The NHS is one of the world’s largest employers, with 1.3 million employees across the UK. This enormous workforce makes daily commutes to health centres, clinics, offices and hospitals to support their patients’ health care needs. In England alone, these journeys generate 20 million tonnes of carbon dioxide emissions annually – around 4% of the NHS’ total emissions output.
Categorised as Scope 3 emissions, employee commutes are included as an indirect emission that occurs in a organisation’s value chain. Often overlooked, commuting emissions are increasingly under the spotlight following organisations setting ambitious net zero targets, including that of the NHS, to be the world’s first net zero health service.
Beyond the day-to-day commuting challenges faced by individual NHS Estates and Travel professionals, the real difficulty they face is tackling these emissions at scale. This challenge is compounded by the fact the NHS is not a single body – but made up of 233 Trusts, 14 Health Boards, 1229 hospitals, and 7613 GP surgeries. Attempting to apply a consistent, data-based approach for measuring and managing these emissions is further complicated by the different systems and structures employed across the UK’s 4 nations.
These organisations know omitting Scope 3 commuting emissions from their reporting means they will fail their net zero goals. As a result, many are turning to new technologies to evidence, track, plan and change their commuter emissions as more of the workforce return to site.
The desire for greener travel can be seen throughout the NHS, from grassroots level requests to the impassioned pleas of the executive. In July 2020, over 190 GPs, consultants and healthcare staff wrote a joint letter to the Health Secretary to ask for improved cycle parking and more active travel provisions to improve health, reduce emissions and alleviate car parking demand.
The ‘For A Greener NHS’ campaign was launched in January 2020 as part of the UK’s commitment to reach Net Zero by 2050. The initiative will tackle all emissions outputs, with the intention of becoming the world’s first net-zero health service. An internal staff survey revealed that NHS employees overwhelmingly back the campaign, with 98% of staff asked believing it is important for the health and care system to support the environment.
The foreword of ‘Delivering a ‘Net Zero’ National Health Service’ states ‘The climate emergency is also a health emergency’ and that it ‘poses a major threat to our health as well as our planet. The environment is changing, that change is accelerating, and this has direct and immediate consequences for our patients, the public and the NHS.’
There is a clear appetite for sustainable commuting at all levels of the NHS – and it’s critical that that desire and momentum is transformed into action.
The environment is changing, that change is accelerating, and this has direct and immediate consequences for our patients, the public and the NHS.
This spotlight on commuting led NHS England to set a requirement for Trusts to have a Green Travel Plan to promote sustainable commuting options to staff and patients. Plans should detail ‘intended actions and necessary interventions to encourage commuters to reduce vehicle use’. You can learn more about developing a Green Travel Plan on this webinar with the Northern Care Alliance.
One of the sustainability stories featured in the webinar examines the success of Newcastle Foundation Trust, a proactive Trust which appointed its first Green Transport coordinator, David Malone, in 2004.
During this time, David was tasked with reducing single car occupancy from a traffic congestion perspective, a requirement of a planning application associated with the hospital. Prior to this, travel had fallen under Estates Management and solely consisted of traffic management rather than addressing environmental impacts. There had been no focus on carbon reduction, no baseline data to work from and ‘certainly no budget’.
The Newcastle travel team used a collection of actions to encourage active travel and car-sharing, successfully reduced single-occupancy car journeys from 57% to 27% over 10 years. Unfortunately, and in line with national trends, these figures are now increasing as a result of the Covid-19 pandemic. This is a result of reduced public transport services and proximity fears in regard to car sharing.
David, who also Chairs the National Performance Advisory Group’s (NPAG) Parking and Sustainability Group is a strong advocate for using data to overcome commuting problems.
The Mobilityways Platform was implemented in Newcastle FT in 2021, in an effort to better understand the local mobility landscape with the intention of tackling the rising traffic levels and associated commuting emissions. The visibility this data provided would afford David greater insight into the commuting challenges facing his team and how to overcome them. “The potential to better understand the barriers to active travel through targeted surveying was particularly attractive.”
Facilitating greener commutes offers wider benefits beyond the intended environmental gains, for both the organisation and the individual. “Increasing the number of staff undertaking active and shared travel will have physical and mental health benefits in addition to the travel costs savings made by employees who no longer bear the travel costs of driving to work alone.”
The NHS spends hundreds of millions of pounds encouraging the public to pursue exercise as a safeguard against the health implications of a sedentary lifestyle. Supporting NHS teams to be more active on their commute feels like a good place to start. Not only are walking and cycling zero-carbon modes of travel, they’re also easily accessible forms of exercise that support improved physical and mental wellbeing.
This is something that Michael Simpson, Head of Sustainability Management at NHS Lanarkshire can attest to. “I’ve heard so many benefits of an active travel commute by our team, from improved mental health to just being refreshed and ready to start the day.” One of NHS Lanarkshire’s sites, the University Hospital Hairmyres, which is district general hospital in East Kilbride, has officially been recognised as a cycling friendly employer thanks to a host of new cycle schemes and cycling infrastructure.
Marie Porteous who oversaw the active travel policy also credits technology as a means to improve sustainable commuting across the Boards three hospital sites. NHS Lanarkshire implemented the Mobilityways Platform to help identify and overcome barriers to sustainable commutes and has launched a dedicated programme to support and promote active travel.
“Our partnership with Mobilityways is the natural continuation of our work to enable more sustainable commuting. It not only helps us better understand employee travel habits but also the emissions associated with commuting. Secure cycle parking, new pathways and safer crossings on site ensure staff can easily commute on foot or bike, while a new low-cost bike hire scheme in association with Brompton gives staff the means to cycle to work.”
The implementation of Clean Air Zones across the country has made the need for sustainable commuting particularly acute for some NHS Trusts. Bristol’s Clean Air Zone (CAZ) is planned to launch in September 2022 and will directly affect access to Bristol Royal Infirmary and the Royal Hospital for children. Once operational, a daily charge will apply to high-polluting vehicles driving in the zone. Whilst the majority of vehicles will incur no charge, it’s in the Trust’s best interests to empower their employees to adopt the sustainable commuting long term.
Helping employees understand all the viable commuting options available to them empowers individuals to make greener choices. Bespoke Personalised Travel Plans (PTPs) provide staff with door-to-door details of all the available routes and modes, detailing journey times, carbon emissions and even calories burned for active travel commutes.
Sustainable Transport and Travel Manager, Stewart Cundy, said, “We welcome the implementation of Bristol’s Clean Air Zone in 2022 and are committed to supporting our staff through those changes with access to Personalised Travel Plans and providing communications on sustainable travel and access to site.”
North Bristol NHS Trust used the Platform to produce 511 Personal Travel Plans (PTPs) for their staff, detailing viable walking, cycling, public transport and car-sharing matches living within a 1-mile radius of each employee. Results showed that 43% of respondents said they had considered changing the way they travel as a result of receiving their PTP. This led to a modal shift of 18%, which saw single-occupancy vehicle journeys reduce by 17.8%. The number of those who cycle increased by a quarter and the number of bus users doubled. 37.5% of travel to the site is now by more sustainable means.
Toxic air pollution contributes to 300 deaths a year in Bristol, further demonstrating how environmental health is public health. Equipping NHS staff with the information they need to make sustainable travel choices – and supporting those choices through data-based policies and initiatives, will be key in making a shift to sustainable commuting viable for the majority of the NHS workforce.
In addition to the health and environmental benefits, a move away from single-occupancy vehicles can reduce localised congestion and take the strain off parking infrastructure. Parking challenges for staff and patients have become almost synonymous with the NHS in recent years, with many Facilities and Estates Managers struggling to overcome staff parking problems – and that’s before they’re picked up by the national press.
When speaking at Mobilityway’s Zero Carbon Commuting Conference, ZC3, Deputy Director of the Net Zero Travel & Transport, Paul Chandler, commented on the difficulties of parking challenges across the organisation. “The NHS is made up of different hospital Trusts and hundreds of other care organisations, each with their own separate policies on things like car parking, travel, and transport. Lots of different local advisors have different rules. They’re all autonomous organisations so we wouldn’t want to specify to them how they would go about their parking but these are issues that are definitely being grappled with in individual hospitals. The demand for car parking outstrips supply and that’s not just for staff that’s for patients and visitors as well.”
As part of Calderdale and Huddersfield Foundation Trust’s Green Plan, a staff and patient travel survey was conducted in November 2020. It revealed 66% of respondents drove to work alone. 21% of staff said that parking frequently negatively impacted their experiences of working, with a further 10% claiming it always negatively impacts their working experience – and they’re not alone. This is a challenge faced by NHS staff across the country on a daily basis.
Parking scarcity dogged the Great Western Hospital, a single-site Foundation Trust located in Swindon. With 4,000 staff and only 1800 parking spaces, the hospital struggled to accommodate both staff and patients. They implemented a branded car-share scheme to connect staff across the hospital with other team members who could share their journey. Incentivised by reduced travel costs and priority parking, car sharers freed up an average of 250 extra spaces for patients every day.
Becoming the world’s first net zero health care system is an ambitious plan – and it’s one 14 other health care systems have taken inspiration from, making the same pledge at COP26. It’s clear facilitating sustainable commuting will make up a large component of meeting these critical net zero goals.
For Paul Chandler, who leads on net zero operations for the Greener NHS Programme, making Zero Carbon Commuting a reality is only possible when you can make data-based decisions to develop programs and infrastructure that make sustainable commutes the first choice. Only then will commuting behaviour change for the better.
“It’s about understanding where staff need to commute to, at what times, and what options are viable for them. There’s no point in banging on about active travel for staff who live 20 miles away, or encouraging them to get the bus if it is actually three buses and takes an hour and a half to get in. That doesn’t make any sense. It’s having that intel.”
“Changing personal behaviours to reduce carbon emissions isn’t a strong enough argument in and of itself for some to change deeply ingrained commuting behaviours. You need to make it personal to people. You need them to understand how to make the switch.”
