Comment & Analysis
Embedding Engineering Expertise
Engineers are vital in developing modern healthcare systems equipped for a Net Zero world, implementing cost-saving technologies, creating novel solutions to major challenges, and ensuring that built infrastructure is safe and resilient. However, the role of engineers is often overlooked in the healthcare system. The Institution of Mechanical Engineers has long advocated for greater emphasis on the crucial yet often underappreciated role of engineering and then need to increase collaboration between healthcare professionals and clinical engineers.
The NHS is under considerable financial pressure, and better management of medical technology could achieve significant savings. For example, healthcare-acquired infections (HCAIs) cost the NHS an estimated £2.7 billion in 2016/2017, with approximately 25% of these infections resulting from airborne respiratory diseases. Modelling estimates there were 834,000 HCAIs that year, accounting for 28,500 patient deaths and 7.1 million occupied hospital bed days. Clean air is vital, and portable air cleaning devices, such as Ultraviolet (UVC) and high-efficiency particulate air (HEPA) devices, can serve as interim solutions. The implementation of air cleaning devices in the NHS could lead to substantial savings, with initial estimates suggesting around £3 billion could be saved annually by reducing electrical costs, staff sickness, prolonged patient stays, and freeing up bed spaces.
Net Zero NHS
Technology is a key enabler for the NHS to meet demands for safety, efficacy, and cost-effectiveness. Engineers will play an essential role in delivering a Net Zero health service in the UK and globally by designing, developing, deploying, and maintaining structures, machines, systems, materials, and processes to address the challenges facing the healthcare sector. The healthcare sector is a significant contributor to global emissions, with a climate footprint comparable to the annual greenhouse gas emissions from 514 coal-fired power plants. Decarbonising healthcare is essential for meeting the Paris Agreement goals, and engineering plays a critical role in developing solutions to meet NHS Net Zero targets and reduce emissions.
However, our report, ‘Transforming Healthcare: The Role of Engineering to Deliver a Net Zero Health Service’, identifies several barriers. To support the development of solutions within the healthcare sector and achieve Net Zero aspirations, strategic enhancement of knowledge generation and sharing mechanisms is imperative. By sharing best practices and expertise internationally, the UK can enhance global sustainability efforts within healthcare systems. An expansion of dedicated funding mechanisms will be required, alongside an evolution of the regulatory landscape that enables innovation to flourish. To tackle the largest contributor to healthcare’s greenhouse gas footprint—its supply chain—industry partners and suppliers must work with healthcare providers and the government to achieve targets relating to supply chain emissions using realistic and robust measures.
Coherent Strategy
The Institution has advocated for the development of a coherent government strategy linking the environmental crisis to patient care. Stories have emerged worldwide about the devastating impact of heat. In the UK, heat risk will impact vulnerable populations, such as those with underlying health conditions, those who are socially isolated, those with mental illnesses, the unhoused, and outdoor workers. Addressing the impact of extreme heat on health is crucial, as it affects both physical and mental wellbeing. Engineering solutions, such as designing cooler urban environments and improving building ventilation, can help mitigate these effects and safeguard public health. It will be vital for a new government to develop a consistent plan to not only mitigate further climate change but also adapt to increasing temperatures.
Water Pollution
Despite significant improvements in the UK's water quality over the past thirty years, sewage overflowing into rivers and seas remains a persistent problem. In May 2024, thousands of residents in Devon had to rely on bottled water after their supply was polluted by Cryptosporidium. To reduce public health risks for recreational water users, a range of interventions could be deployed across the wastewater system.
Efforts should focus on mitigating public health risks from pathogens in water supplies by prioritising the maintenance and rehabilitation of assets, guided by regulatory frameworks., as outlined in the NEPC recent ‘Testing the waters’ paper Accelerating the rollout of Continuous Water Quality Monitoring in England is also crucial. Additionally, reviewing the designation and protection of bathing waters, and developing appropriate risk communication to the public, are essential steps to ensure safer recreational water use.
Engineers have a significant role to play in the development of health and safe communities. We look forward to the start of the new Parliament to collaborate and support healthcare initiatives.
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