2.helen maher
DESCRIPTION
Sustainability in Healthcare Children's University Hospital29/09/2011TRANSCRIPT
Importance of Sustainability in
the Healthcare Sector ?
Helen Maher
Estates Mgr,
Health Service Executive
Healthcare Sector Sustainability?
�Speaking to the Converted……
�Procurement
�Energy & Transport
�Waste Management
�Water & W
astewater
Healthcare Sector Sustainability
€337 Million
New Buildings
€7Billion
Goods & Service
52%
Health Procurement
106,000+
Health Employees
€14 Billion
Health Budget
Property Portfolio
�HSE Properties = 2,730
�50 Acute Hospitals
Non Acute
�Community Hospitals
�Psychiatric Hospitals
�Community Nursing Units
�Health Centres
Support Services
�Procurement Stores
�Maintenance Stores
�Offices
Healthcare Transport
Daily
�Commuters = 106,000+
�Goods Deliveries/Contractors
�Patient 6 Days Average in Hospital
�Visitors
Annual Healthcare
�3.5m Outpatient Treatm
ent
�1.3m Day Care Treatm
ent
�1.1m Accident & Emergency Treatm
ent
HSE Procurement
�5 Categories of Goods & Services = €5 Billion
�Drugs & Medicines
�Medical & Surgical Supplies
�Primary Care -GP’s, Pharm
acists
�Healthcare Services -Nursing Homes, Foster care etc.
�Healthcare Agencies -Voluntary Hospitals etc.
HSE Procurement
Other Significant Categories < €100m
�Catering
�Cleaning
�Bedding & Clothing
�Laboratory Consumables
�Blood Products
�X-Ray Consumables
�Office Supplies
�Furniture (Medical & Office)
�Office Stationary & Printing
�ICT Equipment
�Energy & Utilities
�Transport Fleet
Carbon Foot Print
NH
S C
arb
on
Fo
otp
rin
t
Goods &
Serv
ices
Build
ing E
nerg
y
Tra
nsport
60%
C0
2
Green Public Procurement
�Draft National Green Procurement Action Plan
�6 Priority Green Procurement Categories;
1.Construction
2.Cleaning Products
3.Food
4.Uniforms/Textiles
5.Paper
6.Electricity
�HSE Procurement Officers & Estates Mgrs
Energy Efficiency
�Value for Money; Energy Expenditure €85 Million
�2010 HSE Consumed 1,268 GWh
�2010 Procured Renewable Energy -8 GWh
�Public Sector Renewable Energy 15%
�National Energy Efficiency Target
�33% by 2020
�Regulatory Compliance
�Display Building Energy Rating > 1000m
2
HSE Energy Efficiency
�Energy Concession
�Energy Services Company
�Invest Energy Plant & EquipmentUpgrades
�No HSE capital funds required
�Key Perform
ance Indicators –
BER Ratings
�HSE continue Procure & Pay Energy Supply
�Energy Savings Benefit to HSE
�Pilot HSE South -€6 m
illion
�60 Non Acute Healthcare locations
�Year One Target Savings = 3 GWh
Sustainable Building
L
ife
Cylc
le C
osts
Desig
n
Constr
uction
Occupation
Green Transport
�Healthy Options -Cycle to W
ork Facilities
�Secure reliable Bus services, links Rail/Bus Stations
�High fuel costs, opportunity provide commuters options
�Maps & Inform
ation i.e. Travel ways Map
�NTA Carshare.ie –
CUH, UCHG, Letterkenny etc.
�Free Preferential parking for Carshare.ie users
�Acute Hospitals income from visitor parking
Healthcare Waste
�Value for Money; Waste Expenditure €23 Million
�Regulatory Compliance
�Food W
aste Regulations 2009
�Ban Food W
aste Landfill & Macerators
�Engage Food W
aste Recycling
�HSE W
aste Awareness Handbook
�HSE W
aste E-Learning Slides
www.HSELand.ie
Register & Download
Healthcare Waste
�EPA’s Green Healthcare Programme
�22 Hospitals: Waste & W
ater Audits
�Benchmark waste generation per Hospital
�Quantify W
aste Prevention Opportunities -€1.5m
Typ
ical
Acu
te H
os
pit
al H
eal
thca
re N
on
Ris
k W
aste
Rec
ycla
ble
Pap
er
Rec
ycla
ble
Pla
stic
Rec
ycla
ble
C'B
oard
Org
anic
Foo
d
Rec
ycla
ble
Met
al
Rec
ycla
ble
Gla
ss
Land
fill
Was
te
Healthcare Risk Waste
�National Healthcare Risk
Waste Contract (SRCL)
�Volume healthcare risk
waste reduced 3%.
�Expenditure reduced
10% to €8.6m
�2011 New rate per ton–
20% Discount
�70% Treated waste
diverted to Recovery as
fuel
Healthcare Hazardous Waste
Other as Identified…
White Goods
Waste Oils
Paints / W
eed Killers
Laboratory Chemicals
Fluorescent Tubes
Heavy Metal (Amalgam/Pb)
Batteries
Photographic Fix & Dev
Electronic & Electrical
Healthcare Non Risk Waste
Residual Landfill
Confidential
Records
C&D W
aste
Textiles
Metals
Plastics
Vegetable Oil
Wood
Cardboard
Biodegradable
Mixed Glass
Mixed Recyclables
Healthcare Waste Contract
�HSE Framework Contract for all other W
astes
�Currently 40+ W
aste Service providers
�V4M determ
ined by local competition
�Landfill Cost varies from €120 -€250 per ton
�Not all HSE locations pay by weight
�Framework Tender advertised on e-tenders April
�One Primary
waste contractor per Region
�Mini Competition for HSE Dublin Nth East
�Dublin, Cavan/M
onaghan, Louth, & Meath
�Maximize recycling rates
Water Consumption
�Value for Money; Water Expenditure €8 Million
�Increased 48% between 2006 –
2010
�Change from Flat Charge to per m
3
HS
E W
ate
r C
os
ts p
er
Re
gio
n
€0
€500
,000
€1,0
00,0
00
€1,5
00,0
00
€2,0
00,0
00
€2,5
00,0
00
€3,0
00,0
00
€3,5
00,0
00
WES
TS
THD
NE
DM
L
Re
gio
ns
Euros
2006
2007
2008
2010
Water Costs per M3
Loca
l Aut
horit
y Com
bine
d W
ater
Cha
rge p
er M
3 201
0
0.00
0.50
1.00
1.50
2.00
2.50
3.00
3.50 Wicklo
w Clare Kilkenny Wexford Waterford Meath Lim
erick Cavan Laois
Westmeath Sligo Longford Offa
lyNorth
Tipp.
RoscommonCork
City
Waterford City
Dun Laogh/Rath.DonegalAverage Carlo
wLim
erick C
ity Galway LeitrimMayo Cork Monaghan
South Tipp. KerryLouth
South Dublin FingalGalway C
ity Dublin City Kildare
Euros
Accounting for Water
�Water Expenditure per Acute Hospital, and per county
�Identify locations above Average Expenditure
�C&AG Report 2010 -Unaccounted for Water
�Local Authority Average UFW 41 %
�ForFAS Assessment of Water Services 2008
�58% UFW on consumer sidei.e. healthcare pipe work
�Routine water shortage by 2013; Athlone, Dublin, Galway,
Letterkenny, Limerick, Tralee, Waterford & Cavan
�Leak Detection surveys & water conservation
H2O Consumption
Wat
er
Co
nsu
mp
tio
n p
er
Ho
psi
tal T
ype
0
100
200
300
400
500
600
Acu
teM
ater
nity
Lon
g S
tay
Phyc
hiat
ricE
lder
ly C
are
Litr
es
per
Bed
per
Day
Health Technical Memorandum 04-01 (NHS UK)
Waste Water Discharge
�Local Authority W
astewater Discharge License
�Oil Fats & Grease -Catering Facilities
�Organic Loading –
Sewage, Milk etc.
�Alter pH Neutral -Chemicals
�24 Hour Sampling System
�Annual Monitoring Charges
�Monitoring Results
Health Impact Assessment
Hea
lth S
ecto
r R
esou
rces
Eco
nom
ic, S
ocia
l &
Env
ironm
enta
l Im
pact
s
Impa
ct o
n H
ealth
of
Pop
ulat
ion
Dem
and
for
Hea
lth S
ervi
ces
Hea
lth S
ecto
r C
apac
ity to
Del
iver
Q
ualit
y S
ervi
ces
Impa
ct o
n H
ealth
of
Pop
ulat
ion
Sustainable Healthcare
�Regulation Compliance is important
�Value for Money is the Key Driver
�Government Funding allocated to Healthcare
�Procurement -Green Procurement Criteria
�Infrastructure -Environmental Assessment
�Inform
ation is Pow€r, value of sustainable choices
�Key Healthcare
budget holder support
Importance of Sustainability
in the Healthcare Sector
Helen Maher
021 492 7210
THANK Y
OU
!THANK Y
OU
!THANK Y
OU
!THANK Y
OU
!