How do we operationalise the Route Map?• Link into SDMP – so all aspects are covered• Use to engage with patients and the public• Use to engage with partners across local health system – and develop joint plans for the development of care across settings• Use to embed principles within organisations over and above the CRS actions• Use full life cycle costing and impact assessment in every decision making process• Use full impact and evaluation of changes in models of care and service provision

Behaviours Standards InnovationSociety Individual System Governance Use of resources Models of care Technology

We engage... You understand... Agree... Research... Explore... Adopt and invest...

• Organisations engage with their patients and public about sustainability issues incl: statements and plans in annual reports, schemes and pilots, and engaging with users to support key projects eg recycling/ medicines re-use/transport

• Switch off when not needing equipment

• Reduce air travel

• Reduce reliance on meat

• Reduce consumption generally

• Engage in active transport

• Engage in health and wellbeing for family and self

• Choose sustainable products

• Organisations to encourage and incentivise sustainable behaviour in their staff

• Regulatory bodies to incorporate sustainability criteria/metrics into their licensing/authorisation and reporting requirements

• Organisations report progress in a clear, transparent and consistent manner

• Organisations integrate Route Map into SDMP1 and Board mechanisms

• Ensure it is including in curricula, training and induction processes

• Systematic efficiency drives in relation to water, waste, energy, human resource

• Research the unknown areas and in part ref 5 SDU priorities2

• Managed in a real time manner to ensure minimal waste (eg through smart meters and environmental management systems)

• Procurement of products and services to reflect sustainable products and reduced consumption

• Identify ineffective health processes

• Commissioning of services to include sustainability as core criteria RCGP and commissioning for sustainability3

• Research and pilot sustainable models

• Clearly evaluate on the basis of sustainability issues and hence contribute to a broader development of evaluation/ impact assessment

• Invest in health and prevention

• Innovation boards, procurement processes, business cases to include reference to sustainable technologies and how these are to be encouraged

• Consider how best to incentivise progress and what criteria to judge success by

What actions are required now?

Getting started

1. http://www.sdu.nhs.uk/sd_and_the_nhs/sd-governance/sdmp.aspx

2. http://www.sdu.nhs.uk/publications-resources/3/NHS-Carbon-Reduction-Strategy/

3. http://www.sdu.nhs.uk/publications-resources/default.aspx?kwrd=commissioning

Behaviours Standards InnovationSociety Individual System Governance Use of resources Models of care Technology

We integrate… You expect... Acount... Model... Collaborate... Enable and support

• Organisations describe services based on sustainability criteria

• Organisations take into account the full life cycle costs and explain this to the public/ patients

• Expect and ask questions of services and providers to know how decisions are made and be able to make choices accordingly

• Full life cycle costing methodology is developed to ensure easy use by all

• Organisations ensure that board and business decisions are made using full life cycling costing and valuing future in an effective way.

• Development of full carbon analysis on all resources and services

• Health business decisions take full impact analysis into account

• Develop cross system joint sustainable service plans

• Integrate with a benefits realisation process and risk assessment process

• Encourage and prioritise a shift to de-medicalise the services

• Ensure technology supports wellbeing and does not contribute to greater isolation of individuals

TransformationBehaviours Standards Innovation

Society Individual System governance Use of resources Models of care Technology

We embed … You demand… Self regulate … Value… Tailor… Require and expect…

• Start thinking how best do we achieve this?

• Start thinking how best do we achieve this?

• Start thinking how best do we achieve this?

• Start thinking how best do we achieve this?

• Start thinking how best do we achieve this?

• Start thinking how best do we achieve this?

Transition