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NHS Supply Chain Working Towards Net Zero – Over 200,000 A4 Sheets of Paper Saved Every Year

20 May 2024

The NHS represents approximately 40% of public sector emissions and 62% of the carbon footprint of the NHS comes from the supply chain. The carbon footprint of NHS England in 2019 totalled 24.9 million tonnes of carbon dioxide equivalent CO2e. In October 2020, the NHS became the world’s first health service to make a net Zero commitment.

Working towards this target, the Home Delivery Service have made CO2e savings and improved service to our Community Trust partners. Making a significant and positive contribution to lowering the carbon footprint of NHS Supply Chain and its customers.

This has been achieved by moving to email-generated Patient Referral Forms (PRF) and removing the use of paper-based PRFs from the Home Delivery Service processing procedure.

Reducing NHS’s carbon footprint by going digital

NHS Supply Chain’s Home Delivery Service (HDS) receives over 100,000 patient referral forms every year to generate deliveries to patients and Care Homes for the 61 trusts we service and support. PRFs are sent to the Home Delivery Service to provide patient and prescription information for continence products. Historically PRFs were sent to an HDS inbox collated and printed to distribute to the Customer Service team to manually log and process on the HDS Online system.

Each PRF generated a minimum of two pages of A4 (the PRF form and a cover page) and occasionally up to an additional seven pages if the trust included the patient urine test chart. Between November 2022 and October 2023, there were 100,062 PRFs which equated to 200,128 sheets of A4 paper. This equates to 400 reams of paper plus peripherals such as printer cartridges, energy costs to print, and additional impacts.

PRFs were then filed for three months before being collected twice weekly by a confidential service for shredding at a cost of £140 (£280 per week). One full-time equivalent Customer Service Advisor was responsible for all printing and collating of PFRs taking time away from supporting trust clinicians and patients on calls.

In November 2022 a decision was made to change the PRF processing model and remove all use of paper generated PRFs from the system. PRFs are now sent to an HDS inbox and distributed to the Customer Service Advisor via Outlook throughout the day. PRFs are then processed within HDS and moved to a completed folder. The new process allows the whole Customer Service team to support the completion of PRFs if required.

The result

The initiative has resulted in NHS Supply Chain HDS moving to a completely paperless system for processing PRFs. The time taken to complete a PRF has reduced by 25% and processing has reduced from 48 hours to 24 hours. In January 2023 the Customer Service team processed the highest number of PRFs within a 12 month period. In addition to the carbon footprint reduction, there has been approximately £2,000 per month savings on paper and printing. The CO2e impact of avoiding the purchase of 400 reams of paper is approximately 650kg CO2e1.

It is worth noting that the average email has a CO2e impact of 4g so as a comparison the same activity would have an impact of 400kg CO2e meaning the email route has a carbon benefit of 250kg CO2e. To put this into context, 250kg of CO2e is an individual’s approximate carbon footprint for an hour’s flying time.

Additional costs avoided also include printer cartridges and the energy costs of printing. This new process now frees up a FTE (full time equivalent) Customer Service team member that can now spend their time supporting trusts managing customer and patient calls.

[1] Based on cradle to gate for recycled paper using the Department for Environment, Food and Rural Affairs (Defra) 2023 conversion factors.