Last month the first ever sector wide report looking at how the health and care system is preparing for climate change was published (also known as the ARP report).
It was a first in the sense it looked at the whole sector and a first in that it was produced by a group of organisations from across that sector, who provided a perspective on their areas of responsiblity – with the Sustainable Development Unit (SDU) acting as the co-ordinator and editor.
Undeniably there were challenges, sometimes differences of opinion and the sign-off process was a lengthy one – but we got there in the end and importantly, I’d like to think produced a very useful document.
There was a real benefit in taking a cross sector approach to the subject matter but also the production process. So often we talk about moving away from working in silos – and how organisations in health and care must work together – but find it hard to do so when it comes to reality. By working together we were able to gain the understanding and perspectives from across the system.
What did we learn?
The report was split into two sections – the risks to the health of the population and risk to the delivery of services. The big risks are of course things like heatwaves and overheating in buildings, increases in air pollution and increase in flooding – as well as the impacts they have on services and communities.
We also know that the effects of these events are likely to be distributed unequally - with the unwell, old and deprived most at risk.
Is the sector prepared?
I don’t want this to sound like an end of year report but we do find ourselves looking at case of ‘making progress but must try harder’. It’s true there are parts of the sector and organisations that are well aware of the challenges and are putting plans and processes in place to deal with the repercussions.
There are some outstanding pockets of work. For instance there is great work going on in Somerset to build community resilience around flooding – in fact there’s a good film about Lostwithiel in Cornwall, and how the community responded since severe flooding in 2010.
The film shows the severe effects not only on property and infrastructure – but also to the community and physical and mental health of individuals. The area now has a flood forum that links up the community and local services to help evaluate local needs, raise and awareness and monitor risks.
So why is this so patchy?
We know for some organisations the current financial challenges are making it hard to look beyond the end of the month, let alone a year or longer. I can understand why a CEO of a local authority or hospital trust has other things on their mind when they are asked how they are thinking about dealing with the forecasts of extreme weather in the years and decades to come.
But we know by improving resilience and reducing the impact of climate change we will also bring health benefits for individuals, communities and services. Many actions can also save money – in effect they are ‘win-win’ – just like Lostwithiel where communities are coming together to make the most of local assets and protect the health of the local population.
The Sustainable Development Strategy (SDS) for the NHS, Public Health and Social Care system describes how a resilient sector can also be sustainable and reduce its impact on the environment. Indeed these are best considered jointly and in a collaborative manner to maximise benefits to all.
So what do we do now?
There is a clear synergy between responding to emergencies, preparing for extreme weather events and developing sustainable communities and services. It’s important we support planning at a local level – this means working with Local Resilience Forums (LRFs) and Local Health Resilience Partnerships (LHRPs) to embed climate change into local thinking and decision making.
This includes sharing information and plans, ensuring climate change is included in risk registers, HWB assessments and strategies as well as supporting local assurance mechanisms.
We understand the risks to the population nationally – but it’s also important we make use of the local knowledge about risks and infrastructure – and bring it together to gather a national perspective. We can also learn a lot from patient and staff experience in relation to climate change – such as what effect heatwaves have.
Most of all it is key that we do not allow this report to sit on file. It must be brought to life and used to catalyse action and make progress in taking forward more sustainable and resilient services. This needs to happen nationally, and in every locality too.
I really hope that we can embed this into discussions that are already going on and provide some impetus to keep developing a healthier nation and healthier system – one that is ready to face the challenges of the future.