiversity and Green Spaces.
•    Adaption. 

Historically the term sustainability has often been used with regards to finance and cost saving programs, but the truth is that sustainability encompasses everything we do both at work and in our home lives.

Sustainability means ‘meeting our own needs without compromising the ability of future generations to meet their own needs’.

Sustainability within LPFT and the wider community is everyone’s responsibility, and we all need to work together to ensure we can meet our sustainable goals and objectives.

6.1 Workforce and system leadership

LPFT has already made great strides in supporting staff to work more flexibly, whether working from home or providing clinical services remotely, but, in order to successfully embed sustainability, it must become part of all our processes, and it must be a consideration of all activities, leading to behavioral and operational change.

To support staff, LPFT will:

• Provide a dedicated Energy, Environmental and Sustainability intranet page to allow all staff to access available sustainability information and promotions that support active and more sustainably means of travel.
• Encourage staff to increase their knowledge and awareness of sustainability via the Building a Net Zero NHS or the Environmental Sustainability in Quality Improvement training  available on the electronic staff record (ESR). Additionally, over the coming years LPFT will look how to further promote and support learning, development, and training opportunities so that its workforce is aware and able to contribute to the organisation’s goals and objectives.
• As a key aid to supporting and promoting sustainability, LPFT will look to recruit a voluntary team of Green Champions from within the existing staff structure. Green Champions will work together to promote and embed sustainability at a more local level across all Trust sites, whilst contributing to the Trust’s sustainability ambitions, through meetings and workshops.  

6.2 Sustainable models of care

Our Vision: Supporting sustainability through the provision of effective and efficient health and social care in partnership with local communities. 

The pandemic accelerated the influence digital changes on Trust services, but there continues to be more we can do to influence and embed sustainable care models.

With more patients being treated in the community, sustainable care will be even more important to ensure operational efficiency too. However, equity of service is important, and we recognise digital methods will not always be appropriate. Recognising our impact on the environment will help us to improve patient care. Identifying and supporting activities that prevent clinical intervention and reduce demand, will lead to improved health and wellbeing in the community we serve.

To achieve its objectives, LPFT will:

• Provide more services in the community and closer to people’s homes to reduce travel in and out of the area.
• Continue to develop sustainable working practices to reduce travel, whilst ensuring the best patient outcome.
• Develop mental health crisis cafes and other community-based support services, to provide more local places to go for people in need of mental health support. This will enable a reduction in travel for staff and patients, and a reduction in patient transport journeys, carried out by the Police, ambulance service and mental health transport providers.

6.3 Digital transformation

Our Vision: To support sustainability and sustainable healthcare through the provision of effective and efficient use of digital technologies.

LPFT is fully aware of the need to reduce carbon emissions and the impact it has on the environment, and will look to embrace digital transformation, whilst maintaining a high standard of clinical service and patient care. 

To achieve its objectives, LPFT will:

Buildings and networks

• Ensure all buildings will have speed network access and dynamic workspaces allowing any member of LPFT to work in any building to reduce travel.
• Continue to invest and develop on-line collaboration tools to promote virtual meetings and interactive working via the internet.
• Create a framework and the right technology to allow LPFT staff to work from anywhere (local, national, or international).

Systems and paper

• Reduce and replace traditional paper processes with electronic processes to reduce paper use.
• Build on its paperless approach and develop its Electronic Paper Record, Electronic Prescribing and Medicines Administration and other corporate processes.

Supporting Care

• Ensure staff have modern and up to date technology so they can work from any location and prevent trips to IT for repair.
• Work with patients, service users and advocates to ensure they have access to healthcare via digital means and are included in our digital journey. 
• Offer care and support via digital means to prevent travel where appropriate.
• Build on our ‘digital first, not only’ approach and support those patients and service users who wish to access our services digitally.

Using data 

• Use data and analytics to ensure resource and workforce planning is evidence based.
• Work with clinical services to support teams to use data themselves to target resources at the areas in need.

6.4 Travel and Transport

Our Vision: To reduce the negative impacts from travel by supporting staff and patients to use more sustainable forms of travel to our sites.

Promoting and increasing sustainable forms of travel used by Trust staff, patients, and visitors, and reducing the number of journeys taken using unsustainable forms of transport, can have a range of benefits, including helping to improve health by reducing air and noise pollution, to improving health through increased physical activity. 
 
To achieve its objectives, LPFT will:

• Install electric vehicle charging across the Trust Estates to provide an infrastructure to support and promote the use of electric vehicles.
• When a sufficient EV charging infrastructure is in place at LPFT sites, all new Trust fleet leased vehicles procured to be ultralow or zero emission vehicles.
• Produce a travel plan to promote and encourage more sustainable modes of transport or active travel for both staff, patients, and visitors alike.
• Introduce secure cycle parking with electric bike charging stations, and facilities for staff changing, to include showers and lockers.
• Engage and work with suppliers/contracts to work towards a transition to ultralow or zero emission vehicles.
• Create a baseline for business mileage and target for improvement.
• Track carbon emission from staff business travel.

6.5 Estates and Facilities and Capital Projects

Asset Management and Utilities 

Our Vision: To work with the staff and Estates teams to ensure buildings and services are managed safely and efficiently in order to reduce costs and limit the environmental impact of the Trusts estate.

LPFT fully understands that its estate consists of a number of different sites and buildings that vary in size, age, condition, and use, but the one thing that all buildings need to have in common is energy efficiency. Therefore, the Trust will be taking an approach to improve energy efficiency of buildings to ensure maximum benefit when sustainable forms of heat energy generation and forms of renewable energy generation are installed.

To achieve its objectives, LPFT will:

• Identify areas for energy efficiency improvements through energy and six facet surveys and calculating the carbon output of each building from energy consumption.
• Refurbish and upgrade existing estates by improving the building fabric i.e., insulation levels, windows, and doors to increase the thermal efficiency of a building.
• Upgrade existing equipment such as building management control systems, install energy efficient LED lighting and equipment, to improve the energy efficiency of buildings.
• Sustainable sources of heat energy and renewable Energy Sources i.e., heat pumps and photovoltaic panels will be installed across the trust estate as and when buildings have been sufficiently upgraded to increase their thermal and energy efficiencies.
• New and emerging sustainable and renewable technologies will be constantly reviewed with professional advice sort for suitability of use.

Utilities

• Facilitate electrical supply onto a zero-carbon tariff.
• Energy consumption data monitoring and recording to be increased to highlight areas for improvement and capture carbon emissions, by installing smart metering and sub-meters where applicable. 

Capital 

New builds and refurbishments will be developed and constructed in accordance with the NHS ‘Invest to save’ initiatives, ensuring high levels of energy efficiency are met, contributing to significant reductions in carbon emissions or net zero (incorporating Modern Methods of Construction – modular units).
Waste & Recycling 

100% of waste generated by LPFT is diverted from landfill. This is achieved through various forms of recycling and sending our offensive waste stream to an EFW (Energy from Waste) power generation site, helping to minimise our carbon footprint from waste. 

6.6 Medicines

Our Vision: To work with staff, patients, and suppliers to reduce the impact of medicines on the environment from carbon emissions and waste.

• LPFT does not use anesthetic gases.
• LPFT will work with, and be supportive of, sustainable initiatives introduced by the Integrated Commissioning Board (ICB) and primary care colleagues.   
• LPFT will review how it collects and recycles any current aerosol metered dose inhalers when patients bring them into Trust settings.
• LPFT will encourage patients to return their inhaler devices and used medicines packaging to pharmacies for green disposal.

6.7 Supply Chain and Procurement

Our Vison: To promote and support sustainable procurement to reduce the impact of carbon emissions on the local and wider environment. 

Supply chain and procurement accounts for approximately 60% of all NHS carbon emissions. To support the reduction in carbon emissions LPFT will continue to follow national NHS guidelines for sustainable procurement, whilst endeavoring to explore all avenues, at a local level, to maximise opportunities for sustainable procurement, whilst supporting the local economy.

Our Vision: To support sustainability by working with suppliers, staff, and patients alike to support and promote the provision of sustainably sourced food products and meals, whilst ensuring quality and nutrition.

To achieve its objectives, LPFT will:

• Where possible, procure locally sourced food products.
• Work with main food suppliers to ensure they are working towards achieving Government set targets for carbon emission reductions.
• Work with staff and patients to reduce food waste.

6.8  Food and Nutrition

Our Vision: To support sustainability by working with suppliers, staff, and patients alike to support and promote the provision of sustainably sourced food products and meals, whilst ensuring quality and nutrition.

To achieve its objectives, LPFT will:

• Where possible, procure locally sourced food products.
• Work with main food suppliers to ensure they are working towards achieving Government set targets for carbon emission reductions.
• Work with staff and patients to reduce food waste.

6.9 Biodiversity and Green Spaces

Our Vision: To develop our spaces in a way that reflects the importance of green spaces and natural environments for people’s health.  Biodiversity is the complex network of all living things on our planet. 

To ensure that we are sustainable, we must do all we can to complement the plant and animal life in our communities and reduce any negative impacts. Green spaces are an important feature of our sites; not only do they improve the natural aesthetics, making our sites more appealing, but they also play an important role in maintaining local air quality and patient wellbeing. All LPFT sites have some green space, either on the site itself, or nearby, that can be further promoted for activities, relaxation or food growing.

As a Trust we intend to develop a group of Green Champions throughout the Trust who will be able to identify and help to develop our green spaces.

To achieve our objectives LPFT will:

• Identify areas of grassed space that can be enhanced by the introduction of wildflower meadows, that will not only encourage and support pollinators and biodiversity but will also reduce the areas of grass that require regular cutting, therefore reducing the carbon emissions emitted by fossil fuel lawn mowers.
• Actively support Trust staff to develop green spaces within their own working environments.
• Identify areas on Trust sites where shrub beds require rejuvenation or improvements.

6.10 Adaption

Climate change is one of the biggest public health threats and challenges that we face. Extreme weather conditions, such as flooding and heatwaves, are becoming more frequent and severe. This section considers how our organisation’s infrastructure, services, procurement, local communities, and colleagues are prepared for the impacts of climate change.

The Trust is part of a wider NHS system that must consider the following risks relating to climate change: 

• People/population risks, e.g., changes to disease patterns, changes to the health needs of population, social and community impacts including vulnerable communities, migration, and mental health.
• System risks, e.g., resilience to normal ways of protecting health and delivering care, business continuity, workforce and service delivery including training requirements. 
• Infrastructure risks, e.g., buildings, transport, supply chain, getting to essential services as A user or staff, resource use, scarcity and continuity including energy, food, and water. 
• Risks posed by specific event, e.g., heat, cold, floods, air quality. 

LPFT must remain flexible and alert to the constant changes and challenges the environment poses, and in order to achieve this, the Trust will:

• Follow NHS policy guidance for climate adaption as it is issued. 
• Continue to update our extreme weather policy and resilience action plans, including reviewing and updating the Heat Wave Plan. 
• Improve estates to ensure insulation for cold weather and cooling for hot weather as described in the Estates section.
• Continue to develop digital transformation.

7: Governance and measuring progress

7.1 Governance    

The Green Plan is the key sustainability, Trust Board approved document. Members of the Green Plan Committee are responsible for the content of the plan and for ensuring that the action plan is completed.

The Trust must ensure compliance with sustainability legislation, regulations, and best practice guidelines, and must contribute to the national sustainability targets. Compliance with legislation, regulations and best practice guidelines is monitored by the Trust’s compliance officer and the energy and sustainability team, with quarterly reports submitted to the Trust Board, Sustainability Committee and Health & Safety Committee.

Responsibilities
The Director of Operations is the Trust’s lead for sustainability, supported by the Associate Director for Estates and Facilities, and Energy Environment Sustainability Manager.

Reporting
The Trust is required to report its emissions annually, in order to satisfy a number of legislative, NHS and Department of Health and Social Care requirements. 

Sustainability is reported though a number of annual and quarterly reports, both at national and Trust levels.

7.2 Measuring Progress

To ensure that LPFT is delivering on its promises, both locally and nationally, it will have an action log for all areas of focus, with quarterly meetings of a Green Plan Committee to monitor progress and implement further actions or escalate actions if required.

For carbon emissions and energy usage, baseline data has been collated for the financial year 2019/20, against which all progress can be measured.

The main area of work will evolve around de-carbonising the Trust’s estate and reducing emissions from Trust business travel.

A Smart action plan will be produced, which will be under pinned by a formal programme of works to capture all planned project work that will be carried out to LPFT buildings to reduce carbon emissions, including installation of electric vehicle charging stations. 

The formal programme of works will be produced to identify person/s responsible for each project, whilst showing timescales for planned projects that will be deliverable within the required time frames. Timeframes will be linked to the projected carbon emission reductions to ensure reduction targets are being met. 

Each project will have its own specific individual programme, so progress can be monitored to ensure the main programme stays on track and the Smart actions are being achieved, in line with projected carbon emission reductions. Other actions such as promoting active, or more sustainable, modes of transport will also be recorded. 

Progress for all projects will be monitored and tracked by the Green Plan Committee, whilst annual data for the reduction in carbon emissions will be produced as a carbon footprint, to show carbon emissions and reduction in tonnes for energy consumption and travel and transport.

Carbon emissions will be calculated and reported to the Green Plan Committee and Sustainability Committee quarterly for for energy, waste & water, and business mileage.

8: 2028/2032 carbon reduction ambitions

LPFT is not only fully committed to the afore mentioned actions to reduce its carbon emissions by 60% by 2025, but the trust is also fully committed in its ambitions to achieve the target of an 80% reduction in carbon emissions by 2028/32, based on 2019/20 carbon emission data.

Progress, strategies, and plans will continue to be monitored and reviewed, ensuring all opportunities and avenues are exploited and taken in order to achieve the extra 20% carbon emissions reduction required between 2025=2028/32. The Trust will continue to invest its own capital moneys, and any funds obtained from government grant schemes, in the de-carbonisation of the LPFT estate, by reducing our reliance on fossil heating systems and increasing our use of sustainable renewable energy sources.

LFPT will continue the drive to promote, encourage and support trust staff, patients, and visitors to use of more sustainable modes of transport, from electric vehicles to public transport, or more active modes of travel. 

The further down the path we get in our quest to reduce our carbon emissions, the opportunities in each area of focus to reduce carbon emissions will become harder to come by and targets harder to achieve. To ensure our journey continues, digital technology, and innovation with regards to how we work and provide patient services, will need to play a significant part.  Another key area is cultural change, with regards to sustainability and how we lead our everyday lives both at work and home. Cultural change will continue to be supported and promoted through education, awareness training, and information supplied via the communications team will also play significant part in achieving our target.  All efforts to reduce our carbon emissions and impact on the environment, no matter how small, whether by departments, groups, or individuals, will help the Trust to reach our goals.

9: What have we achieved so far?

LPFT has been working hard and investing time and money into sustainability projects across the Trust, to support the reduction in carbon emission from energy, waste and water, and business travel. Since April 2021 LPFT has invested £1,283,352 in sustainability projects, to increase the energy efficiency of our properties, and support the use of electric vehicles by installing an infrastructure of electric vehicle chargers across Trust sites.

Along with financial investment, time and energy has also been focused on promoting and supporting Trust staff to become more aware of sustainability, the impacts on climate change, and how they can support the Trust, the local community, and the wider global population, by making small changes in their everyday behavior both in their working and home lives.

As a result of this, LPFT as of 2023/2024, has managed to reduce its carbon footprint by 2522 tonnes of carbon (44%). £1,283,352 has been invested in energy efficiency and carbon reduction.

9.1 How have we invested the money?

Correctly insulating a loft can reduce the overall heat loss from a building by 25%. So far LPFT has invested £184,755 on improving loft insulation across various Trust properties. Levels of loft insulation have been increased from an existing depth of 100mm to a depth of 300-400mm, saving heat lost through a roof by up to 50%.

91,906 has been spent on upgrading old fluorescent lighting, to energy efficient LED lighting across six Trust properties. Lighting accounts for approximately 20% of energy use in a building, with LED lighting saving approximately 80% in energy efficient when compared to fluorescent lighting.

Where the Trust had properties, with gas boilers that where 30+ years old and only about 50% energy efficient and required immediate action to maintain the heating systems for clinical services, we invested £188,500 on new 96% energy efficient gas boilers. Although still fossil fuel, they will help to reduce carbon emissions for those properties by  30 - 40%, until low carbon heat sources can be installed.

In Oct 2022, LPFT removed all the old gas boilers and waters at the Sycamore Unit, and invested £311,000, of which £111,500 of funding provided by the Public Sector Decarbonisation Scheme 3a, to install our first Air Source Heat Pumps to provide heating, and electric point of use water heaters for domestic hot water. As a result of this we have saved approximately £ 3,000 in energy costs, and 50 tonnes of carbon annually.

Since 2023, 87,557 has been invested in building management systems (BMS) and energy metering. The new BMS systems will significantly improve the control of the heating, hot water and ventilation within the respective properties, providing an annual saving in energy consumption and carbon emissions by 10-15%.

9.2 Major Capital Projects

LPFT has been and is continuing to invest heavily in new inpatient facilities, which not only eradicates dormitory style accommodation as the main objective, but also provides new energy efficient buildings, help to further reduce our energy consumption and carbon emissions.
 

Peter Hodgkinson Centre

£21 million has been invested in two new wards have been constructed at the Peter Hodgkinson Centre on the Lincoln County Hospital site. Designed to meet all the latest building regulation energy efficiency requirements, the project also included an investment of £180,000 in the installation of a roof mounted 88kW solar PV array.

Norton Lea

Work has started on a £41 million investment to provide what will be our first completely Net Zero inpatient facility in Boston. All heating and hot water will be supplied via Air Source Heat Pumps, whilst the grid supply of zero carbon electricity will be supported by 118 kW solar PV array. When compared to conventional construction design, to achieve net zero added approximately an additional £2 million to the cost of the project.

9.3 Travel and transport

To support sustainable travel and the use of electric vehicles, LPFT has invested £239,634 in the installation of 16 double charge point electric vehicle chargers, across seven Trust sites in Boston, Grantham, Skegness, Sleaford, and Lincoln.

To support sustainable travel for Trust staff, working in partnership with the Stagecoach bus company, LPFT has set up a salary deduction bus travel discount scheme, around Lincoln and the surrounding villages. This can be used seven days a week, 24 hours a day.

9.4 Workforce and system leadership

To help support Trust staff join us in our quest to live and work more sustainably, various initiatives have been put in place to help educate, inform, and encourage staff to become more involved in their workplace reducing waste, energy usage, and to become more aware of their environment and climate change.
A network of voluntary green champions has been set up, recruiting staff from different sites, departments, roles, and levels of responsibilities, to help support and promote sustainability across the Trust.  

Regular communications are sent out via newsletters, the Trust intranet, and Facebook, to promote sustainability and any special events. The Energy Environment Sustainability team has instigated a series of conversations with the executive leadership and their teams, to discuss understand and support, what sustainability means to them, and how they can work and support the Trust with its ambitions to become net zero.

Sustainability is promoted at new staff induction day, to inform new starters what information is available and howe they can help support the Trust with its green ambitions.
 

9.5 Medicines

LPFT Pharmacy have implemented Electronic Prescribing & Medicine Administration (ePMA) across all inpatient sites within the Trust, which has reduced the business travel to sites to physically check prescriptions. It has also enabled medical staff to remotely prescribe and lessen their need to be on site, especially if on call or covering many sites over a week. The plan is to roll this out into the community teams by the end of the year to give the option of even further lessening the carbon footprint from driving. It also means that we have significantly reduced the need for paper charts and the impact of producing those has on the carbon footprint within the trust.

Consideration has been given as to whether we can recycle the blister strips from medicines, but with the pharmacy waste regulations and the type of client group that we care for, currently it has been assessed as a high risk to segregate these out or ask for a third party to remove them. There is also the risk of medication being left in the blister strips and so allowing patients potential access to medication that could harm them. 

However, all pharmacy waste bins are sent for high temperature destruction, and they are often sent to a waste plant that uses the heat to generate electricity for the national grid so turning waste in to a form of energy.
 

9.6 Waste and recycling

A new Trust waste strategy is being implemented to support recycling with an aim to improve recycling rates, reduce costs, and reduce carbon emissions. Within LPFT properties centralised bin locations are being created, and induvial room and under desk bins removed, this will hopefully encourage Trust staff to segregate their waste into the correct bins.

A food waste collection service is to be implemented; all food waste will be sent to an anaerobic digestion plant within Lincolnshire.

LPFT will be introducing a Vape recycling scheme.

Blister strips – we have considered whether we can recycle the blister strips from medicines, but with the pharmacy waste regulations and the type of client group that we care for it would be of a higher risk to segregate these out and ask for a third party to remove them, so we have discounted this for now.

LPFT has signed up to the reducing single use plastic pledge at Discovery House Café. Single-use plastic stirrers and straws are no longer purchased, except where a person has a specific need, in line with Government consultation, and the Trust no longer purchases single-use plastic cutlery, plates or single-use cups, made of expanded polystyrene or oxo-degradable plastics.

Changes to packaging of cook freeze meals to recyclable containers has reduced packaging for plated meals (TORUS).

9.7 Sustainable models of care

More services have been provided in the community and closer to people’s homes. This has enabled a reduction in the number of people needing to access 24-hour inpatient services and a reduction in the number of patients having to travel out of area to access an inpatient bed.

The use of remote and digital working has been scaled up during the Covid-19 pandemic, in order to improve access and reduce the need for staff and patients to travel for their care. New ways of working are currently being reviewed to ensure best patient outcomes; however, a significant proportion of the Trust’s clinical work will continue to be delivered remotely from now on.

A programme of work is currently underway to develop mental health crisis cafes and other community-based support services, to provide more local places for people in need of mental health support to go. This will enable a reduction in travel for staff and patients, and a reduction in patient transport journeys carried out by the Police, Ambulance Service and Mental Health transport providers.

Following the introduction and implementation of more sustainable ways to provide patient care, the Trust has achieved the following:

• Approximately 10,000 fewer inpatient bed days per annum, compared with 2019/20.
• The use of secure patient transport has reduced from approximately 150 journeys per month in 2019, to approximately 65 journeys per month in 2023.

9.8 Food and nutrition 

All salads and sandwiches are now made and procured locally from ULHT. 

All patient meals are now sourced and supplied by a regional supplier, with all bread and diary supplies are now procured from a regional supplier, with milk procured from local dairies, which in turn supports local farmers and the local economy. 

Patient food will be reviewed, following feedback from a patient survey, to ensure satisfaction and a reduction in waste.

Work is being carried out by the Trust’s dietitian to produce menus which will promote and support healthier eating at LPFT units, that provide self-cooking with patients, using locally procured ingredients.
The Trust has increased menu choice to include more vegetarian options. 

9.9 Supply chain and procurement

LPFT’s procurement service which provided by United Lincolnshire Hospitals NHS Trust, are currently working towards the - NHS England » Evergreen Sustainable Supplier Assessment.  All NHS Suppliers are working towards this and are being tracked on progress.  Going forward, any supplier who does not meet this requirement will not be able to work with the NHS.

In every tender over a certain value, we now have to assign at least 10% of the weighting on the tender evaluation to social value and sustainability. This ensures that suppliers need to think about how to deliver sustainability in multiple contracts. This is especially true for large capital schemes, and we fully track these and report against them.

Frameworks for the NHS are in the process of having a major overhaul and all frameworks will have to sign up to the NHS target of Net Zero and work hard to ensure all suppliers on the framework are working to achieve this – again it is a work in progress, but the ambition on this is aggressive and will be reported on when the new framework launch takes place later in 2024.
 

9.10 Climate adaption 

When designing the new Norton Lea inpatient unit, climate adaption was taken into account due to flood risk and incorporated into the design. The new building will be constructed one meter about normal ground level, the main incoming electrical supply switch gear will be installed on the first floor with equipment such as building controls and electrical sockets, installed at a height as to reduce the risk of damage in the event of a flood. The main plant room equipment will be installed of the ground, and all external doors to the building will have flood barriers installed. 

Water attenuation tanks are also being installed to improve the drainage of surface water on the site, again reducing flood risk.

9.11 Digital transformation

Laptop safes have been installed at geographical, and accessible strategic sites across  the Trust. These safes contain new or refurbished laptops, that once authorised by Digital & data Services  can be accessed by staff for a new or replacement laptop should theirs have a fault that require repair. This system reduces the need for staff to travel for a laptop repair or replacement, saving both time and business mileage.

     
9.12 Governance and measuring progress

Data and information for energy, water and waste usage, business mileage and the associated carbon emissions, are collated and recorded monthly, and reported on quarterly and annually, with progress measured against the 2019/2020 carbon emissions baseline year.

Quarterly and annual reports are reviewed by the newly formed Green Plan Committee, with any additional information supplied at committee meetings added to the reports. Fully completed reports and then submitted to the overarching Sustainability Committee.
 

10: The next steps

10.1 Workforce and system leadership

• Work will continue to encourage more Trust staff to become a green champion, whilst work will be carried out to increase support and guidance for green champions to enable them to have a bigger impact on sustainability within the Trust.
• LPFT will work towards making Net Zero training on ESR mandatory. 
• Conversations and meetings with various executives, departments, and teams to promote and support sustainability within everyday business, will be ongoing.
• LPFT will work towards increasing the requirement for the inclusion of a sustainability impact assessment in all business cases, both corporate and clinical. 

10.2 Sustainable models of care

• Work will continue to explore all opportunities to provide high quality sustainable clinical services for the best patient outcome. 
• To help support clinicians and healthcare staff provide care as sustainably as possible, in November 2023, the Royal College of Psychiatrists launched a new document 'Delivering greener, more sustainable and net zero mental healthcare'. The document has two parts, Guidance and recommendations, and Evidence review and resources.

10.3  Digital transformation

Work will continue to explore all opportunities to integrate the use of digital technology into our everyday working lives, practices, processes and procedures. 

10.4 Travel and transport

• EV charging stations will continue to be installed across LPFT sites to continually  improve and grow the existing LPFT EV charger network across the county, supporting sustainable travel. 
• As of 2026, all newly leased vehicles, inclusive of fleet/pool, salary deduction, and salary sacrifice vehicles will be required to be electric/zero carbon.

10.5 Estates and Facilities and Capital Projects

LPFT will continue to follow the Estates decarbonisation strategy up to 2032. 

• Improving the thermal fabric of our properties via improved levels of insulation, and installation of new energy efficient windows and doors where required.
• Government grants will continue to be applied for to support the decarbonisation of the estate.
• Air/ground source heat pumps will continue to be installed, replacing gas heating and hot water systems.
• Solar PV to generate green electricity will be installed across Trust properties. 
• Other renewable sources of energy and technology will continue to be researched and evaluated for use within LPFT properties.
• Investment will  continue to be made in energy metering, and new building management systems (BMS) for heating, hot water, and ventilation, to ensure we are utilising energy as efficiently as possible, highlighting areas of concern.

LPFT will continue to purchase its supply of electricity from a zero carbon source of power generation. The Trust will continue to work with partner organisations both in Lincolnshire and the rest of the NHS, to work collaboratively, share ideas and best practice. To fully achieve net zero within the LPFT property estate by 2040, will require significant capital investment, in the region of 20 million over the coming years.

Waste and recycling 

Work will continue to roll out the LPFT new waste bin strategy to increase rates of recycling. 

10.6 Medicines

Working closely with the ICB, LPFT pharmacy team will continue to explore or options available to increase sustainability and reduce the pharmacy generated carbon emissions.

10.7 Supply Chain and Procurement

• LPFT and the procurement service provided by the ULHT team, will continue to follow and implement sustainable procure guidance and requirements as informed by NHS England. 
• Where possible local suppliers for good and services will be arranged.  

10.8 Biodiversity and green spaces

• Identify areas of grassed space that can be enhanced by the introduction of wildflower meadows, that will not only encourage and support pollinators and biodiversity but will also reduce the areas of grass that require regular cutting, therefore reducing the carbon emissions emitted by fossil fuel lawn mowers.
• Actively support Trust staff to develop green spaces within their own working environments.
• Identify areas on Trust sites where shrub beds require rejuvenation or  improvements.

10.9 Adaption

• All new building projects or property purchases/long term leases will be assessed for potential effects of climate change.
• Sustainability assessment will be carried out across the Trust Estate to identify areas to reduce the impact of climate change, for example reducing over heating within properties from solar gain.
   

11: Risk

As with all ambitious projects and targets, the race to reach net zero by 2040, does not come without significant risk that could prevent the Trust from achieving the ambitious carbon emission reduction targets. 

To physically decarbonise the LPFT freehold Estate, in terms of engineering and carrying out the work is the easy bit, so what are the risks that could prevent LPFT from reaching the required carbon reduction targets.

Financial risk – as mentioned above, the Trust will need to invest an approximated £23,500,000 up to 2040, in all Trust occupied properties to reach net zero. Lack funding from available capital budgets, financial constraints (CDEL limits), and not guaranteed continuous, but limited government funding, poses the biggest risk by far to the Trust not reaching carbon emission reduction targets.

Clinical and Estates strategies – to effectively plan annual spending on sustainability up to 2040, and in order to take full advantage of any funding opportunities, ensuring money is spent efficiently and effectively, it is essential that the as a Trust and as far as is practicable, we have a robust clinical & estates strategy to identify the current, and future needs/requirements of the Trust Estate to serve all clinical, patient, and operational needs. 

Leased properties – whilst leasing properties can be an easy, quick and financially more attractive fix when clinical/operational space is required, leased properties do pose a significant risk to the Trust not reaching the carbon emission reduction targets. Providing landlords permission can be obtained, all our current leased properties will require significant investment to decarbonise the heating and hot water systems. So potentially investing large sums of Trust money into buildings we do not own, and if we do not renew any of the leases at some point in the future,  it will be to the landlord's benefit,  and money lost out of the system.

Business mileage – Whilst LPFT is working hard to support the use of electric vehicles through the installation of EV chargers across the Trust, and the requirements of NHS England new Travel & Transport Strategy for all new salary sacrifice/deduction lease vehicles to be electric from 2026, and all newly owned or lease Trust fleet vehicles to be electric by 2027, carbon emissions from business travel will still pose a significant risk to not meeting carbon emission reduction targets.