The health sector will play a crucial role in reducing the impact of climate change on health. However, little is being done to address the impact of hospitals themselves on the climate and the environment in the EU. Hospitals and other healthcare units are energy and resource intensive, which indirectly affects human health by contributing to climate change. The healthcare sector in Skåne is responsible for CO2 emissions of more than 73 000 tonnes/yr. This suggests that the healthcare sector in the EU is responsible for millions of tonnes of CO2 emissions every year.
The CLIRE project aimed to demonstrate methods for dramatically reducing the carbon footprint of the health sector in Skåne. These actions were in line with EU objectives in relation to climate change, in particular, increasing the contribution of renewables to 20% of total energy supply and reducing carbon dioxide emissions by 20%, both by 2020. Specific objectives of the project included changing the public procurement system to favour products with a low carbon footprint; establishing a demonstration facility (the sustainable treatment room) and a working methodology that can be employed by health clinics; increasing the use of locally-produced renewable energy sources and refurbishing a hospital building using climate-smart technology; and transforming a number of buildings used for primary healthcare into demonstration sites.
The CLIRE project demonstrated how the healthcare sector can reduce greenhouse gas emissions and reduce its overall carbon footprint through different measures. These include green public procurement, increased use of renewable energy and energy efficiency measures, reduced transport use, and the application of climate-smart technologies in buildings. In particular, CLIRE enabled the two beneficiaries, Region Skåne and the city of Malmö, to make reductions in the climate change impacts on healthcare through a fruitful collaboration that has also bought economic benefits.
Two public procurement actions were completed, to favour the purchases of products with lower carbon footprints, after modifications were needed because the suppliers were not used to this type of environmental criteria. The project team calculated that when all the procurements actions in which CLIRE has participated in Skåne are implemented, carbon dioxide emissions could be decreased by 490 tonnes. This is equivalent to a reduction in climate impact of 11% relative to the 2014 total level. The two beneficiary organisations have exchanged experiences, which in the long term may result in joint procurements being made for certain product groups.
Energy efficiency actions implemented have achieved good results. These included 100% renewable energy being used in one hospital building. Energy efficiency and climate-smart technology initiatives implemented included sun-tracking solar panels, a green roof, improved ventilation and air recycling systems, and the use of renewable district heating. Through the various measures implemented at the clinics, at least 21% of their climate emissions have been reduced compared with the baseline established in 2011. This approach is now being followed in other buildings in Malmö. It has also been demonstrated that in addition to reducing the carbon footprint by improving processes, patients can be treated more efficiently. Through interviews with patients and staff, and by closely mapping the journey of a patient being treated for bladder cancer, the project team identified methods to make the process more efficient in terms of number of patient visits; travel to and from hospital; and materials, time and money consumed per patient. Furthermore, economical savings are gained when procuring better products and improving the energy efficiency of healthcare buildings.
One procurement action centred on the purchase of disposable items, which cost Region Skåne around two billion SEK annually. The project showed that some disposable items are discarded unnecessarily, and that in other cases there is an unnecessarily large consumption of disposable items since they do not fully meet the required needs. If the consumption of materials can decrease by 10% through rational choice and improved storage management, a large amount of money can be saved.
The project team built a climate-smart hospital room by refurbishing an existing room in the hand surgery unit using climate-friendly materials. This resulted in clear social benefits, in terms of patients being treated more efficiently and the climate-smart room providing a better working environment. The target of a climate-smart primary healthcare unit in the form of a demonstration facility had to be modified, however, because the target unit was relocated. Therefore, efforts were instead placed on educating and changing the behaviour of service personnel. The LIFE project has enabled healthcare personnel in the Department of Urology, for example, to broaden their approach, enabling them to get other clinicians to recognise that environmental issues are an integral part of operational development.
The project team produced a handbook for healthcare units, and also disseminated its findings at conferences and via noticeboards, leaflets, a website and other media. Properties that are currently used for healthcare activities within counties, regions and local authorities are often relatively old and energy-intensive. The project has shown a range of energy-efficient methods that could significantly lower the carbon footprints of healthcare units and reduce costs.
Further information on the project can be found in the project's layman report and After-LIFE Communication Plan (see "Read more" section).