The award-winning Saving Lives with Solar project turns five this year marking the quarter point in its 20-year journey. But what does the project mean in 2021, in relation to Covid-19 and keeping the voice loud on public health? Quadrant Health sits down with members behind the organisations collaborating on the project, Jessica Brownsword, Mike Kinghan, and Martin Peak, to find out more!
Projects improving environmental and public health will be critical as the North Midlands bounces back from the COVID-19 pandemic, the Saving Lives with Solar scheme has told Quadrant Smart.
In a new interview, Jessica Brownsword, Mike Kinghan, and Martin Peake, representing the organisations behind the award-winning project, said the pandemic has refocused public attention on improving public health and the environment around them.
“I think the pandemic has forced people to think about their health and their situation,” commented Jessica, sustainability manager at University Hospitals of North Midlands (UHNM) NHS Trust. “It’s brought about the impact of social and environmental factors to our health.”
Saving Lives with Solar
Established at UHNM in 2016 in collaboration with charity Beat the Cold and South Staffordshire Community Energy (SSCE), the Saving Lives with Solar project was hailed as an “excellent example” of sustainable healthcare in the 2020 BMJ awards.
The scheme sought community investment and government funding to install solar panels on the UNHM estate, reducing the trust’s carbon footprint, and passed on surplus savings onto Beat the Cold, a Staffordshire-based charity tackling fuel poverty in the region.
Mike Kinghan MBE, chair of SSCE, a Community Benefit Society, told Quadrant Health that sales of community shares totalling £335,600 provided the funds for the eight solar PV installations on six of UHNM’s buildings.
“The idea at the beginning from the trust was that they would set up a phone line that patients can dial into for advice from Beat the Cold. We thought we could better than that,” Mike explained.
“We had a discussion between the hospital, Beat the Cold, and ourselves. The scheme was instead devised for referrals coming from the hospital, rather giving people a card and saying: ‘if you need help ring this number.’”
In addition to shareholders receiving a 4.5% average return over the 20-year scheme, surpluses of savings from the solar panels will be passed onto Beat the Cold. The scheme expects to provide around £300,000 in total over the 20 years and a £33,000 payment was made last year following the bumper savings brought about by a particularly sunny 2018 summer, for example..
Public health in the region
The North Midlands’ industrial make-up means respiratory health issues are prominent in the area, Martin explained.
You have pottery dust, you have coal dust, you have ex-steel works, and potentially hard laborious jobs that have not been good for health
“Particularly on the footprint of the hospital, you have a large area that is ex-industrial land. You have ex-mine working and ex-pottery,” said the Beat the Cold Charity development manager.
“You have pottery dust, you have coal dust, you have ex-steel works, and potentially hard laborious jobs that have not been good for health.” The knock-on effect, Martin adds, leads Staffordshire to hold the fourth highest level of Chronic Obstructive Pulmonary Disease (COPD) in the country, and declared with some 17,700 Staffordshire residents suffering from the condition in 2019.
In the home, fuel poverty in the Stoke on Trent is higher than the national average, with 12.4% of homes in fuel poverty in 2018, in some of the more deprived areas of the city this can rise to 43.9%. Across the area, Martin says, there can be a staggering eight-to-10 year difference in life expectancy between more affluent and industrial areas due to many living in poor housing stock or being unable to afford to heat their homes, leading to a surge in respiratory diseases and health issues.
Community impact
By targeting those referred by the trust with respiratory disorders and health issues from the home, Martin says those most in need are cared for first. National and World Health Organisation evidence highlights a third of cold-related excess hospital admissions are caused by the home, giving the project team a priority group to work with.
“If you can prevent those at risk presenting to A&E through a cold-related issue, it’s a no-brainer,” he said. “Typically, some of the respiratory patients we have may say: ‘You are not going to carry out an intervention at my house which means my COPD gets better.’ But what you can do is you can slightly decrease that curve of how quickly it worsens?.”
Working in the community, Beat the Cold and local authorities can benefit residents with a variety of improvements to the home: including removal of mould, and adjusting energy tariffs to provide savings for residents and encourage them to utilise central heating in their home.
“A gentleman early in the project had been discharged to home on oxygen, and when we arrived at his house, he had a brand new boiler. But his house had damp and mould growth,” explained Martin.
“He thought he couldn’t afford to use the boiler, so he just put the fire on in one room, our advice showed him that this was a more affordable oprion. The rest of the house was initially very cold. It doesn’t take a rocket scientist to work out what was more likely to happen, based on his living.
“That was really simple to resolve. We are taking these opportunities to prevent him, or someone in similar circumstnaces from ending up in hospital, or for his condition to be made worse.”
2021 and beyond
Despite the trust’s attention currently being turned to providing acute care in response to COVID-19, Jessica has a positive outlook for the Saving Lives with Solar for 2021.
Success for her would be a mandatory care plan consideration of a patient’s home environment before discharge, as well as engaging with a wider cross-section of clinicians at the trust and ensuring sustainability is embedded in all healthcare practices in the region.
Our behaviours directly impact how many patients we get in
“Our [societal] behaviours directly impact how many patients we get in,” she said. “We’ve got a bit of work to do in terms of engagement, communication, and training.
“Part of that is going across a wider cross-section of staff: there’s physiotherapists and occupational therapists who are at that point of assessing that patient, before they are discharged. It’s finding a way to make people think about it in a positive mindset with health at the forefront.” Jessica added that building in sustainability in medicine procurement, waste management, and travel options to the trust will be key goals following on from of UHNM’s 2020 sustainability strategy.
In addition one of SSCE’s Directors, Anthony Walters will be continuing to work with other hospital trusts and community organisations such as Royal Devon and Exeter NHS Foundation Trust, Northampton General Hospitals Trust, and Holborn Community Association.
“There’s quite a lot of dialogue and discussion going on with interested organisations, some of which will implement the schemes in various ways,” Mike noted. “Not all of them are linking it back to solar, and that’s a good thing in itself: because there’s an interest in the whole methodology and idea of trying to tackle problems caused by poor housing at its roots.”
Beat the Cold’s Martin echoed Jessica’s sentiment to mandate NICE guidance in preventing discharge of patients into a cold home. What next in term of providing for those in need?
“We have hit the two top cohorts of people vulnerable to cold,” he said. “There’s a long list of people already identified by NICE, and that’s the next target cohort. You should be asking why anybody is leaving a health setting where their home, their living conditions, and their health inequalities are being caused by issues in the home.
“They could be rectified and they’re not. That circular home and then hospitalised way of working needs to be broken. If there’s something we can do to change that mindset then that would be fantastic.”