Adding air pollution to your trust's risk register? | Sustainable Healthcare Networks Hub

Has anyone successfully added air pollution (outdoor, indoor, or both) to their trust's risk register. I've started looking into doing this after attending a trust board meeting where I learnt that the effects of climate change are on the trust's risk register, which triggers board-level attention to reduce and mitigate the risk. The risk from air pollution is so tangible and health-related, with so many immediate actions that could be taken to reduce it (eg no idling on car park, plug in points for ambulances so they don't have to idle whilst queueing up outside ED, getting the trust's cooking/heating off gas) that I am really keen to get it on there. If anyone has done it before, any top tips on wording/ what to include? Or would you be willing to share your template? Thank you in advance!

Comments (8)

James Warham • 1 month ago

If you do a search for 'air pollution NHS Trusts' it brings up a couple of documents including a Toolkit & documents on the Long Term Plan, I've listed a few below.

Mostly this focuses on digitisation and transport, but it does mention engine idling.
Nothing on food or cooking that I can find.

https://www.transformationpartners.nhs.uk/how-can-healthcare-profession…

https://www.transformationpartners.nhs.uk/wp-content/uploads/2017/11/To…

https://www.longtermplan.nhs.uk/online-version/chapter-2-more-nhs-actio…

This segways onto something I was to respond with.

I'm a tenant rep for my local Housing Association. They have a sluggish '3 point plan' to tackle sustainable issues in their housing stock. Habinteg is a HA that specialised in accessible and integrated homes.

They latest 'energy saving' advice is NOT conducive to good air quality.
Some sound advice including getting radiators checked and balanced. And installing radiator reflectors, but others such as draft excluders are something that make me uneasy.

As a tenant I have an Air quality monitor installed in the bedroom.
CO2 levels reach around 4000 PPM overnight in the winter (vents shut & doors shut) and domestic acts like drying washing on radiators increase humidity above recommend level.
Also monitoring Radon, VOC's and Particulate matter.

Hope you find some of this useful.

James

Jennifer Nixon • 1 month ago

Thank you James, those links looks really useful, and also some interesting points about the balance between air quality and air tightness/reducing heat loss.

Chris Birch • 1 month ago

I have been approaching this mainly from an indoor air quality perspective. The Global Action Plan (GAP) hospital clean air framework lays out practical measurers to address hospital air quality https://www.actionforcleanair.org.uk/files/clean_air_hospital_framework…

The challenge we have faced has been the multifaceted nature of the actions that have to be undertaken to improve air quality within a hospital site. This can be addressed and the evidence exists that this would have dramatic impact on patient recovery times and staff well being (both of which would be easily measurable) however to fully implement the strategy across a trust would cost millions and the savings made come out of many different budgets but certainly appeal to the director of finance so this could be your best approach from a board perspective . The challenge is getting a trust board to commit to such a project and to have the staff availability to maintain some of the measures e.g. air filer device maintenance. We calculated that for a large hospital such as a regional centre you would need at least 3000 localised air filter devices, which would need a maintenance team of at least 16 working full time to keep these filters working optimally. Would be more than happy to have a conversation and maybe this might help you in your quest.
cbirch@rsk.co.uk
07586 714358

Jennifer Nixon • 1 month ago

Hi Chris, thank you so much for that link, it is so thorough, and looks like it contains everything I could possibly need to include (and much more than I would have thought of myself!). Agree that things that cost will be a challenge, but getting it on the risk register will hopefully mean that the people in positions of power are aware of the direct health risks (as I think many people still think of air pollution as a bit abstract/something that happens in big cities (we are a rural hospital)) and start to consider these. And in the meantime, there are some simple measure that are cost neutral (or even cost-saving!). Thank you again, and I will certainly get in touch if we make any progress, or get to a point of considering things such as air filters.

Chris Birch • 1 month ago

Jennifer Nixon You can also mention this https://www.bbc.co.uk/news/articles/c5yx6leg4nqo

Una Devlin • 1 month ago

Hi Jennifer, you might find the work by Dr Mark Hayden at Great Ormond St useful. He spoke at the NHS Forest conference and you can watch his talk here: https://youtu.be/mlsy01OACAI?t=585

Jennifer Nixon • 1 month ago

Just watched this, what an interesting idea, and really makes you think when you think about how many deaths are attributed to air pollution but Ella's is the first case where the direct association has actually been acknowledged on the death certificate. Thank you

Chris Birch • 1 month ago

Jennifer Nixon I had a meeting in Southampton whereby I asked the question why do we not add Air Quality as a contributing factor on death certificates? Spoke with an Oncologist in India who had raised the same question. He sees non smokers riddled with lung tumours and is convinced poor air quality is a contributing factor but cannot comment on death certificates. Surely if clinicians were able to do this the political impact would be immense....

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