At a glance 23: Sustainable social care: climate change

Key messages

Introduction

The Sustainable Social Care Programme encourages commissioners of adult social care to promote sustainable development across the sector, particularly to reduce carbon emissions and adapt to climate change. Sustainable development requires us to consider social, economic and environmental outcomes simultaneously. It also means having regard for the needs of future as well as present generations.

For further information about the programme and related resources, please visit the Sustainable Social Care Programme section of this website.

Climate change and health

The climate is not static. Over the millions of years of earth’s existence, it has changed many times in response to natural causes. When people talk about ‘climate change’ today, however, they mean the changes in temperature over the last 100 years. During this time, the average temperature of the atmosphere near the earth’s surface has risen by 0.74° C. The Intergovernmental Panel on Climate Change says it is very likely (>90%) that human-generated greenhouse gas emissions caused most of the observed temperature rise since the mid 20th century.

In Europe, as around the world, changes such as rising sea levels, retreating glaciers, longer growing seasons, and shifts in species ranges are already evident.

The health implications of climate change are already manifest and impact more greatly on vulnerable groups. Health depends on a wide variety of determinants, and many of them (for example, temperature, pollution levels, access to food and water, and stress levels) will be affected by climate change. In the UK the positive effects of a warmer climate, such as a reduction in cold-related deaths, are likely to be outweighed by a series of negative impacts:

• an increase in heat-related deaths – predicted to reach 20,000 a year in the UK by 2050 due to more frequent and severe heat waves
• increased cases of skin cancer and cataracts
• injuries and infectious diseases as a result of increased flooding – a Foresight report predicted that by 2080 over three million people in the UK could be at risk from flooding
• anxiety and depression linked to physical and economic insecurity – flooding increases the risk of depression fourfold
• respiratory disease, insect-borne disease, and food poisoning are also expected to increase.

The August 2003 heat wave was associated with a large short-term increase in mortality. Overall, there were 2,139 (16 per cent) excess deaths in England and Wales. Worst affected were people over the age of 75 years. The impact was greatest in London where deaths in those over the age of 75 increased by 59 per cent. See health impacts of 2003 European heat wave.

The purpose of the Government’s Heat wave plan for England 2009 is to enhance resilience in the event of a heat wave. It is an important component of overall emergency planning, and will become increasingly relevant in adapting to the impact of climate change. See Heatwave plan for England 2009.

In support of this plan, SCIE published SCIE Guide 15: Dignity in care (Nutritional Care – Hydration) (Cass et al, 2009).

What is a ‘carbon footprint’?

A ‘carbon footprint’ measures the total greenhouse gas emissions caused directly and indirectly by a person, organisation, event or product. The footprint considers all six of the Kyoto Protocol greenhouse gases including Carbon dioxide (CO2) and Methane. A carbon footprint is measured in tonnes of carbon dioxide equivalent (tCO2e). The carbon dioxide equivalent (CO2e) allows the different greenhouse gases to be compared on a like-forlike basis relative to one unit of CO2. CO2e is calculated by multiplying the emissions of each of the six greenhouse gases by its 100 year global warming potential (GWP).

Mitigation and adaptation

Climate change mitigation is any action taken to permanently eliminate or reduce the long-term risk and hazards of climate change. This largely means action to reduce carbon emissions or our carbon footprint. Climate adaptation refers to the ability of a system to adjust to climate change (including climate variability and extremes) to moderate potential damage, to take advantage of opportunities, or to cope with the consequences. This includes the work of Local Resilience Fora, which work to ensure effective emergency planning and response, in preparing for extreme weather events; and commissioners and service providers designing buildings and services to take account of changes in climate overall. Some of these measures help address climate change in both ways. For example, health and care buildings designed with green spaces provide healing views, assist in cooling and flood run-off, and are also more energy efficient.

Co-benefits for health and climate of mitigation

The UCL Lancet Commission on Climate Change has provided evidence that action to combat climate change can lead to improvements in health. For example:

• Improvements in household energy efficiency could have net benefits for health, mainly through improved indoor temperatures and air quality, as well as helping to address fuel poverty.
• Meeting targets to reduce greenhouse gases will require more walking and cycling and less motor vehicle use, bringing substantial health benefits from reduced cardiovascular disease, depression, diabetes and dementia.
• Changing methods of electricity generation to reduce CO2 emissions would reduce particulate air pollution and deaths.
• The food and agriculture sector contributes 10–12 per cent of total global greenhouse gas emissions, with additional contributions from land use. A reduction in animal source foods could have great benefits for cardiovascular health as well as the environment.

Business case

The costs of stabilising the climate are significant but manageable; delay would be dangerous and much more costly.

The Stern Review (2006)

There are business benefits to tackling climate change.

Financial savings

Increasing energy efficiency and reducing overall energy consumption can have significant and long-term financial benefits.

Complying with legislation

The Climate Change Act 2008 has set challenging carbon reduction targets, and local authorities, the NHS and service providers have obligations with regard to these.

Reputation

Taking action against climate change helps set a leading example and raise public profile. Under the Carbon Reduction Commitment Energy Efficiency Scheme (see below), an organisation’s success in achieving carbon reduction will be published and compared with others’.

Improving population health and reducing health inequalities

This can be achieved by helping to mitigate the negative health consequences of climate change, reducing the direct negative health impacts of carbon-intensive lifestyles (e.g. from air pollution); and reducing the indirect negative health impacts of carbon-intensive lifestyles (e.g. inactivity resulting from high levels of car use rather than cycling or walking).

Risk management and good governance

With volatile energy costs, decreasing dependency on fossil fuels will reduce the vulnerability of the social care sector to future price rises. Care services can improve both efficiency and health while making a contribution to reducing carbon emissions.

Policy and legislation

Climate Change Act

The Climate Change Act 2008 introduced the world’s first long-term legally binding framework to tackle the dangers of climate change. The Act aims:

• to improve carbon management, helping the transition towards a low-carbon economy in the UK
• to demonstrate UK leadership internationally, signalling that we are committed to taking our share of responsibility for reducing global emissions.

Provisions in the Act include:

• a legally binding target of at least an 80 per cent cut in greenhouse gas emissions by 2050, to be achieved through action in the UK and abroad. Also a reduction in emissions of at least 34 per cent by 2020. Both these targets are against a 1990 baseline
• a carbon budgeting system which caps emissions over five-year periods, with three budgets set at a time and running from 2008– 12, 2013–17 and 2018–22. A number of policies and strategies are in place to help deliver on the Act.

Adapting to climate change programme

Co-ordinated by the Department for the Environment, Food and Rural Affairs (DEFRA), the Adapting to climate change programme co-ordinates and drives forward the Government’s work assessing and managing the risks from climate change. In March 2010, individual Government Departments published Adaptation and Mitigation Plans. Some of these were combined as Climate Change Plans, including the Department of Health’s Climate Change Plan.

Local authorities and Local Strategic Partnerships (LSPs)

An average county council produces 30,000 tonnes of CO2 per year, but its local community can generate 10 million tonnes. Councils therefore must not only lead by example but facilitate action where the greatest savings can be made. For example, 28 per cent of emissions are generated by transport and 27 per cent by domestic users.

From April 2010, the mandatory Carbon Reduction Commitment Energy Efficiency Scheme (CRC) will operate as a ‘cap and trade’ mechanism, providing a financial incentive to reduce energy use by putting a price on carbon emissions from energy use. The scheme will cover large public and private sector organisations, which are responsible for about 10 per cent of the UK’s emissions. This will affect around 20,000 organisations including local authorities and the larger NHS organisations.

For local authorities and LSPs, five National Indicators relate to the effects of climate change:

• mitigation of council emissions (NI 185)
• mitigation of community-wide emissions (NI 186)
• tackling fuel poverty (NI 187)
• adaptation to climate change (NI 188)
• flood planning (NI 189).

However, wider health and social care Indicators are also relevant, because of the positive interrelationship between health, being physically active and access to a good quality environment including housing and green space.

The NHS

The NHS in England alone is responsible for more than 21 million tonnes of CO2 each year. This is 25 per cent of total public sector emissions in England and 3.2 per cent of total carbon emissions in England. Saving Carbon, Improving Health: NHS Carbon Reduction Strategy for England (January 2009) www.sdu.nhs.uk/ page.php?page_id=94 provides a framework for action to reduce carbon emissions across energy use, procurement and food, travel and transport, water and waste, designing the built environment, organisational and workforce development, partnerships and networks. The strategy encourages NHS organisations to sign up to the Good Corporate Citizenship Assessment Model (see below).

Taking action and resources to help

The Nottingham Declaration has been signed by over 300 English local authorities as well as Local Strategic Partnerships and partner organisations. All Scottish and Welsh councils have signed their own versions. The Declaration is a statement of commitment to act on climate change, and is supported by a web-based gateway to information and advice on taking action at the local level.

Guidance and good practice in achieving National Indicator targets, including a directory of national and regional support, is published by the Improvement and Development Agency.

Down to zero from think-tank The Local Government Information Unit offers practical suggestions that will help local authorities tackle climate change in three stages – as an organisation, as a service provider and a community leader.

The Carbon Trust provides specialist strategic and practical support to business and the public sector to help cut carbon emissions, save energy and commercialise low carbon technologies.

The Good Corporate Citizenship Assessment Model devised for the NHS provides guidance and tools for putting sustainable development into practice and is applicable to other public service organisations.

Further information

Below is just a small selection of places to go for further information, including the sources on which we have drawn for this publication.

• Directgov: Understanding climate change - Directgov is the UK government’s digital service for people in England and Wales.
• UK Climate Impacts Programme - UKCIP helps organisations assess how they might be affected by climate change.
• SCIE Guide 15: Dignity in care (Nutritional Care – Hydration) (Cass et al, 2009).
• The health impact of climate change: promoting sustainable communities – guidance document (DH 2008) - contains advice for public health professionals on what can be done to mitigate and adapt to climate change and promote sustainable communities.
• The Sustainable Development Commission’s Healthy Futures programme helps the NHS and wider health sector explore how it can promote improved health and stronger, healthier and more sustainable communities.
• The Improvement and Development Agency offers wide-ranging information and guidance for local authorities on climate change and the environment.