NCIC Green Plan 2025 to 2028

Our plan for a greener more sustainable future

• Executive Summary
• Introduction
  • About the Trust
  • Why do we need a green plan?
  • Net Zero Carbon
  • What are we seeking to achieve?
  • Our progress so far
• Working with our partners
• Health Inequalities
• Public Sector Equality Duty
• Areas of focus: Workforce and leadership | Net zero clinical transformation | Comms Behaviour | Digital Transformation | Travel and Transport | Waste | Energy/Water | Biodiversity | Medicines | Supply chain and procurement | Food and Nutrition | Adaptation
• Governance and accountability
  • Tracking and reporting progress
  • NCIC governance structure
• How you can help us meet the challenge
• Green Plan Action Plan 

 Executive Summary 

At North Cumbria Integrated Care NHS Foundation Trust, we are fortunate to provide care in one of the most beautiful, and environmentally sensitive, parts of the UK. We are committed to delivering high-quality care while protecting the health of our patients, staff, and communities—not just today, but for future generations.

We recognise that climate change is a health emergency, and as a leading healthcare provider, we have a responsibility to take decisive action to reduce our environmental impact.

This Green Plan sets out our strategy to become a more sustainable and resilient healthcare organisation. By reducing carbon emissions, improving energy efficiency, minimising waste, and promoting sustainable models of care, we will contribute to the NHS’s ambition of becoming the world’s first net zero health system.

We recognise that sustainability is not just about reducing our environmental footprint—it is about improving health outcomes, enhancing operational efficiency, and ensuring our Trust is fit for the future. Our approach aligns with the NHS Long Term Plan and the Greener NHS programme, ensuring that our actions support national and local sustainability goals.

Delivering this Green Plan requires collective effort. We will work with our staff, patients, suppliers, and partners to embed sustainable practices across all areas of our organisation. Every department, team, and individual has a role to play in making our Trust greener and healthier.

We are proud of the progress we have made so far, but we know there is much more to do. This plan is a commitment to continuous improvement and innovation as we strive towards a more sustainable NHS.

Together, we can create a healthier future for our communities and our planet.

Trudie Davies 
Interim Chief Executive

 Introduction 

About the Trust

We provide hospital and community health services to a half a million people. We are responsible for delivering over 70 services across 15 main locations and we employ over 6500 members of staff. Our values drive us to provide: Safe, high-quality care every time.

Our values:

Kindness - Kindness and compassion cost nothing, yet accomplish a great deal
Respect - We are respectful to everyone and are open, honest and fair - respect behaviours
Ambition - We set goals to achieve the best for our patients, teams, organisation and our partners
Collaboration - We are stronger and better working together with and for our patients
NCIC is part of North East and North Cumbria Integrated Care System (ICS), which is a partnership of organisations including local councils, voluntary and community services that provide health and care across our region.

Led by the North East and North Cumbria Integrated Care Board (ICB) we work collectively, join up resources and expertise to provide the best health and care for our local communities.

Why do we need a green plan?

Climate change is now viewed as one of the most serious threats to the continued health and wellbeing of millions of people worldwide. The worst aspects of climate change will inevitably affect greatest on those within society who are most vulnerable and least able to cope. It is therefore vital that action is taken at all levels to implement effective strategies to not only reduce carbon emissions, but also apply the broader principles of sustainable development.

The harm to health posed by climate change is both urgent and increasing. In addition to increased air pollution, the UK is already seeing more frequent and severe heatwaves and floods. Air pollution alone is linked to up to 38,000 fatalities annually, disproportionately affecting the most disadvantaged and escalating health disparities.

Chief Medical Officer’s annual report 2022: air pollution

Climate change will have a costly impact on society and the NHS, with the costs of heat-related deaths from climate change is estimated at £6.8 billion per year in the 2020s, rising to £14.7 billion per year in the 2050s. In contrast, addressing climate change directly benefits taxpayers, public health, and health equity.

A healthier environment means healthier people and healthier people have a lower impact on the environment by requiring less treatment and/or fewer medicines. Across our region, NHS organisations and partners are already taking-action, but there is more we can all do as users of the NHS services, staff, and those who supply us with goods and services, to make this happen. Good health is not just defined by the quality of health services but by the buoyancy of our local economy, as well as the quality and availability of housing, education and employment and the environment.

This Green Plan outlines projects and activities, which will evidence continual improvement in sustainability performance throughout the Trust, covering areas such as staff awareness and engagement, through to projects aimed specifically at reducing the carbon emissions associated with our service delivery, how we care for our patients and operate our estate.

Net Zero Carbon

Net Zero Carbon refers to the balance between the amount of greenhouse gas produced by the NHS and the amount removed from the atmosphere. Net Zero is reached when the amount we add is no more than the amount taken away.

The NHS has set two ambitious targets for delivering a Net Zero NHS strategy:

1. Net Zero by 2040 for the emissions we control directly scope 1 and scope 2 (the NHS Carbon Footprint), with an 80% reduction by 2028-2032.
2. Net Zero by 2045 for the broader emissions we can influence scope 3 (the NHS Carbon footprint plus), with an 80% reduction by 2036-2039.

Scope 1 carbon emissions are direct emissions from owned or directly controlled sources, on site.

Scope 2 carbon emissions are indirect emissions from the generation of purchased energy, mostly electricity.

Scope 3 Carbon emissions are all other indirect emissions that occur in producing and transporting goods and services including the full supply chain, patient and visitor travel.

The Trust is committed to achieving net zero, as part of this commitment the Trust has recalculated its 19/20 baseline emissions which has enabled more quantifiable emissions data to be captured, which has allowed more effective monitoring of progress. The Trusts recalculated 19/20 baseline footprint and emissions is 56,548 tCO2e. We will continue to strive to meet our targets and respond to challenges.

What are we seeking to achieve?

We will make the best use of our resources and deliver financial and environmental sustainability. Embedding net zero principles across our services, identifying carbon reduction opportunities in the way care is delivered.

Our progress so far 

The Green Plan and action plan sets out how we will do this and the Trust will follow the trajectories for reaching net zero. The Trust’s Green Plan working group meet on a monthly basis, to lead work on carbon reduction and assist the ICB North East & North Cumbria (NENC) in becoming England’s Greenest Region by 2030. The Trust in partnership with the ICS should reach net zero on or before the NHS deadline of 2040 for direct emissions and 2045 for indirect through:

• Ensuring the delivery of the NCIC Green Plan.
• Supporting the engagement of staff across all parts of the Trust in delivering the NCIC Green Plan.
• Actively champion the work of the sustainability programme across the Trust.

• NHS Net Zero Building Standard Training is available to all staff.
• The Trust is supporting a member of staff through the Junior Energy Manager apprenticeship, an apprenticeship identified in the NHS estates sustainability career pathway.
• Piped nitrous oxide has been decommissioned on some of our sites; we are working with clinical teams to reduce the usage of piped nitrous oxide and to move to cylinders where nitrous oxide is still clinically required.
• Carbon friendly inhalers are now promoted in the Trusts formulary.
• Teams are currently working on reducing patient travel by making clinics available closer to home through promoting use of remote clinics.
• The Trust has recently launched the Electronic Patient Record (EPR). The EPR programme will bring a suite of fit-for-purpose digital tools and technologies designed to manage patient information and make it easily available for our staff and patients. This will provide patient information at your fingertips, enabling better, more effective decisions. It will provide access to decision support tools, meaning decisions are based on best available information. From an environmental aspect, it will reduce fleet transport mileage and reduce the volume of paper used within the Trust.
• A reusable (textile) hat project is being implemented in theatres to replace disposable theatre hats. The textile hats are sewn by volunteers with role and name embroidered on top. There is a current project to establish reusable gowns as default PPE in theatres, which will further reduce reliance on single use items.

• Energy saving investment has taken place in the form of increasing on-site renewable energy generation through installing solar photovoltaics at the West Cumberland Hospital and installing more energy efficient lighting (LEDs) across the acute and community hospitals.

• All NHS waste is diverted from landfill.

• Recycling facilities (dry mix recycling) are available at all sites.

• The Trust continues to work towards the clinical waste national segregation target of 20/20/60 – incineration, alternative treatment and energy from waste respectively.

• Additional electric vehicle charging points have been installed at the Cumberland Infirmary.

• The Trust has developed a furniture swap shop platform; due to the success, the Trust is exploring the possibility of increasing the range.

• All NHS Procurements include a minimum 10% net zero and social weighting.

• Carbon reduction is a key priority in all capital investment decisions.

• Catering departments have eliminated single use plastic cups, dishes and cutlery. 

• The waste team has reduced the volume of single use sharps containers sent to incineration by extending the open date of a container to 12 months.

 Working with our partners 

We work closely with our partners across the North East and North Cumbria Integrated Care System and share an ambition to be the greenest region in the NHS. We are challenging each other to deliver carbon reduction at pace and have an effective community of practice to share best practice and different ways of working.

Within North Cumbria, we have played a leading role alongside Cumberland Council to establish and Anchors Institution Network, which is bringing together major employers and service providers to collectively explore how we can go beyond our core functions to bring added economic, environmental and social benefits to our community. Our partnership is developing and we are confident it will bring practical collaboration to impact on climate change and carbon reduction.

The Trust Green Plan working group is a cohort of staff from multi-disciplinary teams, who have collaboratively worked on refreshing priorities, actions, time- frames and have identified clear metrics and key performance indicators.  

 Health Inequalities 

The Trusts plays a big part in tackling health inequalities, the Green Plan is part of this. The Green Plans actions are aimed at lessening the Trusts environmental effect as part of its promise to become a net-zero carbon organisation by 2040. Environmental problems like pollution, access to green spaces, and climate change can disproportionately harm deprived populations; our Green Plan actions are in line with addressing health inequalities.

Reducing carbon emissions, enhancing building energy efficiency, encouraging environmentally friendly travel and cutting waste are all part of the Green Plan. Beyond these environmental considerations, the Trust ensures that its sustainability initiatives benefit all groups, especially the underprivileged or those with less access to healthcare.

By incorporating health equity into the Green Plan, we can:

Reduce environmental health risks: communities who are frequently the most impacted by air pollution might gain from enhancing air quality through emission reduction and the promotion of green energy.

Promote active travel and access to green spaces: Physical and mental health can be directly improved by promoting walking or bicycling to healthcare facilities and expanding access to green spaces in deprived regions.

Increase public engagement: Participating in sustainability projects, such waste reduction campaigns or tree planting can empower people and communities, and promoting better health outcomes.

 Public Sector Equality Duty (PSED) 

The Public Sector Equality Duty (PSED) is part of the Equality Act 2010, and it requires public bodies, including NHS Trusts, to have due regard to three main aims:

Eliminate unlawful discrimination, harassment, victimization and any other unlawful conduct prohibited by the act.

1. Advance equality of opportunity between people who share and people who do not share a relevant protected characteristic.
2. Foster good relations between people who share and people who do not share a relevant protected characteristic.

In the context of the Green Plan:

The Trusts makes sure that no specific group is unintentionally disadvantaged by our environmental strategies:

• We act proactively to guarantee that everyone, especially those living in deprived  areas, benefit from sustainability's advantages, such as better public health, green spaces, and cleaner air.
• Health and environmental gains are fairly distributed, with an emphasis on underserved or deprived communities.
• Decision-making procedures are open, inclusive, and take into account the requirements of many groups.

Sustainability projects, like waste management plans or energy-efficient hospital structures, do not inadvertently put marginalised groups at a disadvantage (for instance, by raising healthcare expenses or failing to consider physical access demands).

 Areas of focus 

The Green Plan is our commitment to reduce our impact on the environment and to deliver sustainable healthcare, helping to secure better health. We will work with patients, staff, local communities and partners to put our organisation on a path to a cleaner, greener, healthier and more equitable future.

Our Green Plan sets out a framework for how the Trust will reduce the impact of climate change and pollution on health, reduce reliance on unsustainable services and medicines and embrace ‘green’ learning and innovation.

The Green Plan is underpinned by 12 green goals for the Trust.

1. Workforce and system leadership
2. Net Zero clinical transformation
3. Communication and behaviour
4. Digital transformation
5. Travel and Transport
6. Waste
7. Energy/Water
8. Greener NHS/Biodiversity
9. Medicines
10. Supply Chain and Procurement
11. Food and nutrition
12. Adaptation

An action plan has been developed to accompany the Green Plan. Within each area of focus on the action plan, actions include time bound actions and associated key performance indicators (KPIs) to support progress tracking. The actions for the period 2025-2028 are enclosed as an appendix.

Workforce and leadership

People will be the driving force behind the trust's shift to a net zero. The trust remains committed to empowering our staff and leaders to engage in innovation, and the integration of sustainability into their daily practices. We will continue to raise awareness of sustainability, providing staff with access to training and opportunities for educational development.

The trust continues to provide the option of flexible working including working from home, the number of remote meetings across the NHS increased enormously. Staff have reported higher productivity, with less time spent travelling, and the additional benefits of less exposure to air pollution, better attendance in (virtual) meetings, and better work-life balance.

Net zero clinical transformation

In order to improve illness prevention and lessen health disparities, the trust is dedicated to implementing out-of-hospital and digitally enabled care where clinically suitable. At every level, patients should receive high-quality, preventative, low-carbon treatment thanks to net zero clinical transformation.

There is no ‘one size fits all’ when it comes to patient care, but we aim to build a platform of competent healthcare tools that can assist both clinicians and their patients in bettering the level of their treatment. The long-term aim of the Trust is to reduce carbon whilst increasing the quality of patient experience. The purpose of digital models of care is not to replace hospital treatment but to work alongside physical appointments for the benefit of our patients.

Communications and behaviour

The way in which our colleagues use our resources plays an essential role in helping us to manage our climate impact. We are focussing our communication and engagement activity in a number of areas

• Recycling and effective waste streaming, especially in clinical areas.
• Appropriate use of resources - including use of reusable surgical gown and hats, reducing the use of single use items, and promoting re-use of equipment no longer needed.
• Energy efficiency - turning off lights and electrical equipment on standby.
• Transport planning – reduce miles travelled and increase take up of electric vehicles.
• Encourage climate literacy – through the take up of climate awareness training

Celebration of green champions - staff who are making a contribution to our green agenda.

Digital transformation

Strong digital underpinnings are necessary to improve care by increasing productivity, quality, accessibility, and lowering emissions. We will focus on ways to utilise existing technology and systems to streamline service delivery, maximising the advantages of digital transformation to lower emissions and enhance patient care.

Travel and transport

The NHS fleet is the second largest in the nation. It is a direct cause of dangerous air pollution. In addition to offering financial and health advantages, the NHS Net Zero travel and transport strategy provides a path for decarbonising NHS travel and transportation.

Waste

As part of the NHS 10 year plan for waste management the Trust will segregate clinical waste into three core streams, hazardous, infectious and non-hazardous/non-infectious. The Trust will continue the work to remove plastics from high temperature incineration. The Trust is responsible for producing over 2,800 tonnes of waste per annum and irrespective of its disposal method, waste has the potential to pollute land, air and water.

Energy/Water

Focus on reducing the carbon emissions arising from the Trust’s buildings and infrastructure. The Trust is committed to reducing the environmental impacts from our buildings, infrastructure and equipment essential for the smooth running of the hospital, where feasible and affordable. We need to improve energy efficiency of the equipment we use and in our buildings to reduce energy and water consumption.

Like most NHS sites, NCIC has a variety of buildings constructed over a period that range vastly in their energy efficiency. We will continue to reduce demand and consumption; we will also continue to implement renewable energy technologies subject to feasibility, capital, and planning constraints.

Biodiversity

There have been a number of studies demonstrating the benefits of exposure to green space. The findings show that interventions to increase or improve urban green space can deliver positive health, social and environmental outcomes as well as the additional benefit of purifying the air in an urban environment. There is limited access to green space on our sites due to location restrictions of residential housing and surrounding roads.

Medicines

We will continue to examine the key opportunities to reduce carbon emissions in relating to prescribing and use of medicines and medical products. Medical gases play an essential role in making surgeries safe and have undisputed benefits in the medical field. Anaesthetic gases, however, contribute approximately 5% of the NHS emissions and reducing the use of carbon intensive anaesthetics is essential to achieve Net Zero. The trust continues to improve patient care, cut waste, and reduce these "point of use" emissions. Reducing nitrous oxide also supports the Royal College of Anaesthetists recommendation that the continuous supply of nitrous oxide via pipelined supply is longer essential and by reducing nitrous oxide protects staff by limiting their occupational exposure.

The trust continues to improve patient care, cut medicinal waste, and reduce these "point of use" emissions.

Supply chain and procurement

The biggest contributor to our carbon emissions as a Trust comes from procurement, which includes all of our purchases. Our waste and procurement carbon footprints are combined because it is also the primary source of a large portion of our waste. Procurement is a scope 3 emission that, in general, comes under the NHS carbon footprint plus targets. Although we have some control over it, we can also lower it through our purchasing patterns, delivery strategies, and procedures.

Suppliers must adhere to the NHS net zero supplier roadmap in order to meet the NHS net zero goal by 2030. Trusts, systems, regional procurement hubs all share responsibilities for implementing the roadmap. When clinically suitable, the trust will try to incorporate circular solutions, which are frequently less expensive and include adopting reusable, remanufactured, or recycled solutions.

Food and nutrition

In order to reach Net Zero, we will make our catering services more environmentally friendly. Our goal is to expand on the efforts previously made in the catering department to cut down on plastic waste, make lower-carbon food options available, and boost the local economy and making our supply chains more sustainable.

The National Standards for Healthcare Food and Drink has been implemented within the trust, which mandated that NHS organisations provide high-quality, sustainable, and healthful food while minimising waste.

Adaptation

Both now and in the future, climate change will make it more difficult for the NHS to provide its vital services. Longer-term planning and business continuity should incorporate resilience and adaptation to prevent service interruptions caused by climate change. Collaboration between public health, emergency response teams, sustainability leads, and estates leads at the trust and system level is essential.

 Governance and accountability 

A clear governance structure for accountability and reporting on progress towards the Green Plan is vital. We must ensure compliance with sustainability legislation, regulations, best practice guidelines and contribution to the national sustainability targets.

The Green Plan has an approved Director lead and an operational net zero lead

The Trust has an established Green Plan working group, which has overseen the review and development of our proposed plan, which works collaboratively to achieve the net zero target, attendees of the group, are from a range of different multi-disciplinary teams.  Members of our Green Plan Working Group are responsible for ensuring that the Green Plan action plan is completed.

The group reports to the Estates and Procurement Committee, and meet monthly and at such other times as may be required.

Environmental Sustainability is featured within the Trust’s ‘Our Strategy’ 2024-2029  reinforcing the Trusts commitment to embed net zero principles across the services we provide through identifying carbon reduction opportunities in the way care is delivered.

Tracking and reporting progress

The Green Plan is accompanied by a Green Plan action plan. Progress within each domain is reported periodically as per the reporting timetable. 

In order to assess the progress made and any new priorities, guidance, technology and other enablers, the Trust is committed to reviewing the Green Plan and action plan annually.

NCIC governance structure

 How you can help us meet the challenge 

In order to achieve the vision and goals set out in this Green Plan, our people will need to be inspired, empowered and motivated to take action to contribute to the climate emergency challenge at a personal, organisational and community levels. Green Champions Become part of the green champion network, we are growing a network of green champions from a wide range of departments. We recognise that our people are central to the successful implementation of our key objectives.

Greener suggestions

Suggestions are always welcome; these will identify areas of concern, which can be identified for potential improvement: ncic.environment@ncic.nhs.uk

 Action Plan 

The Trust has a comprehensive Green Plan action plan, actions identified from the Green Plan action plan 2025 to 2028 are: