Sustainability benefits of energy behaviour change in a NHS Trust

Abstract

In 2015/16 National Health Service (NHS) hospitals in England spent over £570 million on energy, consumed over 10,983,151 megawatt hours of energy and produced 4.6 million tonnes of carbon dioxide equivalent (MtCO2e) from energy. In a survey of 70 NHS energy managers, it was reported that energy conservation is important to NHS organisations. However, to NHS healthcare staff energy conservation is a low priority and sometimes considered to be in conflict with their primary driver, which is delivering excellent patient care. This study assessed the implications of running a behaviour change intervention in a NHS hospital designed to reduce energy whilst putting patients first. To the researcher’s knowledge to date, there has not been a published academic study that has directly measured the sustainability (economic, environmental and social) benefits of running an energy behaviour change intervention in a hospital. In addition, all published information on energy behaviour change in hospitals relates to general acute-care hospitals. Therefore, this study addresses current research gaps by undertaking an academic study using mixed method data collection to directly measure the potential sustainability (economic, environmental and social) benefits to patients, staff and the organisation of running an energy behaviour change intervention in a NHS community hospital. The study was run in three older persons’ in-patient acute-care wards in a NHS community hospital (the Trust) in the South of England over a nine month period. The quantitative data collection methods used in this study included the use of air temperature, relative humidity, sound, carbon dioxide and light monitors together with window movement sensors to directly measure and monitor the ward environment. Other quantitative data collection methods used include the use of Trust management information to measure and monitor patient length of stay and movement sensors on patient beds to measure and monitor patient wellbeing in relation to rest and recovery. Together with Trust management information on staff satisfaction in relation to sickness levels and staff retention. The qualitative data collection methods used in this study included staff comfort surveys (n = 30 participants, 463 surveys) and staff focus groups (n = 30 participants, 6 focus groups) to directly measure the staffs’ experience and indirectly measure the patients’ experience. The study produced an economic and environmental saving of 13% in electricity consumption. Other environmental savings included an 11% decrease in artificial lighting loads, a 1 decibel reduction in mean noise levels, 0.6 degree Celsius reduction in median air temperature and 27% reduction in window movements during the heating season. Social savings included a 22% increase in patient rest when compared to the control group. In addition, this nurse led behaviour change intervention created the quieter periods required for better patient outcomes, which continued for at least a month after the intervention before gradually tailing off but not stopping during the monitoring period. It took up to a month to implement quieter periods showing a delay in the effect. Switching off small power equipment took effect immediately and continued for a month after the intervention, before tailing off over the next month and completely stopping the following month. The study also showed that the nursing staff had a heightened awareness of the environmental impacts on the wards as a result of the evidence based information used during the intervention, particularly in relation to noise and temperature, which creates risks in terms of acceptability of the approach to the nursing staff participating in the intervention, who reported their wards were cold as a result of controlling temperatures to remain within the CIBSE recommended levels (22-24⁰C) during the heating season.

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Identifiers

ORCID for Louise Kathleen Sawyer: orcid.org/0000-0001-7730-5118

ORCID for Patrick James: orcid.org/0000-0002-2694-7054

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