Examining the uptake of low-carbon approaches within the healthcare sector: case studies from the National Health Service in England

The National Health Service (NHS) in the UK, is one of the largest organisations in Europe and indeed the world. It therefore has a significant ecological footprint. As a result there are key corporate, financial and environmental targets that the organisation is expected to meet as a means of reducing resource consumption. Using a case study approach, this manuscript examines best practice examples for the uptake of low-carbon strategies for energy conservation. These strategies included sustainable procurement, use of renewable energy technologies, supply chain management, use of building management systems, renegotiating energy contracts, undertaking energy audits, and behaviour change, to realise significant financial, as well as energy and carbon savings. A key focus was management of water resources, including the use of recycling and recovery of heat. The implications of the findings for building ecological and financial resilience within the organisation are also discussed

Supporting the UN's Sustainable Development Goals: reconceptualising a 'sustainable development assessment tool' for the health and care system in England

Aims: As one of the biggest organisations in the world, the NHS in England can contribute considerably to the United Nations’ Global Sustainable Development Goals (SDGs). In order to optimise this, this study evaluated and reconceptualised a sustainable development assessment tool for health and care settings in England. Methods: A quantitative survey and user/expert discussion panels were conducted to evaluate and reconceptualise the existing sustainable development assessment tool used by the NHS in England, the so-called ‘Good Corporate Citizenship Assessment Tool’, between 2007 and 2016 including potential improvements such as the integration of the UN SDGs. Results: A reconceptualised self-assessment tool integrating the UN’s SDGs was developed and implemented online as the ‘Sustainable Development Assessment Tool (SDAT)’. Further improvements included a process orientated redesign and the creation of new modules and cross-sections aligning them with the leads responsible for the implementation of key initiatives in NHS organisations, which would contribute to achieving the targets of the SDGs. Conclusions: User/expert involvement has enabled an informed approach to a reconceptualisation of a sustainable assessment tool for health and care settings. The tool will support organisations to build their mandatory Sustainable Development Management Plans, as part of the national Public Health Outcomes Framework. Alignment of the tool to the UN Sustainable Development Goals provides an opportunity for health and care organisations to demonstrate accountability and progress against the UN’s set of transformational goals. Furthermore, the tool could be adapted to other public service providers

Perspectives on Scedosporium species and Lomentospora prolificans in lung transplantation: Results of an international practice survey from ESCMID fungal infection study group and study group for infections in compromised hosts, and European Confederation of Medical Mycology

Background Scedosporium species and Lomentospora prolificans (S/L) are the second most common causes of invasive mold infections following Aspergillus in lung transplant recipients. Methods We assessed the current practices on management of S/L colonization/infection of the lower respiratory tract before and after lung transplantation in a large number of lung transplant centers through an international practice survey from October 2016 to March 2017. Results A total of 51 respondents from 45 lung transplant centers (17 countries, 4 continents) answered the survey (response rate 58%). S/L colonization was estimated to be detected in candidates by 48% of centers. Only 18% of the centers used a specific medium to detect S/L colonization. Scedosporium spp. colonization was a contraindication to transplantation in 10% of centers whereas L prolificans was a contraindication in 31%; 22% of centers declared having had 1-5 recipients infected with S/L in the past 5 years. Conclusions This survey gives an overview of the current practices regarding S/L colonization and infection in lung transplant centers worldwide and underscores the need of S/L culture procedure standardization before implementing prospective studies