Intended for healthcare professionals
New concordat is necessary but no match for the scale of the challenge
The newly released Concordat for the Environmental Sustainability of Research and Innovation Practice, co-developed by the UK research and innovation community—including universities, research organisations, funders, and their partners—represents a broad ambition for the sector to transition to a sustainable future.1 Concordat signatories are asked to prioritise action on leadership and system change, sustainable infrastructure, sustainable procurement, emissions from business and academic travel, collaborations and partnerships, and reporting data on the environmental impact of their activities.
We commend the developers of the concordat for encouraging the advancement of environmental sustainability in research and innovation across all sectors, including healthcare, but it does not go far enough given the scale of the challenge. Important limitations include the voluntary nature of the concordat, lack of clarity in reporting standards and guidance, lack of verification, and a limited capacity to address the environmental impact of supply chains.
First, action stronger than voluntary participation is needed to achieve the scale and speed of the changes required. The clock is ticking, and the global carbon budget is dwindling.2 The concordat emphasises the “need to act now” with measures in the next 5-10 years that include “deep, rapid, and sustained reductions in greenhouse gas emissions” and “actions to address unsustainable resource consumption.” But to really drive change, public and private research funders, including the National Institute for Health and Care Research (NIHR) and Wellcome, should consider making funding contingent on a commitment to the concordat. This would create the strongest possible incentive for all stakeholders.
Second, although the concordat calls on its signatories to publicly disclose their commitments and report progress, there is no verification requirement and the consequences of failure to follow through are unclear. Verification is essential and could be achieved through the EU Corporate Sustainability Reporting Directive (CSRD) or a similar authority. The directive requires large and listed companies, including some independent research organisations, to measure, track, and disclose direct and indirect emissions, along with their efforts to operationalise sustainability.3 Assurances are assessed through transparent third party verification, to avert greenwashing and reduce the risk of conflicts of interest.
Clear reporting standards are also important for ensuring accountability, but the concordat provides limited guidance on emissions accounting. Consistent with guidance from the Environmental Association for Universities and Colleges,4 the concordat recommends including direct greenhouse gas emissions, indirect energy emissions, and other indirect emissions that are material to an organisation’s activities. The first two are well defined and quantifiable but usually contribute only a minority (15-35%) of an organisation’s emissions. Other indirect emissions, such as those arising from supply chains, business travel, and waste management, comprise a much larger proportion of an organisation’s carbon footprint but are harder to measure. Accuracy is particularly important when comparing emissions across different organisations and when tracking emissions over time.
Measuring greenhouse gas emissions associated with procurement and supply chains is critical since purchased goods and services often comprise at least 50% of an organisation’s emissions. The concordat encourages life cycle assessment (LCA) where possible, as this is the most accurate way to quantify these emissions. However, LCAs require expertise and resources unavailable to many organisations. Furthermore, each analysis has a specific scope and goals, limiting generalisability, and the quality of existing assessments is heterogeneous.
In response to the mixed quality of existing LCAs, proposed guidelines for assessing the environmental consequences of healthcare (Ecohealth) aim to provide a reporting standard for analyses relevant to healthcare, including research and innovation.5 This will improve both the quality and the comparability of sustainability reports.
Ultimately, though, industry partners in research and innovation will have to use their own knowledge of materials, production methods, and energy sources to report product level emissions in a standardised and verifiable way that enables downstream organisations to report supply chain emissions accurately. This would be better than the spend based models suggested by the concordat.
Finally, the concordat asks institutions to establish “sustainable procurement policy … that prioritise[s] more environmentally sustainable options” but does not indicate how. Manufacturers make numerous claims about the environmental credentials of their products and services, but without evidence based on standardised product level LCAs and independent verification of claims, purchasers may make incorrect choices based on inaccurate or misleading environmental information.
Consistent with the EU’s CSRD, NHS England is phasing in a requirement for vendors of healthcare products and services to report emissions in a standardised, transparent, verified manner along with decarbonisation plans consistent with the Paris agreement. Product level disclosures will be required by 2028.6 The concordat could help create collective purchasing power to drive down embodied emissions by directing signatories to require standardised and verified product level environmental disclosures in all their purchasing processes. This would also improve environmental accounting and procurement decisions.
We support the concordat’s vision and aspiration but call for more, to enable the research and innovation sector to truly lead change. This means mandatory, verified reporting of emissions by all stakeholders using accurate, comparable methods to help organisations make better environmental choices.
Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: JES has received consulting fees from Teleflex, AstraZeneca, and AlphaSights; honorariums for speaking on healthcare sustainability from the University of New Mexico, Columbia University, the University of Colorado, Harvard University, and the Institute for Healthcare Improvement; and travel reimbursements to speak on healthcare sustainability from the Canadian Anesthesiologists’ Society, Vizient, University of Colorado, and the Institute for Healthcare Improvement. Further details of The BMJ policy on financial interests are here: https://www.bmj.com/sites/default/files/attachments/resources/2016/03/16-current-bmj-education-coi-form.pdf.
Provenance and peer review: Commissioned; not externally peer reviewed.
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