For our latest interview in our digital sustainability series, we spoke to Luke O’Shea, Director of Innovation and Executive Lead for Sustainability at University College London Hospitals NHS Foundation Trust.
We discussed what they are aiming for in their green plan, their digital projects, what has gone well, and more.
Here’s what Luke had to say…
The green plan
Luke explained what UCLH is working towards in their ten point green plan, and how they are doing it: “As a trust we have recognised that climate change is the greatest global challenge we are facing and time is running out. About a year ago, we made the decision to declare a climate emergency and we set ourself a goal of reaching net zero by 2031 – quite an ambitious programme. That was driven by a clear health need; the last 20 years have been the hottest on record, we have seen high temperatures over 40 degrees for the first time. Climate change is harming our patients and this is just the start.
“We put in place a ten point plan around the climate emergency and that net zero target. We did lots of things in the last year to deliver that plan – lots around renewables, purchasing renewable energy, putting solar panels on all of our hospital roofs – we have just bought another 488. We are working to really up our game on virtual appointments. Last year we did about half a million virtual appointments which cut the patient travel miles about 13 million miles, so it’s quite a big deal.”
He added: “We moved away from the worst anaesthetic gasses, particularly desflurane. That’s really important because anaesthesia is about five percent of our footprint.”
Other factors in the ten point plan included reducing single use plastics and moving the trust’s approach on sustainability in procurement.
The approach
“We created a lot of sustainability champions throughout the hospital,” said Luke. “We have been supporting them to lead with changes, like increasing recycling, reducing medication waste, reducing plastic bag waste in pharmacy – all kinds of things.”
He added: “It’s really a process of engaging with staff to deliver that change, things that you can’t do as a senior executive alone. You have to get everyone working in the same direction.”
Digital projects
Regarding their digital projects, Luke commented that digital and technology are fundamental to everything they are doing within their plan.
He said: “There are specific tech innovations that you would expect – really exciting things that clinicians are coming up with all across the hospital. One example might be our gastroenterology colleagues working on things like new forms of testing through our colon capsules. They are swallowable cameras that patients can swallow in their own homes, and then we can look at detecting polyps and cancers without full endoscopy needed in hospital. We’re working with much less invasive technology models that can help patients at a far lower cost, and lead to a very significant reduction in carbon.
“Another big change is the increase in remote monitoring that we are able to deliver, including linking the monitoring into our electronic health record EPIC. We’re using our data to take on a population health approach, and using data and AI in more sophisticated ways to achieve lower carbon.”
He added: “In terms of interoperability, we have got our health information exchange; we can get blood test data from all over London on our patients, with all kinds of diagnostic data. This reduces the need to have the repeat diagnostics and reduces the amount of unnecessary tests and appointments, resulting in better care for patients.”
Successes along the way
The trust’s digital projects have brought about many positives. Luke commented: “I’d say that any project like this isn’t just about tech and digital, it’s very much about people. We have engaged people throughout the organisation, from ward to ward. We found that staff want to be proud that we are leading the way, that they are making changes. The starting point is really that staff and senior level of engagement, and it’s gone really well.
“Shifting away from high carbon areas like anaesthesia is definitely a success, as is our move towards renewable energies. Even in digital services themselves, we’ve thought about how we can do things differently – like moving to cloud for our data centres, for example, and looking at the future in terms of what a circular economy might look like on our tech and digital infrastructure. A lot of our tech partners like Microsoft are really pushing towards a carbon negative footprint.”
He added another benefit that has helped their green journey: “One of our clinical scientists suggested moving to a carbon negative search engine like Ecosia. Ecosia uses ad revenue from your searches to plant trees – it’s a very straightforward process, and nearly 10,000 trees later everyone is using it! Its’s a fantastic example of how a simple change can lead to a big improvement in sustainability. It was led by a single member of staff here at UCLH – every hospital can do it.”
Learnings as a digital leader
Luke expressed how important it is to get staff on board: “As a leader, first of all, you have to bring your senior colleagues with you. You have to make it a core part of what everyone wants to do and set a clear trust priority. It helps to get staff excited about it, so that everyone is talking about it and wants to push it in the same direction.
“Then you can find areas where you can make quick wins, things that save money – we have invested in over two and half millions pounds in LED lights which has generated a significant return on investment for us. That’s got people behind us, seeing how we can deliver less waste and lower carbon models of care. That was a big early win for us.”
The biggest impact
For Luke, the biggest change was the anaesthesia. “That was five percent of our footprint which is quite a significant amount. The impact of reducing our most harmful gasses has been very substantial, and there are certain things that you can do quite quickly. We supported our anaesthetists with 138 pumps so that people can move over to intravenous anaesthesia and away from gasses all together, which made it easy for them to do the right thing.
“On the digital side, people can make significant gains by thinking about their data centres, their recycling, and the shift to circular economy. Ultimately all of this has to start with the right structure, the right staff engagement and senior leadership.”
Digitising the workforce
When Luke joined the trust nearly three and a half years ago, they were just bringing in their new EPR. He reflected on how far they have come since: “Our electronic patient record, EPIC, was a massive change in terms of digitising all of our processes and moving away from paper. Everyone needed to have a certain level of digital skills to make things work on a day-to-day basis.
“The exciting part is that now we have reached digital maturity, all those brilliant members of staff have an understanding of digital capabilities and in many cases, the capabilities of how to use that infrastructure we have built to deliver better care and lower carbon care. It’s become a fundamental part of everyone’s daily job.”
The move from paper to digital
“Getting rid of paper is a delight!” Luke said, highlighting the positives of digital over paper records: “It’s fascinating to see clinicians have access to all the information they need on a patient wherever they are. We’ve got our patient clinicians running their clinics from home because they have far more information on their laptop at home on EPIC than they would ever had in the clinic with a paper file in front of them.
“It’s amazing. It’s really changed everything about they way we work in the hospital for the better. I don’t know anyone who would move back to paper.”
Green digital success, in five years and beyond
Considering what success will look like for himself and the trust, Luke said: “We are intent on moving rapidly to zero carbon, what will that look like? I think strategically, as I’ve said, we will see an acceleration of trends away from those high intensity carbon settings, and a move towards the delivery of care in lower intensity settings such as outpatients or home.
“Technology is going to play a really vital part and our tech vendors really need help us to deliver. We will see much more exciting things become mainstream – the colon capsules, as just one example.
“Alongside this, I’d expect to see much more use of virtual clinics and remote monitoring. They can produce significant savings in terms of the way we manage the infrastructure, and we can use our equipment in a much more effective way rather than single use culture.
“Clinicians are excited about being able to do their job better but without worrying so much about the harm its causing to the environment – so that’s what I’m looking forward to.”
We would like to thank Luke for sharing his time and thoughts.
