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Holistic population health; ICB activity to empower positive sustainable change Andrew Urquhart SNEE Integrated Care Board ESNEFT Conference 10 March 2025 What we are expected to do • ICSs aim to • improve outcomes in population health and healthcare • tackle inequalities in outcomes, experience and access • enhance productivity and value for money • help the NHS support broader social and economic development Section 52 Duty to have regard to wider effect of decis• ICSs.. Local need…focus on prevention, better resources efficiency and sustainability in relation to thoutcomes and reducing health inequalities.The ICB response to these asks is Noting that The ICBs role is.. Integrated care boards are populatione for planning health services for their local • We have a green plan • We have embedded this with a sustainability impact assessment process • Included sustainability in staff PDRs • Included sustainability in staff induction • Made net zero and social value training mandatory We have included‘Sustainability’ as one of theICS ‘seven down approachuccess’ in thejoint forwardplanto driveour 3 up & 3Example Sustainability Impact Assessment • SIA is an approach for exploring the combined economic, environmental and social impacts of a range of proposed policies, programmes, strategies and action plans. • Such assessments can also assist decision making and strategic planning throughout the entire policy cycle. (OECD) • Embeds net zero at the heart of every commissioning process • Toolkit is an enabler to design sustainability inCelebrating our successes in SNEE …… Nature at Work (NAW) In partnership with RSPB, ICB & ESNEFT Charity Staff health and wellbeing programme to improve physical, mental & digital health via nature connectedness nature-connected-organisations- handbook.pdf (findingnature.org.uk) Managed & driven by nature champions Monthly calendar of activities Lunch and learn & other events Quarter of ICB staff involved Legacy & impact… ICB now includes nature-based prescriptions as a clinical intervention Trust rollout – get involved!Appendices of useful background informationThe Sustainability Impact Assessment (SIA) • Document walkthrough Sustainability- NHS Suffolk and North East Essex Intranet (icb.nhs.uk) • Is a conversation starter/prompt • Contains a snapshot guide of salient issues • Outlines social value • ICB responsibilities • Steps to take to complete • Two social value questions i.e environmental & non environmental • Contains a series of prompts or guidance questions to pose as you formulate your approach. • Focused on key domains where the biggest impacts are • Example responses to help you • Links to useful informationHow to Stages Actions 1.Upskill & get Read the introduction snapshot guide complete ready Complete the online training on social value & carbon in healthcare the SIA 2. Read the Use the snapshot guide &/or the guidance prompts to see questions where your hotspots and point of difference might be 3. Answer the Remember the sustainable models of care lens questions Carbon impact is mandatory (& any others?) Non environmental social value 4. Sense check Discuss this with your partners, providers, teams, suppliers. What’s the art of the possible? Look at the example answers Utilise the useful information Use our ‘sustainability surgeries’SIA Example – Be Well Bus • Carbon Negative = bus transport emissions. • Solution = Optimise routes, switch fuels to HVO, longer term EV/biofuel. • Carbon negative = generator diesel powered. • Solution = Solar powered generators & battery storage • Carbon positive (?) = reduced patient's transport. • community integration, covd 19ing, recovery, equality. Prevention. Patient self-care. Lean. Lower carbon alternativesSIA Example - T eledermatology & community skin clinics  Carbon positive = Utilises technology to  Carbon positive = Supports care closer to minimise ‘care miles’ clinic patients seen in a community  Around 40% of patients do not need to attend a hospital outpatient clinic  Carbon positive = Reduces avoidable  Evidence-based, personalised care that hospital admissions – 70% of patients do achieves the best possible health and not require hospital appointment well-being outcomes  Social value positive = are discharged  Social value positive = supports recovery with reassurance (wellbeing) of dermatology services following Covid-  Reduced inappropriate 2WW referrals - 19 by reducing unnecessary hospital improved rate of biopsy demonstrated appointments  Deliver integrated care, one that co-  Social value positive = community health ordinates different elements of care & Wellbeing more effectively and remove duplication Prevention. Lean. Lower carbon and redundancy from care pathways also alternatives reducing unnecessary hospital appointments. Prevention. Lean. Lower carbon alternativesSIA Example - Proxy access for online medication ordering in older adult care homes medications online rather than using paper • Impacts….. forms Advantages: • wastage of medications as • Live system updated 24/7 so staff can see home only order what is status of prescription negating the need to needed ring the practice or pharmacy • Carbon positive = Reduced • Record of what is ordered and when paper/printing and errors • New medications added from hospital that • Social value = staff training wouldn’t show on paper prescription • Improved relationships between care homes Prevention. Lean. Lower and practice carbon alternatives • Upskilled care home staff • Better patient careSystem wide approach; Example to improve air quality Partnership work • Joint strategic approaches • Linking poor indoor & outdoor air quality • Linking to Colchester Hospital Respiratory hub • Staff training • Patient engagement • approachesg care pathway • Role of procurement & commissioning Example Medicines Management Started with inhaler switch programme. The team won the Presquip award for sustainability Has grown to • 2 Sustainable healthcare apprenticeships • Dedicated resource on inhaler switches • Dedicated resource on patient medicine waste • Future system wide approach • Wider waste considerations