Context Barts Health NHS Trust is one of the largest NHS Trusts in England, employing circa 17, 000 staff within a group model of 6 hospitals. Barts Health (BH) in northeast London, delivers acute, specialist care to a diverse population with some of the worst health outcomes in the UK.

Green at Barts Health (GABH) is a pressure group of clinical and non-clinical staff, created in 2019 in response to the climate crisis, and the need for a greater response from the Trust to address its impact. Its audience is senior hospital executives as well as ground level staff, with an additional aim to role model effective climate action to our patients and local community.

Issue/Challenge Healthcare organisations have been slow to recognise their contribution towards climate change.

The NHS declared a climate emergency and pledged to reach net zero by 2040, in acknowledgement that healthcare services make a significant contribution to the impact on the environment.

As of 2022, all Trusts are mandated to produce a green plan to outline how they will reduce their carbon emissions and waste. These ambitious goals will only be realised through the focus of senior leaders and the commitment of staff.

Assessment of issue and analysis of its causes

BH offers great opportunity for large scale impact due to its size but the resulting organisational complexity leads to risk of a disconnect between senior leadership and ground level staff. This can cause challenges for staff to effectively contribute to positive change.

Increased policy mandates for greener working, in addition to increased energy costs meant that execs were increasingly looking for solutions, including knowledgeable and passionate staff who could champion local changes. Amplifying and providing an adjunct to work carried out by estates teams.

GABH worked as a grass roots staff network to identify motivated and passionate staff who were already volunteering time and working in healthcare sustainability, but who had not been networked effectively for maximum impact.

Impact By growing the group to become a big (200+) and well organised staff network, who are taken seriously and are the established staff leads for green issues. We have ensured an invitation and a seat at vital strategic and management meetings. And are Nationally recognised.

As a result we have greater power to successfully implement change. Successful advocacy so far; rebuild of Whipps Cross to be UK’s first net zero hospital, Trust declaration of a climate emergency, allocated staff time for sustainability work.

Intervention Some of our specific outcomes include:

• Proactive engagement of the Group Deputy CEO (Net Zero lead) who has now moved on to be CEO in common with BH and BHRUT, resulting in high level support and feedback.

• GABH evolved to develop better awareness of hospital and group strategic challenges, which has helped fast–track projects

• GABH projects, such as BH reusable masks for staff, supported by Waste Team and Barts charity. (This project flagged the need to develop sponsorship and governance mechanisms to help with blocks and better understand the many sign off processes required.)

• Increased visibility for the group amongst staff and in the local community in partnership with the Public Health Team through events (Clean Air Day and NHS Sustainability day)

• High visibility through partnership with Comms Team for Green Sustainability month, and all staff webinar on sustainable healthcare chaired by CEO during COP 26.

Involvement of stakeholders, such as patients, carers or family members:

Monthly, staff, online, GABH meetings, active discussions on WhatsApp, annual AGM

Key Messages Small group of staff can have a big impact on a large NHS Trust.

Staff’s passion is a powerful resource available for senior leaders and Trust sustainability teams to achieve green goals. See staff networks as your allies!

Lessons learnt The work is ongoing, barriers to progress will be staff time, advocate early on for allocated staff time to ensure longevity of the project.

Measurement of improvement Please see sections on impact and intervention.

Strategy for improvement As a voluntary advocacy and expert group, creating a succession plan for staff is a key driver for the longevity of the project