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And next speaker is Andrew. He is the sustainability lead for that ICB in Suffolk and Northeast Essex. And he's part of the ICB team that won the sustainability Best practice award for its lower carbon inhaler switch program. He's now in his fifth year in the NS sustainable healthcare. But previously, he's worked in community forestry, organic waste management and also in management roles to reduce waste and carbon emissions. So, thank you two. This is serious, isn't it? So it should be ok. Fabulous. Thank you. And I look at which one do I look at that? As long as I see? Ok, you don't need the not anything uh I can as long as that's the one that's showing. Yeah, doesn't matter. Yeah. Ok. Just like to ask. Yeah, thank you. Right. I've got reading glasses so I can look at my screen and look at the room. So, thanks, Becca. Hi, everybody. My name is Andrew. Er I'm the sustainability lead for the integrated care board. And so what is my role? Let's to work with Tim and Bride and Bec and other system partners on supporting them is to look at the I CBS role in this bigger picture, how we will integrate care services and also working with other strategic partners like local authorities, my job to reduce the impact of climate change on population health. So without further ado, I thought at four o'clock on a Monday afternoon, what better thing to talk to you all about than legislation? So, um I just want to highlight what we're expected to do and why and actually, as the legislation goes, it can always be pretty dry. But this is actually really exciting because what this does is this gives us legitimacy. This absolutely gives us a foundation for everything that you've heard today and what we want to talk about. So if you look on the left hand side, Health and Care Act in 2022 I've just snuck in underneath section 52 duty to have regard to the wider effect of decisions including efficiency and sustainability in relation to the use of resources. You've heard this time and time again today about resource efficiency, reusing materials, reusable equipment. Don't throw it away in the first place that circular economy thinking there are no landfills in nature. So we've got to absolutely try and nail this. If you think about giving good quality clinical care, we're always going to have a resource pool. But the more we can do to reduce the use of those resources, the better. And then underneath that, there's some other legislation I CBS must contribute towards the Climate Change Act. So the NHS has set net zero targets. So part of my role is looking at our own carbon emissions, but our biggest carbon emissions are commissioning. We're still a commissioning body. We plan, we pay for the healthcare services across Suffolk and North East Essex. So we're really well placed to start to drive and embed and change this, this agenda. And then the Environment Act has got four principal pieces of environmental legislation. This is all in the Health and Care Act waste legislations. We've covered that air quality, air pollution legislation. You've heard from Poland, from others. That air quality is the fourth largest contributory factor to premature death in this country. Up to 38,000 lives stands to reason, we need to do something about air quality nature and biodiversity, going to talk about that a little bit later on and water. I think Tim touched on it earlier with the driest region in the country. And if you look at Essex Council's Climate Commission, there's a real concern about the impact of climate change on subsidence. There's a clay scene that runs from Oxfordshire through London, London clay up towards Essex. Real concerns as the ground dries over the coming years. What that means in terms of buildings starting to sink because of subsidence. So that's medium to long term climate adaptation. How are we gonna adapt to this as we go along with one of our speakers spoke about that earlier and then the bottom one there um adapt to climate change like climate resilience. And I'm telling you all this for a reason, I'll be on the next slide. Now, the other thing is with the Health and Care Act, we form something called integrated care systems and we do have a bit of jargon, don't we? So what's an I CS? The I CS is coming together of everybody in health and social care in Suffolk and North East Essex. There are 42 systems across the country and that is about pulling all those partnerships together that whether it's GPS hospitals, mental health trusts, so on and so forth. And what have we been set up to do those integrated care systems, improve outcomes in population health and health care, tackle inequalities, outcomes, experience and access to service, enhance productivity and value for money and help the NHS on broader social and economic development. Um The lady that spoke from the Royal College of Nursing this morning touched on the un Sustainable Development Goals and the un sustainable Development Goals very firmly say you cannot tackle one thing in isolation if we want to eradicate poverty, which is a key driver of health inequality. And we all know the links with poor health and, and, and, and, and, and poverty and deprivation. You can't do that in isolation. You absolutely have to have something that protects the environment and tackles climate change simultaneously. And that's what those un sustainable development goals are about. So the I CSS are about local need, focusing on prevention, better outcomes, reducing health inequalities. Now, within this whole sphere, something called integrated care partnerships have been set up. They're an alliance of bodies that come together all the senior leaders across the health and social care system and they set a plan and I'll come onto that in a sec. And then also now talk about what's the role of the integrated care board and all of this. Now, everything I've just talked about and everything you've heard everyone talking about so far today looks suspiciously like me to what's in the left hand corner, the four key principles of sustainable care prevention, patient empowerment, lean, lower carbon alternatives. So we've absolutely got a platform. The legislation is telling us to do this. So if anybody's looking for advocacy or you're coming up with barriers or we can't do this, we can't do that. This is absolutely a statutory um requirement. The NHS has response to the Health and Care Act is two principal bits of statutory mandated um obligations, having a green plan, net zero strategy and NHS supply roadmap, all the stuff that we buy, consume where we can influence. Now, I'm not going to talk about the Social Value Act and Procurement and whatnot cos that's all just changed. I am going to talk about a previous model we developed based on the previous MO um Act, but we're still digesting that it's only been out a couple of weeks, but procurement and commissioning is also um really important for us in this space. So what's the I CBS role in all of this? Well, our job, we're responsible for planning health services for the local population. We're still a primary commissioner. We still work as a commissioner. So we're planning health care services. We're working with our partners and it's our job to embed this. Um So what are some of the things we've done before we get into the exciting projects? Well, we've embedded a sustainable impact assessment that encapsulates everything that I've talked about and what previous speakers have talked about so that every time we commission a project, whether it's buying goods and services or for health care or a contract renewal, this goes in it. That's really important and really exciting because that gives every single person that works to be able to do a project specific. One thing, you've got a corporate green plan which is changing the light bulbs and putting in renewable energy and all the great stuff that Tim and Re and Scott talked about earlier. But this is an opportunity to do something at contract specific level to drive meaningful change which people can own at the coalface. And that's what really excites me because I told you, I thought this legislation was exciting. So we've got um sustainability impact assessments. We've included this in the staff PD RSI think there's about 480 people in the ICB. Every single person has to do something around sustainability like you in the staff induction and we've made net zero and social value training mandatory. Now, the reason we've done that is to equip our staff, if someone, if we design this in at the beginning to tackle health inequalities and get better climate and environmental health outcomes, it's in at the beginning, we don't want to bolt it on halfway through. So this is about helping those people do that. And then just there look, sustainability is also one of the II CSS seven enablers to success in something called a joint forward plan. I talked about what um I CPS were they set the direction of travel and say, what's the strategy, the joint forward plan and that includes clinical input and within the joint forward plan for our entire system sustainability. We're there. We're one of seven critical enablers alongside the States and digital because we can help underpin good health care. So we're in there. The foundations are done because the legislation has given us the platform to start to do that. Really exciting. How do you take all of that stuff and condense it down into something that everyone understands because there's an awful lot there isn't there. Well, quite simply we've come up with up free down mantra. Three things. We want to reduce carbon emissions, air pollution