What future now?
a sustainable health service: case for action
[template presentation for NHS Boards –May 2010]
Agenda
0:00
introduction
0:10
aim of today
0:20
big issues exercise
0:30
sustainable health service:
presentation
1:00
exploring the business case
1.20
making it happen
2.25
action planning
3.00
close
The next three hours…
Explore how [name of Trust] can use
‘sustainable development’ to secure
the most appropriate services for
addressing health needs
The next three hours…
Explore how [name of Trust] can use
‘sustainable development’ to address
its challenges in putting patients’
needs at the core
Looking forward to 2015…
What are the big issues keeping you
up at night?
- in your NHS role?
- thinking about the wider world?
Key themes
1. the big global challenges
2. the pressures facing the NHS
3. how these interact
4. how we can resolve these issues simultaneously
5. why this makes good business sense
Numbers + Growth in
Economic + Growth
in Human Output …
has resulted in
HUGE Growth
in our
Environmental
Footprint
tightening planetary boundaries
Lancet edition
A changing context
EU Targets
20% reductions in CO2 by 2020
20% Renewables by 2020
United States
80% reduction in CO2 by 2050
UK Climate Change Act
34% cut by 2020; 80% by 2050
Independent Committee;
annual report to Parliament
Carbon Reduction Commitment
Business as usual?
looming
budget cuts
ageing &
growing
population
increased
patient
demands
‘diseases of
affluence’
wider
citizenship
expectations
Lifestyle diseases
There are as many
obese people in the
world today as there
are starving or
undernourished people
Marmot Review
Sustainability
is…
Sustainable
development is…
meeting human needs
without compromising
nature or society
the process by which
we get there
Sustainability
is…
Sustainable
development is…
meeting human needs
without compromising
nature or society
the process by which
we get there
Key synergies with NHS priorities:
• avoid harm
• cut waste
• reduce variation
• shift to prevention
1. develop understanding of future trends as they relate to health
and business continuity
2. evolve business models/ strategies to meet risks and
opportunities
3. align activity with promoting determinants of health
4. cut cost base by shifting to preventative care not ‘salami
slicing’ services
5. systematically manage tensions between short and long-term
measures of success
sustainable development in the NHS
1. develop understanding of future trends as they relate to health
and business continuity
2. evolve business models/ strategies to meet risks and
opportunities
3. align activity with promoting determinants of health
4. cut cost base by shifting to preventative care not ‘salami
slicing’ services
5. systematically manage tensions between short and long-term
measures of success
sustainable development in the NHS
Use resources more efficiently
Illustrative slide – insert relevant MAC
curve for the Trust you will be talking to
http://www.sdu.nhs.uk/page.php?page_id=160
Build resilience
rising energy costs
+
increased volatility
+
cost of carbon
=
material business risk
1. develop understanding of future trends as they relate to health
and business continuity
2. evolve business models/ strategies to meet risks and
opportunities
3. align activity with promoting determinants of health
4. cut cost base by shifting to preventative care not ‘salami
slicing’ services
5. systematically manage tensions between short and long-term
measures of success
sustainable development in the NHS
Join-up the benefits
• transport
• employment &
• procurement skills
• new buildings• community
engagement
• facilities
Promote health now
1. develop understanding of future trends as they relate to health
and business continuity
2. evolve business models/ strategies to meet risks and
opportunities
3. align activity with promoting determinants of health
4. cut cost base by shifting to preventative care not ‘salami
slicing’ services
5. systematically manage tensions between short and long-term
measures of success
sustainable development in the NHS
Transform care
• Quality
total picture to be considered
• Innovation
achieve multiple objectives
• Productivity
platform for collaboration and
working across boundaries
• Prevention
opportunities to act upstream to
manage demand, make resilient
investments, community dialogue
1. develop understanding of future trends as they relate to health
and business continuity
2. evolve business models/ strategies to meet risks and
opportunities
3. align activity with promoting determinants of health
4. cut cost base by shifting to preventative care not ‘salami
slicing’ services
5. systematically manage tensions between short and long-term
measures of success
sustainable development in the NHS
Show leadership
The leadership spectrum
compliance-led incremental
strategic
systemic
• SDMP not integrated
• Clutch of ‘good
EnvIronmental factors/
practice’ projects
objectives are separate • Focus on estate and
• Inadvertent
environment not SD
undermining of health • A competing priority
objectives
• Senior-level drive
• SD is hardwired
into business model
• SD integrated policy/
plans/ business case • Tensions between
short/ long-term
• Evident in priorities
priorities
• Communications and
systematically
actual performance
managed
Where are you?
application &
impact
at risk
impact trajectory of embedding
sustainability in NHS Trusts
compliance-led
incremental
strategic
systemic
medium
impact
low
impact
high
impact
knowledge &
engagement
Where are you?
application &
impact
at risk
impact trajectory of embedding
sustainability in NHS Trusts
compliance-led
incremental
strategic
systemic
medium
impact
low
impact
high
impact
knowledge &
engagement
QIPP makes no reference to SD
SD seen as one board member’s job
Where are you?
SD integral to business case,
QIPP & World Class Commissioning
future trends/ scenarios shape
strategy & service models
application &
impact
at risk
impact trajectory of embedding
sustainability in NHS Trusts
compliance-led
incremental
strategic
systemic
structured
dialogue about
investment/
disinvestment
medium
impact
low
impact
high
impact
new health economy
collaborations
knowledge &
engagement
use of MAC cost curves to cut cost base
Conclusions
1. there are big global challenges
2. these add to the pressures facing the NHS
3. these problems are interlinked
4. they can be resolved together using sustainable
development
5. this makes good sense for business, patients and
wider health
[written case study template]
picture or
quote
[insert business
issue here]
Issue:
[insert facts of
what took place]
Action:
1. key benefit or result 1
2. key benefit or result 2
3. key benefit or result 3
[written case study template]
picture or
quote
[insert business
issue here]
Issue:
[insert facts of
what took place]
Action:
1. key benefit or result 1
2. key benefit or result 2
3. key benefit or result 3
[role play scenario template]
Insert relevant role play scenario from
the accompanying Resource Pack as an
instruction slide for the ‘Making it
Happen’ exercise
The last three hours…
Explore how [name of Trust] can
use ‘sustainable development’ to
address its challenges in putting
patients’ needs at the core
The last three hours…
Explore how [name of Trust] can
use ‘sustainable development’ to
secure
the most appropriate services for
addressing health needs