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Welcome to Sustainable Health Scotland
#sushealthscot
Chair's Welcome & Introduction
Jim Leiper, Strategic Facilities Director, Health Facilities
Scotland
#sushealthscot
Housekeeping
• Fire Alarms
• Toilets
• Mobile phones
• Timekeeping
• Refreshments and lunch
• Workshop locations
• Feedback
• Twitter (#sushealthscot)
• Help and Support
Sponsors, Exhibitors and Supporters
Morning Programme
• 09:30 Chair’s Welcome and Introduction
• 09:45 Keynote Address: Securing Scotland’s Health
Dr Gregor Smith, Scottish Government
• 10:00 Q&A
• 10:10 Climate Change and Public Health Impacts: Adaptation, Mitigation and Their Consequences
Dr Emily Stevenson, SMaSH
• 10:30 Energy Efficiency and Fuel Poverty
Lisa Glass, Shelter
• 10:50 Resilient Cities
Alastair Brown, Glasgow City Council
• 11:10 Healthy Eating: The Route to Health and Well-being
Louise Needham, Quorn Food
• 11:30 Q&A
• 11:40 Refreshments and Networking
Workshops
12:10
Clyde Suite
Climate Change and Public Health: Achieving Co-Benefits (NHS Health Scotland)
Dalhanna Suite
Sustainable Travel (Cenex)
Ramillies Suite
Utility Cost Recovery (PCMG)
12:50
Clyde Suite
Supporting Organisations to Tackle Fuel Poverty (Home Energy Scotland & NHS Greater Glasgow & Clyde)
Dalhanna Suite
Green Space: Delivering on the Wider Sustainability Benefits (Green Exercise Partnership and NHS National Services Scotland)
Ramillies Suite
Lighting for Health and Well-being (Arup)
Securing Scotland's Health
Dr Gregor Smith, Deputy Chief Medical Officer, Scottish
Government
#sushealthscot
Sustainable Health ScotlandSecuring Scotland’s Health
Dr Gregor SmithDeputy Chief Medical Officer for Scotland
Healthy Life Expectancyyears
Years in Poor Healthyears
Total Life Expectancyyears
MenRichest 10% 76 5 13Poorest 10% 57 11 68Difference 19 6 13
WomenRichest 10% 78 6 84Poorest 10% 61 15 76Difference 17 9 8
Jordanhill
Charing Cross
Hyndland
Partick
Anderston
Exhibition Centre
CENTRAL
Argyll St.
Bridgeton
QUEEN STREET
Govan
Hillhead St George’s Cross
Buchanan Street
Life expectancy data refers to 2001-5 and was extracted from the GCPH community health and well-being profiles. Adapted from the SPT travel map by Gerry McCartney.
Males - 75.8y
Females - 83.1y
St Enoch
Males - 61.9y
Females - 74.6y
Ibrox
Cessnock
Each stop on the Argyll line travelling East represents a drop of 1.7 years in male life expectancy
Leading causes of attributable global mortality, WHO 2004
%
1. High blood pressure 12.8
2. Tobacco use 8.7
3. High blood glucose 5.8
4. Physical inactivity 5.5
5. Overweight and obesity 4.8
6. High cholesterol 4.5
7. Unsafe sex 4.0
8. Alcohol use 3.8
9. Childhood underweight 3.8
10. Indoor smoke from solid fuels 3.3
59 million total global deaths in 2004
COSTS TO THE NHS
Comparative level of importance varies depending of figures used – message is the same – physical inactivity is a major issue
In 2006–07, costs to NHS in UK for behaviour related ill health:
• poor diet £5.8 billion
• smoking £3.3 billion
• alcohol £3.3 billion
• overweight and obesity cost £5.1 billion
• physical inactivity was £0.9 billion
Scarborough et al 2011
The Choluteca Bridge
Building on Public Health Successes
“...everyone in healthcare really has two jobs when they come to work every day: to do their work and to
improve it.”
What is ‘‘quality improvement’’ and how can it transform healthcare? Batalden,P; Davidoff.F Qual Saf Health Care. 2007 February; 16(1): 2–3
Question & Answer Session
#sushealthscot
Climate Change and
Public Health Impacts:
Adaptation, Mitigation
and their consequencesEmily Stevenson
Public Health Specialty Registrar
Co-chair Scottish Managed Sustainable Health Network (SMaSH)ScotPHN is hosted by
Outline of presentation
How does climate change threaten public health gains?
What is the public health role in mitigating and adapting
to climate change?
What are the health benefits and disbenefits of climate
change adaptation and mitigation?
COP21
“the increase in….temperature
to well below 2…. and to
pursue efforts to limit the
temperature increase to 1.5”
Department for Environment Food and Rural Affairs (Defra). Adapting to climate change. UK Climate Projections. London, 2009.
Available at: https://www.gov.uk/government/uploads/attachment_data/file/69257/pb13274-uk-climate-projections-090617.pdf
“Climate change is the biggest global health threat
of the 21st century”
Watts et al, Health and climate change: policy responses
to protect public health. The Lancet 2015; 386 (10006);
1861-1914
Who bears the burden of disease?
Costello A et al. Managing the health effects of climate change:
Lancet and University College London Institute for Global Health
Commission. The Lancet 2009; 373 (9676); 1693-1733.
What does Climate Change look like in Scotland?
Adaptation Scotland. Risk Management Plan
• Rise in temperatures
• Increase in flooding
• Increase in sea level
• Increased frequency and
intensity of storms
• Warmer wetter winters
• Warmer drier summers
Projected changes in summer and winter temperature and
precipitation for Scottish climate regions (2050s – medium
emissions scenario)
•Security of global food
production
•Population migration
•Changes in vector borne
disease distributions
•Changes in agriculture
•Changes in fishing
•Coastline flooding,
erosion and coastline
retreat
•Quality and availability
of potable water
•Food safety
•Species extinction, new
species
•Air pollution
Damage to infrastructure –
buildings, transport
Affects on the wider determinants
of health in Scotland
Barton and Grant. A health map for the local human habitat. The Journal for the
Royal Society for the Promotion of Health, 2006; 126 (6): 252-253
Health impacts of climate change in Scotland
Climate change effects Examples of related health risks
Temperature changes Cardiovascular, cerebrovascular and respiratory disease
Extreme weather, changes in precipitation Injuries, diarrhoeal disease, malnutrition, respiratory
infections, depression, anxiety
Air pollution Respiratory, cardiovascular disease
Microbial contamination and transmission Vector borne disease
Food safety
Pollen production Allergic diseases
Reduce crop yield Malnutrition, increases in food prices
Displaced populations Poverty, depression, anxiety, malnutrition
Haines and Patz 2004; Seguin 2008; Friel et al 2011
Examples of Scottish Public Health Actions (1)
Key area of Public Health Public Health Actions
Surveillance and assessment of
the population’s health and
wellbeing
Tracking of diseases and trends related to climate change
Assessing the evidence of
effectiveness of health and
healthcare interventions,
programmes and strategies
With consideration of procurement, energy efficiency, cost analysis including indirect costs to
health through environmental impacts, waste
Policy and strategy development
and implementation
Ensure health policy/plans/strategies have sustainability as a core value running through
Strategic leadership and
collaborative working for health
Ensuring health is included in climate change plans
Build climate change into cross sector plans e.g. through CPP
Informing public of risks to health from climate change
Health impact assessments of adaptation and mitigation strategies to ensure maximise health
co-benefits and minimise disbenefits
Examples of Scottish Public Health Actions (2)
Key Public Health Area Public Health Actions
Health Improvement Prevention of mental health problems as a result of climate change
Community empowerment with particular attention to vulnerable communities
Behaviour change knowledge – ?application to sustainable behaviours
Health Protection Mitigate the effects of extreme weather events e.g. warnings/threshold for boil notices with
private water supplies following intense rainfall/floods
Monitor trends in vector borne diseases, food and water borne diseases, chemical
contamination with respect to seasonality and extreme weather events, and
control/communicate with population accordingly
Health and Social Service Quality Support/provide leadership in the development of financially and environmentally
sustainable health services. Support/link between facilities and other health professionals.
Support healthcare adaptation and mitigation measures.
Emergency preparedness.
Training of health care professionals on the health aspects of climate change
Health services which are reactive to changes in disease distribution as a result of climate
change
Early warning systems
Public Health Intelligence Monitoring of trends of morbidity and mortality relating to heatwaves
Academic Public Health Research considering the relationship between climate change on health inequalities
Benefits and disbenefits of climate change mitigation and
adaptation – a need for Health Impact Assessments
Mitigation/Adaptation Action Benefit Risk
Increase greenspace in
cities/towns to reduce urban
island affect
Mental and physical benefits Skin cancer, cataracts
Aeroallergens
Air conditioning Reduce morbidity and mortality
secondary to heatwaves
GHG with consequences for health
Re-housing at risk coastal
communities
Reduce risk of depression and
anxiety
Impacts on mental health – social
capital disruption, poor housing
Increase community resilience Empowered, better connected
communities
Widening of inequalities
Sustainable diets Sustainable communities, reduced
colorectal ca, improved
cardiovascular health
Nutritional deficiencies
Health co-benefits
Lancet Commission’s report from
June 2015 - “Tackling climate
change could be the greatest
global health opportunity of the
21st century”
“Recognizes the social, economic
and environmental value of
voluntary mitigation actions and
their co-benefits for adaptation,
health and sustainable
development”
Adoption of the Paris Agreement:
Adoption, para 109.
Thank you
“The era of procrastination, of half-
measures, of soothing and baffling
expedients, of delays is coming to its
close. In its place we are entering a
period of consequences”
- Winston S. Churchill
32Monday, 26 September 2016
Until there’s a home for everyone
Health, fuel poverty and energy efficiency
Lisa Glass, Partnership Officer for Health
33
Structure
1. Housing issues in Scotland today
2. Fuel poverty: an introduction
3. Health implications of fuel poverty
4. Why the NHS should be concerned with fuel poverty
5. How can the NHS help tackle fuel poverty?
34
Shelter Scotland helps over half a million people a year
struggling with bad housing or homelessness – and we
campaign to prevent it in the first place.
Our work includes policy and front line services to public
campaigns and training housing professionals so that we
improve housing in Scotland in a wide variety of ways and
increase access to a safe, secure and affordable home.
35
‘Housing’ issues in Scotland today
36
‘Housing’ issues in Scotland today
34,666 homeless applications in 2015-16
- 28,226 assessed as homeless
Some of the best homeless rights in the
world, yet…bottleneck in temporary
accommodation
- 10,555 households; 5,224 children, 1 in 10 > 1 year; 23
weeks on average
150,000 households on council waiting lists
74,000 living in overcrowded accommodation
37
Not just housing issues…
Poor housing increases the risk of severe ill-health or
disability by ^25% during childhood and early
adulthood
41% of the homeless population will suffer long term
health difficulties, compared to 28% of the general
population
Dr Neil Hamlet’s research, Fife, compared ‘secure’ and
‘insecurely’ housed
- Emergency admission rate 244/1000 vs 64/1000
- Multiple attendance, alcohol/self harm/psychiatric
admission rates, DNAs
38
Not just housing issues…
Commission on Housing &
Wellbeing, 2015: www.housingandwellbeing.org
Looked at housing across 5 areas of
wellbeing, including health
47 recommendations, 1 year on
report
Fuel poverty and ‘cold
homes’ are one of the more
obvious areas where
housing links to health.
39
Fuel poverty: an introduction
40
Fuel poverty: an introduction
• More than 10%
income on all fuel
use
• Focus generally on
cold homes,
heating and efforts
to ensure
‘affordable warmth’
– but wider than
just heating costs
• 229,000 (9.5%)
are in extreme fuel
poverty
• 55% in rural areas
vs 32% urban
• 58% single
pensioners,
44% households
with 2 pensioners
41
Causes of fuel poverty
42
Health implications of fuel poverty
43
Useful referencesHills 2012
WHO 1985
Marmot Review 2011
Energy Action Scotland
NICE guidelines 2015/16
Health implications of fuel poverty
EWDs • At least 1 in 10 EWDs 400 people (2014/15)
Other fuel use? • Heat or eat? Hot shower?
Secondary consequences • Dampness, trip hazards, burns & scalds
44
Why the NHS should be concerned
with fuel poverty & energy efficiency
45
Why the NHS should be concerned
with fuel poverty & energy efficiency
• Links with health
• MoneyEstimates of £48-80million savings to the NHS in
Scotland
e.g. 2009 Chief Medical Officer’s report
Every £1 spent tackling fuel poverty saves the NHS 42p
Prof Liddell, Save the Children 2008
• Wider strategies and principles, & today!Prevention
Sustainability
Making Every Opportunity Count
46
How can the NHS help tackle fuel
poverty?
47
Awareness and signposting to available support; there
is a huge amount of support available for people in fuel
poverty, centred around all 4 causes:
• Grants, loans and independent advice for installing
energy efficiency measures in the home (insulation, new
boilers, etc)
• Money and debt advice to increase household income
• Information and support on energy tariffs and switching
supplier to reduce energy costs
• Advice on how to use energy in the home more efficiently
Home Energy Scotland, local services, Shelter Scotland
How can the NHS help tackle fuel
poverty?
48
Ashley (22), lives in Dundee with her two children Ayla (4) and Lily-May (2).
It's been really hard in the last few months with it being so cold. I’ve
spent a fortune on heating, but no matter how much I spend or how long I have the heating on for, it doesn’t seem to
make any difference.
There’s mould crawling up the walls, around fuse boxes and electrics. I’m bleaching it as often as I can but the kids are always ill no matter what I do. We’re
constantly at the GP surgery and recently I had to take Lily-May to hospital things got so bad.
The children are either on antibiotics or steroids at any given time, and my little one has an inhalerbecause all of this damp has got to her lungs. The other day I found a rat in the flat and I’ve been told
that’s because they seek out damp places to nest. It’s disgusting. How long can I live like this?
I buy the kids two beds each a year because I’m chucking out furniture that’s been totally destroyed. Sometimes it’s so
bad the bedding they sleep in is wet by the middle of the night from all of the condensation.
49
• Training and awareness raising
• Not expecting staff to be experts
• Pilot training course
• ‘Social prescribing’, a holistic approach to
medicine, and making every opportunity count
• NHS staff are households too…
• Culture change
• Partnership working
• More information in this afternoon’s workshop
What can you do? Be our advocate!
How can the NHS help tackle fuel
poverty?
50
For any more information:
Partnership Officer for Health
0344 515 2469
To sign up to our latest homelessness: far
from fixed campaign, visit
shelterscotland.org/farfromfixed
• Resilience is the ability to survive and thrive in the face of
shocks and stresses
• Membership of the Rockefeller Foundation’s global 100
Resilient Cities network
• Engagement with partners
• A conversation with 3,500 Glaswegians
• Initial focus on climate change issues soon broadened
Glasgow | City of Transformation
Drawing oncultural assets
Resilient Glaswegians
Economicdiversification
Regenerationprogrammes
Pillar 1 | Empowering Glaswegians
Inclusive
Integrated
Prepared
Pillar 2 | Unlocking Place-Based Solutions
Integrated
Inclusive
Creative
Pillar 3 | Innovating for Fair Economic Growth
Innovative
Resourceful
Flexible
Pillar 4 | Fostering Civic Participation
Robust
Empowered
Reflective
• Strategy launch
• Two year action plan
• Monitoring and evaluation
• People Make Glasgow Resilient
…becoming experts in delicious, healthy
and sustainable alternatives to meat
Louise Needham
Environment & Sustainability Manager
Source: FCRN Food
Source, 2016
The 1960s was a time of
huge achievements...
Quorn in context
....And growing concerns
Quorn in context
A man with a big idea
Remember the history…
“What we need is a new and greener
revolution, like the one we saw in the
developing world in the 1960s, but which
tackles BOTH food security and climate
change.”
~Professor Sir John Beddington
2009 as UK Chief Scientific Advisor
At the heart of all Quorn foods is
mycoprotein…
So, what is
it?
Natural appeal
Our 50 year ‘overnight
success’……….
So it can be done
Belasis Process Overview
Fermentation
To grow the
organism
RNA
Reduction
To meet
specification
Centrifuge
Separate
solids and
liquid
Chillers
Harvesting of
Mycoprotein
paste
Despatch
Chilled to
Stokesley for
onward
processing
Raw
Materials
Utilities
Deep shaft
fermenter
to process waste
Clarifier
to separate
Clean Water
To River Tees
Sludge
to land injection
67
No other protein can create the meat
like textures achieved by Quorn
Unique attributes
Micrographs reveal unique fibrosity
Quorn has a unique meat like texture
Soy
Poultry
Mycoprotein
Additional InterestSCFA productionFibre (chitin and ẞ-glucans)
Mycoprotein as a food ingredient
Physical
Properties (shape)
Denny, A, Aisbitt, B and Lunn, J (2008) Mycoprotein and health. BNF Nutrition Bulletin 33: 298 – 310.Bottin, J. (2014) Nutrition and Surgical Influences on appetite regulation in obese adults. PhD Thesis Imperial College London
BENEFITS
Texture creation• Authentic meat-like texture• Creation of fibrosity through fibre assembly
General Nutrition• High quality protein• Low fat content (membranephospho-lipids)
• High fibre (cell wall)• Low energy densityClinical Research Programmes• Lowering serum cholesterol• Satiety• Insulinemia and
glycemia in diabetics
Composition
Source: FCRN Food Source,
2016
Growing population: 9-10bn by 2050
Changing population: Africa & Asia
urbanising fastest
Rising incomes =
• Changing lifestyles
• Dietary change – “Western diet”
• Changing burden of disease (e.g.
obesity, heart disease, stroke,
diabetes, some cancers.)
The bigger picture…
‘Greenhouse Gas emissions from the
livestock sector account for
15% of the global total…
…more than direct emissions from the global transport sector’
Chatham House Report, 2014
Challenges for a scalable meat based
sustainable food future
Our biggest lever globally is to eat less
meat
GRAPHIC: N. CARY/SCIENCE
Changing the food system to provide sustainable healthy diets
Italy, 2013
EFSA: “Overcrowding is a risk factor for disease
expression and other causes of poor welfare
and should be avoided”
Regular antimicrobial use facilitates high animal densities:The Lancet Infectious Diseases Commission, 2013
“Urgent action is needed to ... reduce antibiotic usage in animal husbandry”, WHO, 2014
“Use of antibiotics as growth promoters should be banned worldwide as has happened in the EU”: The Lancet Infectious Diseases Commission, 2013
“Routine preventative use of antibiotics is unacceptable” UK AMR Strategy:
Annual progress report and implementation plan, December 2014
“failure to address
antibiotic overuse in
agriculture and its role in
drug resistance is like
trying to stop lung
cancer without factoring
in smoking…..”
Urgent action is being called for, but who is
listening?
Unique recipe of benefits…
Health &
nutrition
Taste &
texture
Versatility &
familiaritySustainability
Behaviour Change
The importance of evidence base…
Over 30 years of clinical research into
the benefits of diets rich in
mycoprotein
An exciting programme for 2016
ANABOLIC PROPERTIES
OF PLANT PROTEIN
BEHAVIOUR CHANGE
Quorn Environmental Footprint
Key Comparisons vs
Quorn
GHG LAND WATER
Beef Mixed
x9 more GHG
x9 more land
x10more water
Beef Grazed
x36 more GHG
x12 more land
x11 more water
Chickenx3 more
GHGx2 more
landx2 more
water
By working closely with Carbon Trust we have established that
Quorn Foods offer significant environmental benefits relative to
meat.
Quorn is the first and only meat free brand to have carried out
such a systematic third party analysis of its environmental
footprint.
83
Sampling Quorn to over
2000 NHS Staff and Visitors
Great Ormond Street Hospital
Guys Hospital
St Thomas Hospital
St Barts Hospital
ULC Hospital
Whipps Cross Hospital
Newham University Hospital
Royal London
Mile End Hospital
Nottingham City Hospital
Nottingham QMC Hospital
Sheffield Teaching Hospitals
84
Quorn fits easily into everyday life and makes meat reduction simple…
Question & Answer Session
#sushealthscot
Refreshments and Networking
#sushealthscot
Welcome back
Brian Swanson, Chair of the NHSScotland Sustainability
Steering Group
#sushealthscot
Afternoon Programme
• 14:30 Welcome Back
• 14:40 The Circular Economy Will Benefit Scotland’s Economy and Its Environment
Claire Guerin, Zero Waste Scotland
• 15:00 Inhalational Anaesthesia: Case Study
Dr Frank Swinton, Airedale NHS Foundation Trust
• 15:20 Healthier Catering and Retail in Hospitals
Peter Faassen de Heer, Scottish Government
• 15:40 Q&A
• 16:00 Sustainability in NHSScotland: A Core Priority
Colin Sinclair, NHS National Services Scotland
• 16:20 Q&A
• 16:40 Concluding Remarks and Close
Claire Guerin
Sector Manager – Sustainable Procurement
zerowastescotland.org.uk
@zerowastescot
A Circular Future for Scotland
Overview
• About Zero Waste Scotland
• Scotland’s Circular Economy
Ambitions
• Examples within NHSScotland
About Zero Waste ScotlandWe exist to create a society where resources are valued and nothing is wasted.
Our goal is to help Scotland realise the economic,
environmental and social benefits of making best use
of the world’s limited natural resources.
Setting our sights
We’re funded to support delivery of the Scottish
Government’s circular economy strategy, Making Things
Last. We receive additional funding to support the EU’s
2020 growth strategy.
Scotland’s Circular Economy
ambitions
The Circular
Economy
Green Alliance
‘Making Things Last’
• Scottish Government priorities in moving to a Circular Economy
• Builds on Zero Waste and Resource Efficiency agendas
• Benefits to:
– The environment
– The economy
– Communities
Priorities
• Food & drink & the
bioeconomy
• Manufacturing &
remanufacturing
• Construction
• Energy infrastructure
• Increasing reuse & repair
A Manufacturing
Future for Scotland
• 8 work streams – including Circular Economy
• Innovation & new marketopportunities
• Remanufacturing potential
£620 million turnover and 5,700 new jobs
80%of a product’s lifetime
environmental impact is
decided by its design
ZWS – Circular Economy
Programme
• Business support for SMEs & networks
• Grant support through CE Investment Fund
• Academic & industry partnerships through
support of Scottish Institute for
Remanufacture
• Changing behaviours on purchasing & using
products
NHSScotland Examples..
Benefits through Procurement
Including Circular Economy Outcomes….
• Enhancing Economy
• Security of Supply
• Cost Savings
• Environmental Improvement
• Socio-Economic
• National & Organisational Outcomes
• Reuse – Instruments, sharps bins, furniture
• Reposable products – trocars
• Take Back Service – pumps
• Redeployment – furniture, stationery
• Remanufacture – Single Use Devices
NHSScotland Examples
Thanks
Claire Guerin
Sector Manager – Sustainable Procurement
Mobile 07816 224368
Email: [email protected]
Disclosure:
4AllofUs have provided some travel funding to
me for this event
NHS SDU, Lancaster University, AAGBI,
have previously provided travel funding
I received an honorarium from Sagetech
Medical in 2015.
@frankswinton
How to engage clinicians:
Don't
Get patients to do it for you
Talk about money
@frankswinton
How to engage clinicians:
Don't
Get patients to do it for you
Talk about money
Don't talk about money
@frankswinton
How to engage clinicians:
Don't
Get patients to do it for you
Talk about money
Don't talk about money
Listen and show that you've heard
@frankswinton
How to engage clinicians:
Don't
Get patients to do it for you
Talk about money
Don't talk about money
Listen and show that you've heard
Push their buttons
@frankswinton
It’s not good healthcare if it costs
the health of someone else,
irrespective of geography, social
standing or time
@frankswinton
It’s not good healthcare if it costs
the health of someone else,
irrespective of geography, social
standing or time
@frankswinton
Healthier Retail & Catering
Peter Faassen de Heer
Health Improvement
Scottish Government
Healthier Retail and Catering
Overview
• Why are we doing this?
• Policy context
• What has already been done?
• What do we still need to do?
• Who is involved?
Why are we doing this?
Healthier Retail and Catering
In general:
Scottish Health Survey 2015
Why are we doing this?
Healthier Retail and Catering
Type 2 Diabetes:
Scottish Health Survey 2015
276,430
people by
end 2014
5.2% of the
Scottish
population
Cost of Type 2 diabetes
NHS Cost£1 bn
Scottish Economy Cost
£2.37 bn
Sources: Diabetes UK, 2013,Scottish Food & Drink Federation, 2015Audit Scotland 2015
NHS Board Spending 14/15
£11.4bn
Why are we doing this?
Healthier Retail and Catering
Other Diet Factors:
Why are we doing this?
Healthier Retail and Catering
In the NHS:
Kyle et al, 2016; Scottish Government
• 69.1% are overweight or obese (measured)
• 61% of nurses think they are overweight (self-reported)
• 28% of dietitians think they are overweight (self-reported)
• 96% of nurses feel they have a professional responsibility
to advise patients on diet and nutrition
BUT HOW MUCH DO WE KNOW?
Why are we doing this?
Healthier Retail and Catering
Knowledge test:
CNN
Why are we doing this?
Healthier Retail and Catering
Knowledge test – How many Oreos worth of sugar?
CNN
Why are we doing this?
Healthier Retail and Catering
Knowledge test: How many real donuts’ worth of sugar in
an iced caramel latte
CNN
Why are we doing this?
Healthier Retail and Catering
Knowledge test:
What are the reference (daily) intakes for kilocalories for
adult men/ women in Scotland?
Scottish Government, 2016
A. 3,500/3,000
B. 3,000/2,500
C. 2,500/2,000
A. 3.5%
B. 27.2%
C. 69.3%
Why are we doing this?
Healthier Retail and Catering
Or should we be doing this?
Why are we doing this?
Healthier Retail and Catering
• To improve the population’s diet
• To prevent dietary ill health
• To improve the wellbeing of NHS staff
• To back up patient information
• To save the NHS money
• To improve the Scottish economy
• “It’s the right thing to do”
Policy Context
• A successful Healthyliving Award
• A Commitment for public sector to excel
• A successful Healthy Living Programme
• Scottish Dietary Goals
• Health Promoting Health Service
• National Food & Drink Policy & Good Food Nation
• Supporting Healthy Choices
Healthier Retail and Catering
• Revised Patient Food Specifications – “Food in Hospitals”
Healthyliving Award Plus
• 70/30 split on healthier food & drink
• Applies to catering
• 129 sites across Scottish NHS
• All public sector and majority
voluntary sector compliant
Healthier Retail and Catering
• All including private sector must
comply at contract renegotiation
Healthcare Retail Standard
• A set of criteria for provision and promotion
What is it?
• 50% of food and 70% of drink must
meet provision
• Promotion is any incentive based on price
or position
• Applies to all retailers and trolley services
• Sets a minimum benchmark that boards
may exceed if they wish to
• Broadly consistent with the HLA for
provision and SHC for promotion to create
a level playing field
Healthcare Retail Standard
How are we implementing this?
• NHS NSS Oversight and reporting
• SGF team to audit & provide guidance
• Supplier list
• Eat Better Feel Better
• Health Promoting Health Service
• Securing retailer buy-in
• Health Board lease management
• 31 March 2017 or contract renewal
• Pilot Stores
Before …
…during..
…and after
Healthcare Retail Standard
What have we done?
• Developed and reviewed nutrition criteria
Healthcare Retail Standard
What have we done since 19 January?
• Developed and reviewed retailer guidance
• Developed and revised assessment protocols
• Established an implementation group to oversee
process (meeting 5 in October)
• Engaged with 4 retailers – RVS, WHSmith, Aroma
and M&S at head office and local level
• Established a Health Board Leads group
• Awarded a tender to evaluate the HRS and
conducted some baseline research
Healthcare Retail Standard
What have we done since 19 January?
• Created NSS Policy Guidance on procurement
incl. vending.
• Conducted 5 pilot evaluations. Two passes for
RVS at:
• NHS Lothian - Edinburgh Western General
• NHS GG&C - West Glasgow Ambulatory Care
Hospital (Yorkhill)
• Determined a process for ‘mixed’ sites
Healthcare Retail Standard
What do we still have to do by 31 March 2017?
• Finalise communication plans
• Finalise all nutrition and retail criteria
• Produce any additional support
materials on request
• Put the remaining stores through
the finalised criteria
• Complete and publish the supplier
list.
Healthcare Retail Standard
Bringing it all together…
StoreCustomer Feedback
SGFGuidance
Retailer business
model
HRS Criteria
SGFAssessment
NHS Board
HPHSTargets
NSSReporting
You
Healthier Retail and Catering
Thank
Question & Answer Session
#sushealthscot
Colin Sinclair, Chief Executive
NHS National Services Scotland
SUSTAINABILITY
IN
NHSSCOTLAND:
A CORE
PRIORITY
Direct Impacts (not including public health)
• >154,000 employees (c. 6% of Scotland’s workforce)
• > 4.6 million m2 estate
• Energy consumption around 1.8 TWh p.a.
• Direct greenhouse gas emissions around 650,000
tCO2e p.a. (c. 1.4% of Scotland’s total greenhouse gas
emissions)
• Annual waste arisings around 50,000 tonnes p.a.
Indirect Impacts
• Supply chain emissions
• Staff, patient and visitor travel
• Biodiversity and greenspace
• Corporate Social Responsibility
NHSScotland’s Sustainability Impact
Poor relative health and persistent inequalities.
Changing demographics. Reducing public sector spending.
The challenges
Legislation and Policy Drivers
• Sustainable
Development Action
Plans
• Public Sector Climate
Change Reports
• Biodiversity Action
Plans
• Climate Change
Adaptation Plans
• Waste Management
Action Plans
• Annual Procurement
Reports
• Asset Management
Strategies
NHSScotland
Sustainability
Initiatives and
Projects
Energy Projects
Energy
Efficiency
Projects
Energy Centre
Refurbishment
Renewable Heat and
Power
Greenspace Projects
Gartnavel CampusPossilpark Health & Social
Care CentreForth Valley Royal
Infirmary
Waste & Resource Efficiency Projects
Circular Economy – Metal recovery
Food Waste Reduction
Waste & Resource Efficiency Projects
Upcoming Challenges and Opportunities
• The 20:20 Vision
• Transformational Change
• Our Approach
• Funding Challenges
• From Mitigation to Adaptation
Looking Ahead
Thank you.
Q&A
Colin SinclairChief Executive – NHS National Services Scotland
Question & Answer Session
#sushealthscot
Chair’s Concluding comments
Brian Swanson, Chair of the NHSScotland Sustainability
Steering Group
#sushealthscot
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