November's Healthcare Distribution Association conference featured the NHS's commitment to achieve net zero, and the contribution being made by the medicines supply chain 

Alexandra Hammond, head of sustainable procurement and supply chain, NHS England and NHS Improvement

Over 60 per cent of the climate impact of the NHS sits in its supply chains. The 20-25 per cent of that in pharmaceuticals and chemicals, vital for the effective delivery of health, makes them a priority for decarbonisation. The vast majority of emissions in the NHS supply chain originate and impact in the UK, so we can’t just outsource responsibility by thinking the issues fall in China or India.

When the NHS published its Net Zero report in October last year, it became the first health service in the world to declare a target for delivering net zero – 2040 for direct emissions including purchased energy, known as ‘Scopes 1 and 2’ and 2045 for ‘Scope 3’ indirect emissions, such as inward freighting of goods. The sustainable procurement programme is in Scope 3. 

Pre-Covid, we had 16,500 kilotonnes of carbon sitting in our supply chain. We identified 13 interventions, including reducing single use plastics, metal instrument reprocessing, switching to low carbon diets, and ensuring our suppliers meet NHS commitments. We need to make sure these happen to get us down to zero. Our suppliers are key to achieving the target, but the NHS can use influence only. Working in partnership with the supply chain to build resilience and productivity is huge.

NHS England is not saying to suppliers: “You have to do this, or we stop working with you”. We all see the imperative of addressing climate change, so this needs to get done, but we want to understand what you are doing already, so we are enabling change, and pushing in the right direction. Some suppliers will be way ahead of us, so then we want to learn from you, so we can scale up across other parts of the supply chain.

The effects of poor air quality and climate change are already being seen in our GP practices and our hospitals

The NHS has 80,000 suppliers. When we surveyed them last July, they were broadly happy that what the NHS was suggesting was ‘achievable, reasonable’. Some were saying it’s not fast enough. Our supply chain is already thinking about this, has plans and is setting targets. Some 62 per cent of respondents plan to report the carbon intensity of at least 25 per cent of the products supplied to the NHS within a year, and 74 per cent plan to report on 100 per cent within 8-10 years. 

The Net Zero report said before the end of the decade the NHS will no longer purchase from suppliers that do not meet (or exceed) our commitment to net zero. The plan was accepted by the NHS Board in September, when chief executive Amanda Pritchard said: “The effects of poor air quality and climate change are already being seen in our GP practices and our hospitals; it is absolutely right that we are part of the solution.”

NHS England’s roadmap to 2030 includes milestones to get suppliers on board. Many already have targets for Scope 1 and 2 emissions, but this is something we are going to need from every supplier. By 2027, we want all suppliers to have declared carbon reduction targets for Scopes 1 to 3: what you want to do, how you are going to deliver it. And we want to see progress against those targets too. 

From April 2023, all contracts above £5 million will require suppliers to publish a carbon reduction plan for direct emissions as a qualifying criterion. Evergreen, the NHS Sustainable Supplier Framework to be piloted in 2022, will create a single record of supplier self-certification of alignment with the NHS’s net zero trajectory. 

We are developing a programme of support, including working groups, templates and sharing knowledge to encourage activity. You are not alone.

More information here 

Steve Hoare, quality, regulatory science and safety policy director, Association of the British Pharmaceutical Industry (ABPI) 

Eighty per cent of the ABPI’s members have already made public net zero or carbon neutral commitments, with the vast majority working towards some form of environmental impact statement. The ABPI’s COP26 webpage provides examples of what members have done, are doing and will do to contribute to solving the climate crisis. 

Companies are moving fleets to electric vehicles; telemedicine and remote monitoring are now considered normal. The Nobel Prize awarded for work on organic catalysts that vastly increase reaction yields while reducing use of precious metals, is typical of the ‘green chemistry’ members are now using. 

The industry is purchasing renewable energy or investing in its own generating capacity. In the Energize Project, ten ABPI members are using their combined bargaining power to generate affordable renewable electricity, not just for themselves, but for hundreds of suppliers too.

Looking upstream to raw materials gathering and downstream to patients and customers and beyond requires collaboration. The ABPI is starting to bring people together to share learning across the supply chain. 

ten ABPI members are using their combined bargaining power to generate affordable renewable electricity

With 16,000 UK licences, onshoring all capability is not possible, but we want to use investment in green technologies to bring people to the UK, and if there is a new manufacturing site in the UK, it is the greenest, most sustainable site in the world. 

Sustainability is an agenda item on every workstream. We need to make sure we’ve thought about the unintended consequences or duplication of effort of any policy. We want to create and take opportunities from technologies that emerge over the next few years that could help achieve targets earlier. 

The mindset is: that which seems nigh on impossible now is absolutely possible. More information and examples of members’ actions here 

Matt Addison, operations director, Alliance Healthcare

Alliance Healthcare’s sustainability journey is an ‘and’, not an ‘or’ conversation - sustainability and cost and service and safety and engagement with our colleagues. You cannot prioritise one over another. You might have to be a little more creative to deliver sustainability and cost, for example, but we are going to find taxes coming that will encourage the thinking. 

Route optimisation and network design has taken out 767,800 miles per year

We started with getting our sites to zero landfill through recycling. We saved 3,000 tonnes of cardboard last year – we found we could get £50 a bale more by baling it differently. We’re looking to stop the use of single use plastic; we’ve removed more than 100 tonnes to date. We moved to a green only electricity deal in October 2020 and are in the process of retrofitting LED lighting across our sites.

Delivery is where the lion’s share of our carbon generation occurs. You can start with the small things – conversion of our engines to Euro 6, so we are compliant with low emission zones – but how our drivers drive generates a huge amount of carbon. Managing speed, using stop/start technology, braking, tyre pressure, inappropriate use of air conditioning; we track miles per gallon by driver. Active conversations with drivers has achieved an 8 per cent improvement in miles per gallon, without impacting the schedule. Route optimisation and network design has taken out 767,800 miles per year, but there is still a lot more to do. Fleet initiatives have removed 800 tonnes of carbon. This work is all incremental. 

But what has got us here won’t get us there. We have to change the pace, not only to meet the needs of our shareholders, the NHS and our colleagues, but our own expectations on what we need to do to achieve net carbon zero. In May, AmerisourceBergen signed the letter of commitment to develop validated science-based targets aligned with the internationally recognised SBTi criteria.

Getting to net zero starts with engaging colleagues. Their ways and place of working will change. Drivers will be in electric vans. Company cars, if they exist at all, will be electric and we will be figuring out how we share charging points. Energy prices won’t just be a problem for the P&L; we have to find a solution to gas. We’ve all got temperature-controlled environments, heavy fridges. Our buildings need to be more efficient. All will require investment. We are making choices on fleet now that will run into our net zero carbon years, so we are working with fleet manufacturers to find solutions. They aren’t there now, but they are coming through thick and fast. 

Suppliers and manufacturers are on the journey with us. We can all do the same work, or we can work smart and do it once.