ADD2650 Primary Care Estate Net Zero Roadmap for London

1.1.    The Mayor of London has set a target for London to be net zero carbon by 2030. The NHS also aims to be the world’s first net zero health service. For direct emissions (e.g. on site use of fossil fuels for heating), the NHS nationally has a target to reach net zero by 2040 with an ambition to reach an 80 percent reduction in emissions by 2032. 

1.2.    Community Health Partnerships (CHP) manage primary care estate across London and work closely with the London Estates Delivery Unit (LEDU). LEDU are a virtual team bringing together regional and regionally-based national expertise to support the collaborative development of robust NHS estates strategies and capital business cases, and are hosted at the GLA. LEDU report to the London Estates Board (LEB), which aims to solve some of the challenges involved in securing NHS estates approvals and disposals. 

1.3.    At a national level, the health sector is estimated to contribute to around one third of direct (e.g. scope 1) carbon emissions from public sector bodies. The use of energy in buildings is estimated to account for around 40 per cent of the NHS Carbon Footprint . Acute sites such as hospitals are the largest consumers of energy and account for the majority of carbon emissions from NHS buildings in London. However, the primary care estate contributes a significant proportion of emissions nationally (around 10% of the NHS estate) and the proportion could be higher in London given the density of population and GP practices.

1.4.    CHP and LEDU require additional information on the energy performance of primary care estate in London to help them determine what actions need to be taken to meet net zero ambitions. 

1.5.    Primary care sites are not within the scope of support offered by the Mayor’s Low Carbon Accelerators, due to their small size and mixed ownership of sites. The Mayor’s Business Climate Challenge (BCC) has supported some GP surgeries as part of its cohort of SMEs, enabling them to identify measures they can take to reduce the energy use and emissions. However, this is just a small proportion (less than 5 per cent) of the primary care estate and the BCC is restricted to buildings within Business Improvement Districts. 

1.6.    Data collection and analysis of building performance and energy use are required across the five Integrated Care System (ICS) areas in London, comprising around 1,000 GP surgeries. This will provide CHP with a clearer understanding of the energy and therefore carbon footprint of the estate. CHP also lack information on what potential energy efficiency and decarbonisation measures are needed across primary care estate in order to reduce carbon emissions in line with net zero targets.

1.7.    CHP have received a detailed proposal to develop a clear and concise net zero roadmap for primary care estates across the five ICS areas in London. The first step in achieving this is the development of a carbon baseline for approximately 1,000 GP premises across Greater London. Data will be gathered on energy use from fossil fuels and electricity, water and where possible waste to generate a carbon baseline. On completion of the carbon baseline, CHP propose to develop a decarbonisation roadmap to achieving net zero throughout the NHS primary care estates portfolio. The roadmap will provide recommended actions that the ICS and GP practices can take to decarbonise their estates and guidance on clinical practices to adopt. Each action will be ascribed a carbon impact, providing an understanding of the decarbonisation potential offered. Also included will be an indication on level of investment required to reach net zero by target dates.

1.8.    CHP have estimated the work to cost up to £88,000 and require match funding of up to £44,000 through a grant agreement with the GLA to utilise alongside funds already secured from LEDU. CHP would commission and manage the work, with guidance from the GLA and LEDU. CHP will undertake a benchmarking exercise (comparative rates review) to ensure value for money. The contractors will be appointed by direct award via CHP’s ‘SBS Framework’.

1.9.    The work aligns with the objectives of the Environment and Energy Unit, helping the NHS to develop decarbonisation actions in line with a net zero target and also providing early pipeline development for the potential delivery of measures through mayoral support and/or funding programmes. The work could also inform a wider net zero roadmap for London, demonstrating the level of analysis that may be required to produce tangible plans to deliver net zero for specific sectors.
 

2.1.    The scope of this stage of the project will be the estates of ~1,000 General Practitioners (GPs) practices across the five Integrated Care Systems (ICS) within the boundary of Greater London. The work commissioned by LEDU/GLA and procured by CHP will engage with a select group of GP practices to understand typical conditions and sustainability initiatives. This will then develop “archetypes” which represent all GP premises (e.g., purpose-built health centre, converted house etc.) and will provide average emissions for each type of practice.

2.2.    The aim of this stage is the development of a net zero roadmap for the GP surgeries across Greater London, plotting out trajectories towards net zero targets (both GLA and NHS England targets) and indicative actions required to achieve these targets. 

2.3.    The roadmap will identify potential decarbonisation actions that can be implemented for each GP archetype, benchmark cost and carbon savings that each action can deliver, the level of investment required to reach net zero by target dates and will suggest typical governance procedures that GP practices can use to manage and deliver the roadmap. 

2.4.    The work will help to identify and prioritise key sites to approach for decarbonisation. Outputs will include:

1.    Greater London wide primary care decarbonisation trajectory, from baseline to net zero target (with intermediary targets included)

2.    short-list of typical actions which can be implemented and estimated costs to achieve net zero

3.    early pipeline development for the potential delivery of measures through mayoral support and/or funding programmes

4.    demonstration of the type of analysis that could aid other sectors in developing tangible net zero actions and timelines.

2.5.    Each of these outputs are also key performance indicators which feed into a wider Net Zero Roadmap and Blueprint work being designed by the Environment and Energy Unit and will help drive proactive insights, strategy, policies and programmes for the 2024-25 business plans. 
 

3.1.    Under section 149 of the Equality Act 2010, as a public authority, the GLA is subject to the public sector equality duty and must have due regard to the need to: 
•    eliminate unlawful discrimination, harassment and victimisation 
•    advance equality of opportunity between people who share a relevant protected characteristic and those who do not 
•    foster good relations between people who share a relevant protected characteristic and those who do not.  

3.2.    Protected characteristics under section 4 of the Equality Act are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sex orientation, and marriage or civil partnership status (all except the last being “relevant” protected characteristics).

3.3.    The GLA will take appropriate steps to ensure that there are no potential negative impacts for those with protected characteristics from the work with CHP. The findings of the study will benefit Londoners by helping to identify where improvements can be made across the primary care estate, not only to reduce carbon emissions but also to help improve the performance and comfort of GP surgeries frequented by all Londoners.
 

Key risks and issues
4.1.    Key risks and issues are outlined in the table below:

Links to mayoral strategies and priorities
4.2.    The proposal supports the priorities of the London Partnership Board, and specifically its Green New Deal mission, which aims to tackle the climate and ecological emergencies and improve air quality, while doubling the size of London’s green economy.
4.3.    The outputs of the study will contribute to early pipeline development for the potential delivery of measures through mayoral support and/or funding programmes. It will contribute towards a broad range of objectives, policy and proposals in the London Environment Strategy and the Mayor’s Pathways to Net Zero by 2030, as set out below:

•    Objective 6.1 – reduce emissions of London’s homes and workplaces while protecting the most vulnerable by tackling fuel poverty
•    Policy 6.1.3 – improve the energy efficiency of London’s workplaces and support the transition to low carbon heating and power
•    Proposal 6.1.3.b – support the reduction of emissions and energy use within the commercial sector, including through improved building management, energy efficiency and reporting.
 

5.1.    Approval is requested for a grant of up to £44,000 funding from the GLA to Community Health Partnerships (CHP) toward the development of a Primary Care Net Zero Footprint and a Roadmap to achieve net zero in primary care premises in London. 
5.2.    The works will be contracted via Community Health Partnerships who have estimated the cost at £88,000 based on proposals received to date with half to be funded by the GLA and half to be funded by CHP through funding secured from London Estates Delivery Unit (LEDU).
5.3.    This expenditure will be funded from the Retrofit London Hub budget within the Environment Unit. This expenditure is budgeted for within the approved Mayor’s budget for 2023-24.
 

None.