Professor John Isaacs, NIHR Newcastle BRC’s Deputy Director and Musculoskeletal Disease Theme Lead, reflects on the importance of sustainability and how Newcastle Hospitals are tackling the challenge within research.

There is absolutely no doubt that our climate is changing. Extreme, and often unseasonable, weather is becoming the new norm not only in the UK but around the planet, from winter wildfires in California, to record-breaking heat and severe flooding closer to home. Upon this backdrop, in 2019, partners across the city joined together to declare a climate emergency with our Hospital Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust, the first healthcare organisation in the world to declare a climate emergency, committing to being Net Zero Carbon by 2040.

Newcastle Hospitals has also appointed an Associate Director for Sustainability, who is leading on sustainability for the North East and North Cumbria (NENC) Integrated Care System and our own Sustainable Healthcare in Newcastle (SHINE) programme which provides training, tools and resources to enable our staff to deliver sustainable healthcare. Its vision for sustainability is to deliver healthcare within available environmental and social resources, protecting and improving health now and for future generations. Some notable achievements include:  

  • generating the energy to power our hospitals through efficient combined heat and power plant since the turn of the century
  • buying electricity from 100% renewable sources when we need to top up our on-site energy production
  • ensuring zero waste to landfill since 2011
  • recycling over 40% of non-clinical waste, offering discounts for reusing cups and food containers in our restaurants and cafes
  • removing single use plastics from our restaurants and cafes, providing compostable alternatives
  • encouraging sustainable staff travel through a cycle scheme and public transport discounts, investing in an electric vehicle fleet for our estates and catering services, and procuring electric buses for staff, patients and visitors
  • achieving sustainable catering awards from the Soil Association & Carbon Trust
  • hosting the UK’s first environmentally sustainable Anaesthesia Fellow
  • having a network of over 300 Green Champions – staff who are dedicated to reducing our environmental impact
  • including sustainability specification and evaluation criteria in all procurement contracts
  • planting over 200 trees on our city centre hospital sites
  • forming a ‘Green Gym’ for staff to volunteer on local beach cleans and conservation projects

Within the Directorate of Clinical Research, the Trust’s vision has combined with staff passion regarding sustainability to prompt a review of opportunities to improve the green credentials of our research activities.

Our first, and most obvious, approach was to seek to reduce travel for patients, staff and other stakeholders. Accordingly, and where appropriate, patients have moved to virtual clinical and research appointments and our colleagues have worked remotely. With support from IT colleagues, we have also successfully piloted remote access to the electronic health record for study monitors, which we plan to establish as standard practice over the course of this year. We are one of the first Trusts in the UK to offer this solution to virtual trial monitoring and feedback from sponsors has been excellent, to the extent that it is increasing our commercial attractiveness. In addition, we are recording virtual (video) site tours and introducing equipment to enable on-demand/live virtual site visits.

With all consideration to regulatory requirements, we are also scoping the use of electronic site files and progressing other digital solutions to processes such as consent. Indeed, we have been commended nationally for our virtual trials capabilities and innovations, with our NIHR-funded Patient Recruitment Centre delivering the first fully virtual interventional clinical trial in the UK. This is a very important milestone in our clinical research sustainability journey, whilst additionally providing all the other benefits of virtual trial participation to patients, including those who are otherwise difficult-to-reach. By eliminating all travel, we were able to offer research participation, including access to trial treatment, to individuals across the breadth of the UK - including participants from Inverness, Penzance, Wales and Northern Ireland. This work resulted in the team being a finalist in the Health Service Journal Value Awards and a winner of the Academic Health Sciences Network NENC Bright Ideas in Health Awards.

Emphasising our commitment to sustainability, and demonstrating important leadership to our staff, both our Directorate Manager and Regulatory Compliance Manager hold the Institute of Environmental Management & Assessment (IEMA) Foundation Certificate in Environmental Management alongside IEMA Associate Membership. This means that our senior leaders across the academic-NHS interface have a sound understanding of the breadth of the sustainability agenda and the management tools and skills needed to support sustainability endeavours.

From the above, it will come as no surprise that sustainability is also an overarching goal of our five-year clinical research strategy. Since 2020 we have held a monthly, research-specific, grass-roots sustainability group, enthusiastically attended by colleagues from Newcastle Hospitals and Newcastle University. Over the course of the past year, members of the group have worked with a range of stakeholders, including industry partners, to achieve a position statement for sustainability for external partners. We are very proud to recognise that this will significantly reduce travel to and from our premises, particularly air travel. Our research delivery teams, across Newcastle Hospitals and Newcastle University, are also supported, encouraged and rewarded to be green champions and to attend a range of sustainability educational events.

The above is just the start. Our intention is that sustainability becomes the expected norm within our Directorate, for our staff as well as our external partners. As a proud component of Newcastle Hospitals, and with clinical research increasingly being recognised as an integral part of normal, everyday care, we want to send a strong message about the need to embrace every opportunity to minimise the environmental impact of our activities. Widespread recognition and adoption of our practices will not only make an important contribution to the sustainability of our planet but, ultimately, will also reduce the cost of new medicines by removing expensive and unnecessary elements of clinical research participation.

Prof John D Isaacs

Deputy Director, NIHR Newcastle Biomedical Research Centre for Ageing and Long-Term Conditions
Professor of Rheumatology & Director of Therapeutics North East, Newcastle University
Associate Medical Director for Research & Consultant Rheumatologist, Newcastle upon Tyne Hospitals

February 2022