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Environmental Auditing and Sustainability Issues                           

To introduce myself, I am an internal auditor with around 20 years’ experience in the NHS. I came to Leeds University from my home town, Sunderland, to study BSc. Ecology, graduating in 1988.  I got onto the NHS Financial Management graduate training scheme in 1990, originally with Northern Regional Health Authority, then transferring to Yorkshire RHA after about a year. I was attached to Wakefield HA for my training, and when NHS Trusts were formed, what was then Pinderfields Hospitals NHS Trust.  After leaving the scheme I worked at West Yorkshire Health Authority, which covered the Calderdale & Kirklees area, in a commissioning finance role.  I started with Aire Valley Internal Audit Consortium in 1997, in effect a predecessor of Audit Yorkshire which I now work for. With my background as an Ecology graduate and my interest in things environmental, I thought of combining my job role and interests in this blog.

Environmental Auditing

Environmental auditing is an environmental management tool for measuring the effect of particular activities on the environment, against set standards/criteria. There are different types of environmental audit, depending on the types of standards and the audit focus. Organisations of all kinds, including those in the NHS, recognise the importance of environmental matters and accept that their environmental performance will be assessed by a wide range of interested parties. Environmental auditing is used to:

  • investigate
  • understand
  • identify

These audits are used to help improve existing activities, with the aim of reducing the adverse effects of these on the environment. An environmental auditor will study an organisation's environmental effects in a systematic and documented manner and produce an environmental audit report. There are many reasons for undertaking environmental audits, which include issues such as environmental legislation and pressure from the public.

There are similarities with what Internal Auditing involves. Environmental auditing is a systematic examination, involving analysis, testing, and confirmation, of procedures and actual practices, which aims to verify whether they comply with legislation, organisational policies and procedures and ‘best practice’ and, as stated, an audit report is produced.

The key concepts are as follows:

  • Verification: environmental audits evaluate whether there is compliance to regulations or other criteria.
  • Systematic: environmental audits are carried out in a planned, methodical manner.
  • Periodic: environmental audits are conducted to an established audit plan.
  • Objective: information gained from the audit is reported free of bias/subjectivity.
  • Documented: notes are taken during the environmental audit, evidence obtained and findings recorded.
  • Management tool: environmental audits, like other types of audit, are integrated into the organisation’s management system (such as quality management systems or environmental management systems).

There is a set of standards in the area of environmental auditing, produced by the International Organization for Standardization (ISO). These standards are intended to guide organisations and auditors regarding the general principles common to the execution of all environmental audits.

The NHS and Environmental Impact

In 2010 the NHS published the following report:

Sustainable, Resilient, Healthy People & Places

A Sustainable Development Strategy for the NHS, Public Health and Social Care system

The Strategy provided “Our vision of sustainable health and care: A sustainable health and care system works within the available environmental and social resources protecting and improving health now and for future generations”.

The Strategy report then identified three Goals:

Goal 1: A healthier environment

Goal 2: Communities and services are ready and resilient for changing times and climates.

Goal 3: Every opportunity contributes to healthy lives, healthy communities and healthy environments

It went on to provide guidance documents and tools.

 Areas for the NHS to consider regarding Sustainability and the Environment (personal thoughts, based on what I have read/seen)

  • Energy efficiency: reducing electricity and other energy consumption will reduce an NHS organisation’s ‘carbon footprint’ (and potentially its expenditure as well). Can sustainable energy suppliers be used rather than those producing excessive carbon dioxide?  Can solar panels, even small wind turbines, be fitted to the roofs/other flat surfaces of buildings, even aiming to achieve self-sufficiency in electricity in some smaller NHS organisations?
  • Estate management: there are green spaces around many hospitals/NHS buildings. Are there trees/vegetation planted and properly looked after, and is this space protected from development (e.g. will not be used to extend carparks, replacing plants which take in carbon dioxide and give out oxygen with vehicles which do the opposite)? Are new capital developments, such as hospitals, designed to include green areas surrounding the buildings, with energy efficiency a priority in building design?
  • Reducing stationery use/better sourcing: can paper usage be minimised by increased electronic communication/data storage? Where paper products are used, are recycled ones sourced? Is waste minimised?
  • Recycling: is the organisation recycling everything it can recycle, e.g. all waste paper?
  • Catering and supplies: are organically grown and ethically sound (e.g. free range eggs/meat) products provided for patient and staff catering? Is minimisation of ‘food miles’ considered? Is food waste avoided?
  • Transport: Are unnecessary ambulance transfers/vehicle movements (such as vans travelling empty) occurring? Is there a move away from polluting older diesel engine vehicles, even to the increased use of electric vehicles/hybrids?  Are staff encouraged to walk/cycle to work, or share cars, as appropriate?  Are staff allowed/encouraged to work from home? Does a Hospital Trust work with transport operators/local authorities/PTEs to improve bus/rail links to its sites? Are alternatives to arriving by car publicised adequately to patients/visitors/staff?
  • Pollution: are waste incinerators still used? Could their use be halted/minimised, or filters placed on chimneys to remove ‘greenhouse gases’? Could incinerators be replaced by biomass power generators?

I hope that the Directors/management of NHS organisations can work with their staff/commissioners/the public to come up with imaginative ideas that will produce a less-polluting, more sustainable NHS. Good work in this area has been and is being done. NHS organisations might consider performing a baseline environmental assessment, and will then be able to determine periodically what improvements they have made over time and what might still be done.

by Alan Elliott, Senior Auditor