The NHS Sustainability Day Campaign was delighted to host its 2nd virtual conference examining sustainability within the NHS and wider healthcare field. Once again we explored the solutions already being adopted by the NHS to combat carbon emissions. This virtual conference provided further opportunities for NHS Trusts to discuss their concerns, ideas and plans around embedding sustainable development with fellow peers. Topics discussed on the day included: Looking after nature so nature can look after us; Fighting to make the NHS a greener organisation; and Maximising the health and wellbeing of the NHS We also tackled the hot debate brought up by Covid-19, of how we tackle single-use masks?

1. Welcome to –
Sustainability in the
NHS Virtual
Conference
@dayforaction #sustainability

2. Morning Session
10.30 Chair introduction
Speaker: Scott Buckler, Campaign Manager, NHS Sustainability
Campaign
10.40 Look after nature so nature can look after us
Speaker: Dr Catriona Mellor, Child and Adolescent Psychiatrist,
Oxford Health NHS Foundation Trust
11:00 Fighting to make the NHS a greener organisation
Speaker: Dr Elaine Winkley, HLA Scholar at The Healthcare
Leadership Academy
11.20 Can Reuse support NHS budgets when financial impact
hits?
Speaker: Daniel O Connor, CEO, Warp-It
11.40 Question and Answers
12:00 Comfort break

3. Catriona Mellor
Child and Adolescent Psychiatrist
Sustainability Day Campaign 16/9/2020

4. Overview
• My motivations
• What does thinking about ‘Nature’ add?
• “Looking after nature so nature can look after us”
– The messaging
– How this translates into taking action
• Summary and looking forward

5. Motivating factors

6. Climate Crisis
Global Heating
Reducing emissions,
energy use, waste.
Adaptation of
infrastructure. Disaster
preparation
Bio-diverse
natural
environment
Nature
connectednes
s meaning
belonging
restoration
Pro-
environmental
behaviours
Richardson M et al (2015)
Ecological Crisis
Need to go beyond
‘not doing harm’

7. What does ‘Nature’ lens add? cont.
The NHS undermines some of its work by negatively impacting health
outcomes with emissions, pollution and waste
Climate solutions seen as separate to NHS work, so clinicians not
getting involved
But if we see:
Human beings are part of nature
Climate crisis = health crisis
Climate solutions are good for health and wellbeing
Solutions to eco anxiety are solutions to climate crisis

9. How does this guide
us taking action?
1. Mention protection and rejuvenation
of nature alongside mention of global
heating, emissions, sustainability
2. Starting small: talking to others about the effect of the natural world
and of its destruction, on our physical and mental health is an
intervention in itself.
3. Raise awareness about the waste, destruction and pollution linked to
healthcare and the supply chains we use
4. Integrate sustainable healthcare principles into QIP to ensure our
clinical pathways reduce their negative environmental and social
impact.
5. Promote and support solutions that benefit health AND nature, at
local, national or international level.
6. Embracing the role of nature in our own self-care or in our work is an
evidenced based and low carbon approach to improve wellbeing.
7. Advocate for and get involved in protection of the natural world, and
equal access to it, as a public health strategy.

10. Putting it into practice
Nature lens
A Greener
CAMHS
CYP eco distress
Green
Marlborough
House
Sustainability
Green Care
programme
WWT and
Families in the
wild
Nature
connectedness

11. Final thoughts
• Summary
• Ask of every action we take “does it actively contribute to humans and
nature thriving together as one integrated system on this planet”
(Christiana Figueres and Tom Rivett-Carnac, The Future we Choose)
• Young people
• What lies ahead
• and how can the natural world help us?

12. Thank you
• Feedback and your thoughts welcome
– Catriona.mellor@oxfordhealth.nhs.uk

13. Waste and Environmental
Impact in Northumbria
NHS Trust
Dr Elaine Winkley
Consultant Anaesthetist
Northumbria Healthcare NHS Foundation Trust

14. Northumberland

15. Northumbria NHS Foundation Trust

16. Waste in the NHS
2016/17 – 590,000 tonnes of waste produced by NHS
2% of all industrial and commercial waste in England!
40% of waste could be reclassified as domestic waste or
recycling
1.4 million employees in the NHS
NHS is central to the majority of the population….. We should
lead by example

17. What I saw ?
• No Recycling Bins in Clinical Environments
• No Recycling In Hospital Canteen / Non clinical areas
• Eager employees that wanted to be ‘greener’
• Sustainability Team – Non clinicians
• Lack of Promotion

18. Survey Theatre Staff Trust wide-
August 2019
Total number of Staff took part in the survey- 60
(Doctors, Nurses & Allied Healthcare professionals)
The following questions were answered in relation to recycling
• What type of waste goes in a clear bag ? 86% said RECYCLING
• Does Northumbria NHS Recycle ? 73% said YES
• Does your department recycle metal ? 40.6% said YES
• Do you recycle in your department if not why not ? 49% said YES
• Are you interested in helping the trust recycle more ? 95% said YES

19. Gained Attention
• Invited to Sustainability Team Meeting
• Sustainability Team – Non clinical staff
• Sustainability Work based in non clinical
environment
• Clinicians introduced to Sustainability Team
• Assessment of Clinical Sites

20. Engagement
• Waste Warriors Northumbria NHS Facebook page
• Presented findings to anyone that listened
• Social media platforms
• Consistency

21. Sell it the way they want to hear it
Recycling – environmental and financial savings
Show them the extent of the problem !

22. Achievements
• Trust wide increase in interest in waste and sustainability work
• Education Package Written
• Theatres – culture change
• Plastic Recycling Trial
• Increase in Recycling
• Canteens/Catering areas
• Local network of Green Champions
• Links formed with local authority

23. Challenges
• Multiple Sites
• Large number of staff
• Complexity of Trust Organisation and Structure.
• Global Pandemic

24. The Future
Embrace links with local authority
Engage clinicians trust wide in greener sustainable strategy.
Strategy to reduce emissions from clinical environment
Challenge manufacturers

25. Questions
Thanks to :
Mike Blades, Sathish Sethuraman,
Damon Kent, Veronica Gingell and Sandra Fenwick –
Northumbria Sustainability Implementation Management Team.

26. Mid-Morning Session
12:10 Decarbonising the NHS through the use of renewable fuels
Speaker: Colin Duke, Head of Sales, Argent Energy
12.30 Is your Data Centre helping you deliver your sustainable goals?
Speaker: Jason Liggins, Independent Consultant, Crown Commercial
Service
12.50 Reacting to the new world of water in 2020
Speaker: David Emslie, Director, Novaloo Ltd
13:10 Can Reuse support NHS budgets when financial impact hits?
Speaker: Paul Broadberry, Country Manager UK, Vanguard Medical Devices
13:30 Questions and Answers
13:40 Comfort break

27. 27
An Argent Energy presentation
NHS Sustainability Day
2nd July 2020
Colin Duke
Head of Sales

28. 28
▪ Overview of Argent Energy
• Who are we?
• What do we do?
• How can Argent help the NHS and it’s partners decarbonise their operations?
Vision: To reduce the worlds carbon footprint using sustainable resources

29. 29
• John Swire & Sons Ltd is the Parent Company of Argent Energy.
• JSSL has a Global presence and is involved in Trading & Industrial, Marine Services, Beverages & Food Chain,
Aviation and Property.
• JSSL has an annual turnover in excess of $32,000m and more than 133,000 employees worldwide.
• Argent Energy is the UK’s leading waste based biodiesel producer, specialising in processing degraded
wastes and oils and converting them into High Quality Biodiesel.
• With the recent acquisition of BDA and creation of Argent Energy NL, Argent Energy is now Europe’s leading
Waste Based producer of Biodiesel.
Argent Energy / John Swire & Sons Ltd
Who are we?

30. 30
Operations in UK and Netherlands
BIODIESEL PRODUCTION AND STORAGE
ARGENT ENERGY IN BRIEF
3 locations across UK
and Netherlands
240,000 MT of waste-based
biodiesel production
capacity
145,000m3 of tank
storage capacity
Cleaning and pre-
treatment facilities
Motherwell
Biodiesel
plant
Pre-treatment
facilities
Stanlow
Biodiesel
plant
Pre-treatment
facilities
Tank
storage
Amsterdam
Biodiesel
plant
Pre-treatment
facilities
Tank
storage
Cleaning
facilities
What do we do?

31. 31
How can Argent help?
Transport • High Blend Biodiesel / B100
Heat
• Replace fossil fuels with
Renewable Fuels
Power Generate Electricity using Biofuels

32. 32
Biodiesel blends

33. 33
Argent Energy Biodiesel’s Inherent Advantages
• AE Biodiesel has many advantages and benefits in its use within the Road Transport Sector
• AE Biodiesel is a ‘polar’, ‘surface active’ substance this leads to biodiesel having natural detergency and
anti-wear properties – leading to fewer additives being required in high bio-blends
• AE biodiesel is a small natural molecule which means that it burns more cleanly than fossil-fuel derived
ULSD leading to less or no coking in engine parts
• AE Biodiesel is made from 90% biogenic feedstock – being a near ‘circular’ product within the bioeconomy
• AE biodiesel gives around 88% GHG savings in its manufacture compared to ULSD and this can be twice the
savings of a crop-derived biodiesel
• AE biodiesel is distilled, meaning it has a very high quality which exceeds the current European standard
– EN 14214
• AE biodiesel is totally produced from waste based materials and has no negative impact on the Food or
Feed chain

34. 34
Biodiesel Challenges become Argent Biodiesel Unique Selling Points
• Biodiesel (like fossil-fuel derived ULSD) may have some challenges in its use as a transport fuel – these can be
overcome by the use of performance enhancing additives
• Oxidative Stability – over time the fatty acid component of biodiesel can degrade in the presence of
oxygen/air. To reduce this, anti-oxidants are added to AE biodiesel immediately after manufacture. Due to
AE biodiesel’s high quality it has been shown that our product is oxidatively stable for over 12 months.
Most other biodiesels are recommended to be stored for up to 6 months
• Cold Flow Properties – due to the different chemical structure of biodiesel compared to fossil-fuel derived
ULSD, additives are required (cold flow improvers) to improve the performance of biodiesel/ULSD blends in
the winter period. AE has shown blends of over 20% biodiesel (B20) in ULSD can be reliably used in road
transport over the winter period.

35. 35
1,000,000 3,000,000 5,000,000 10,000,000 15,000,000 20,000,000 25,000,000 50,000,000
Blend
%
M/Tonne
CO2 Saved
Equiv No
of Cars off
Road every
Year
M/Tonne
CO2 Saved
Equiv No of
Cars off
Road every
Year
M/Tonne
CO2 Saved
Equiv No of
Cars off
Road every
Year
M/Tonne CO2
Saved
Equiv No of
Cars off
Road every
Year
M/Tonne CO2
Saved
Equiv No of
Cars off
Road every
Year
M/Tonne CO2
Saved
Equiv No of
Cars off
Road every
Year
M/Tonne CO2
Saved
Equiv No
of Cars off
Road every
Year
M/Tonne CO2
Saved
Equiv No
of Cars off
Road every
Year
10% 285 137 855 412 1,425 686 2,851 1,373 4,276 2,059 5,702 2,745 7,127 3,431 14,254 6,863
15% 428 206 1,283 618 2,138 1,029 4,276 2,059 6,414 3,088 8,553 4,118 10,691 5,147 21,381 10,294
20% 570 275 1,711 824 2,851 1,373 5,702 2,745 8,553 4,118 11,403 5,490 14,254 6,863 28,508 13,726
30% 855 412 2,566 1,235 4,276 2,059 8,553 4,118 12,829 6,177 17,105 8,235 21,381 10,294 42,763 20,589
100% 2,851 1,373 8,553 4,118 14,254 6,863 28,508 13,726 42,763 20,589 57,017 27,452 71,271 34,314 142,542 68,629
Argent Energy High Biodiesel Blends - Greenhouse Gas (CO2) reduction calculator
Annual volume

36. 36
Biodiesel….
• Is renewable and therefore a sustainable energy resource
• Can reduce greenhouse gas emissions and hence help tackle global warming
• Is clean burning and produces less noxious emissions
• Can be used in most diesel equipment with no, or only minor, modifications
• Is compatible with the existing fuel infrastructure
• Is compatible with new technology diesel engines and emissions control equipment
• Is non-toxic, biodegradable, and suitable for use in sensitive environments
• Can be produced locally providing a degree of energy security
• Is somewhat immune to the fluctuations in crude oil price
• Improves fuel lubricity – less wear and maintenance
• Improves fuel cetane number - better cold starting, lower engine noise and reduced emissions

37. 37
Benefits of AE Biodiesel
• AE manufactures biodiesel of a superior quality which has inherent advantages over fossil-fuel derived ULSD
• Performance enhancing additives exist that can overcome challenges of using biodiesel/ULSD in road transport
• Field trials have proven there is no detrimental effect in using high bio-blends long-term in road transport applications
• Other forms of renewable fuel can be difficult to resource (HVO, Hydrogen, GTL)
• Some “alternative” fuels do not deliver Greenhouse Gas reductions
• Electrification of HDV engines and fleets is some way off
• CNG/LNG/Methane powered vehicles currently cannot offer the range (KM’s) or the CO2 reduction
• Post Covid-19 the world is planning on a Green Recovery and Biodiesel will be a key factor in that recovery

38. 38
www.argentenergy.com
Our Services:
• Higher biodiesel blend supported by a variety of OEM’s
• Drop-in replacement with 10% biodiesel content, 90% mineral diesel.
• 7.4% carbon savings versus average blend levels in the UK
• Competitive pricing
EN16734 – B10
• Up to 30% biodiesel content, 70-80% refinery grade diesel
• Drop-in replacement
• Currently in use with major coach and bus operators at more than 50 sites
across the UK as well as numerous Transport Operators nationwide
• Up to 28% well-to-wheel carbon savings
EN16709 - B14-30
• 100% biodiesel
• Minor engine modifications required + storage tank modifications
• 86% well-to-wheel carbon savings
• Competitive pricing
EN14214 - B100
Our Fuels:
• Founded in 2001, Argent Energy produces more than 240mt of high quality
distilled biodiesel annually, meeting the EN14214 quality standard
• All biodiesel produced solely from the most sustainable waste-based
feedstocks, fully compliant with the latest RTFO legislation
• Manufacture takes place at our 2 biodiesel plants in Motherwell & Stanlow
with distribution terminals at Ellesmere Port and Motherwell, and also at our
newly acquired biodiesel refinery and storage facility in Amsterdam
• In-house blending facilities to blend diesel to meet your sustainability
requirements using refinery-grade mineral diesel
• Winner of 2016 LowCVP ‘Low Carbon Fuel Initiative of the Year’ & ‘Winner of
Winners’ Awards
The UK’s leading waste to biodiesel company, supplying
carbon-saving fuel direct to truck, bus and coach fleets
www.argentenergy.com
Contact:
Colin Duke colin.duke@argentenergy.com / 07889 416789
Craig Cowman craig.cowman@argentenergy.com/ 07889 418363

39. 39
Heavy Fuel Oil
Gas Oil
Gas
Renewable
Biofuel
X
CO2 reduced by
circa 90%

40. 40

41. 41
Thank You

42. 42
ARGENT ENERGY Ltd
Suite 1 Sycamore House
Lloyd Drive
Cheshire Oaks Business Park
Ellesmere Port,
CH65 9HQ
42
colin.duke@argentenergy.com
Mob: 07889 416789
craig.cowman@argentenergy.com
07889 418363
jordan.roberts@argentenergy.com
0151 305 8294
www.argentenergy.com

43. Is your Data Centre
helping you deliver your
sustainable goals?

44. What is a Data Centre?
● A home, room or building for technology - not people.
Think servers, network kit and cyber security widgets.
● ‘The cloud’ lives in data centres.
Internet, email, telephone systems, apps all rely on data centres.
● Specialised buildings & facility management.
Data factories - equivalent to heavy industry use of energy.
● Must be secure - All data is important to someone:
think photos, banking, air-traffic control, national security.
* Data centres are used by everyone *

45. What is the challenge?
56% of electricity used by the IT of central government is in server
rooms!
97% of server rooms in public sector are too small to be efficient!
cooling these server rooms uses on average 300% more electricity
that that used by the actual IT!
More than 50% of a building’s electricity
use can be in it’s server room!

46. The Solution
Consolidate scattered server rooms to a smaller number of purpose
built data centres;
● specialised facilities management & security.
● bulk bought - driving economical solution.
● super efficient environmentally friendly cooling of the IT.
● switch from 300% energy wastage to less than 20%.
Uses same facilities as public cloud providers & NHS suppliers!
● less infrastructure & energy required per customer.
Use modern methods of construction;
● reduce embedded carbon and water - and recycled at end of life.
Switch to Green electricity!
● 99.9% carbon savings.
● reduced water consumption.

47. Re-Platform!
Additional savings
66% of electricity consumed in server rooms is
on equipment older than 5 years
the equipment older than 5 years contributes just
7% of the compute capacity
Replacing 9 year old servers with new ones = 85% reduction in
electricity, carbon, water and space

48. The Crown Hosting
Solution
Relocate to Crown Hosting: no change in IT;
● reduce overall electricity by 79%.
● reduce remaining carbon footprint by up to 99.9%.
● save typically 70% of running costs.
● security assured by NCSC, CPNI and DE&S.
● unique T&C’s for building occupancy.
● simple direct award - expert CCS category support for project.
Re-Platform: change your IT;
● reshape and right-size your IT = e.g. 85% reduction in your IT infrastructure.
Public Cloud: someone else’s IT;
● relocate and reshape, but onto a public cloud provider’s IT.

49. Here for you
info@crowncommercial.gov.uk
0345 410 2222
www.crowncommercial.gov.uk
@gov_procurement Crown Commercial Service
Jason Liggins - Crown Hosting Lead
jason.liggins@crowncommercial.gov.uk
07956 050843

50. One hygienic flush at a time

51. A Changing World
• On the record
– Water demand exceeding supply – Water UK
06/20
– Severn Trent Residents without water – 1/6/20
– British Toilet Association requests public toilets to
be reopened – Radio 2
– Public told to cut water use – BBC News 2/6/20
• Commentary by industry
– 25% greater demand for water since pandemic –
hand washing – CEO Water UK
– Sustainable economy and environment is critical
to every community – CEO Yorkshire Water
– We want to transform value for customers and the
environment through Innovation – 2050 Water
Industry Innovation Strategy
– 50% of staff want office hygiene increased, 33%
want touchless bathrooms – British Council for
Offices
Victoria Falls Summer 2019

52. A Changing World
• What this means
• Climate changes – water demand exceeding supply
• Droughts and floods – “the wrong sort of rain”
• Increased hand washing – 25% increase in water use
• Demand for better hygiene – to reassure staff and
patients this is a safe site post COVID
• Increased water demand means increased costs, so
reducing flush volumes is even more important
• The UK Water industry in its 2050 water
Innovation Strategy wants to sustainably
reduce water consumption through new
innovations

53. Global water shortage
* OECD (2012), OECD Environmental Outlook to 2050, OECD Publishing
https://dx.doi.org/10.1787/9789264122246-en
Demand
to increase by
55%
between 2000-2050*
1 in 10
have no
access to
clean water
today
Water is a finite resource – we can’t increase the supply
40%
shortfall
by 2030

54. Hotels Education
Healthcare
Retail & Leisure
Offices
Toilets waste scarce drinking water
90%
Washrooms
Other 48%
Toilets
Urinals
Washing
High maintenance costs
Poor hygiene
Water usage in commercial premises*
*Source: North Staffordshire Water, UK Water Company
Slow refill / toilet queues
Other challenges
All of which lead to increased costs, a drop in productivity & user dissatisfaction.

55. Propelair - the world’s lowest water flush toilet
120l of air propels just 1.5l of water into existing drains,
fully cleaning the bowl and removing all waste
Flushes in only 3 seconds
– powerful and reliable,
leaving a clean bowl
The transparent lid is
closed to form a seal
Refills in only 20-30
seconds
A two-section cistern;
one for air and one for water
Flushes in only 3 seconds
– powerful and reliable,
leaving a clean bowl
The transparent lid is
closed to form a seal
Refills in only 20-30
seconds The anti-microbial
latch sits away from
the toilet

56. Rapid cost savings & positive user feedback
84% less water
80% carbon footprint reduction
Lower maintenance costs, eg £300k pa
Superior flush performance
Shorter queues
95% fewer germs flying around the cubicle
84% less water
80% carbon footprint reduction
Lower maintenance costs
60% lower water & sewage bills –
Payback < 1 – 3 years
Superior flush performance
Shorter queues
99% fewer germs in the cubicle
81% of users value water saving

57. Improved Hygiene is critical
• Conventional toilets have no lids or are often flushed open
• The result is a “mushroom cloud” of airborne contaminants and bacteria
• Contaminants land on skin, clothing and surfaces and can be spread through the
building via the HVAC system
• The Propelair solution – lid is closed before flush
• There is no aerosol effect, 99% of contaminants are flushed to the sewers
• Lid and latch are impregnated with “Steritouch” and so are continuously clean
• Transparent lid to see that the unit is clean and ready for use
• UV-C lighting can also be used to sterilize open areas eg Reception, waiting areas,
A&E, clinics, dining areas, corridors – just ask us how!

58. Reacting to the new reality
• “Hospitals are dangerous places – I don’t
want to attend in case I get infected”
• Critical to regain the trust of the general
population in order to rebuild other
medical areas that have declined over the
last 6 months
• Hospitals do want to get people back –
but with a clear message that hygiene
and safety is improved

59. Reacting to the new reality
• On the positive side it is likely to be
important that all new infrastructure
investments are:-
– Total lifetime cost inclusive – no
hidden extras
– Long term maintenance to be
included
– HSE bombproof
• On the negative side there will be
other major demands on capital –
water saving may have gone down
the priority list for capital expenditure
– UK Finance believe financing green
projects is the future

60. Reacting to the new reality
• We can help!
1. Sustainable Funding Plan – enabling
hygienic sustainability now
2. No capital expenditure needed
3. No payment for 6 months, so savings build
up in advance and pay for the monthly
costs of the plan
4. Example 100 toilets (100 flushes average)
installed month 1, saves £25,500 in first 6
months, net saving in months 7-60 is £525
each month
5. Opex positive from month 1 (there is
literally no budget required at any point)
• We need to Build back better and change “the
old normal”
• You can make the difference for
your patients and staff to help move
forward safely and hygienically

61. One hygienic flush at a time
Any questions?
ANY QUESTIONS?

62. | 62
THE LEADING EUROPEAN REMANUFACTURER OF
MEDICAL DEVICES
Paul Broadberry

63. | 63
Objective
❖ To offer an option for reducing single use plastics in theatre and the
cath lab via remanufacturing.
❖ To talk through what remanufacturing actually is.
❖ To think about when to introduce remanufacturing into your hospitals
sustainability/savings workplan? How about now!
❖ As an example… Leeds General Infirmary Cath Labs diverted 36.8 kg of
single use plastic devices, earned £5,000+ and saved 50% on some line
items expenditure in Q1 2020.
cost saving
safety and
quality
sustainability

64. | 64
What is Remanufacturing?

65. | 65
What is Remanufacturing?
❖ Quality assured.
❖ Savings.
❖ Reducing healthcare’s environmental footprint.
❖ Reduced waste to landfill and incineration
❖ Reduced demand for raw materials
❖ Reduce CO2
cost saving
safety and
quality
sustainability

66. | 66
❖ Commonplace in the EU, US, Canada, Israel, Japan.
❖ Over 20 years of world wide experience.
❖ Fully regulated.
❖ Vanguard is the leading EU provider.
❖ 800 customers in Germany.
❖ 28 University hospitals.
❖ All main GPOs purchase Vanguard devices.
❖ MHRA guidelines 2016.
❖ 25 UK hospitals on-board.
Remanufacturing Overview
cost saving
safety and
quality
sustainability

67. | 67
The network of AMDR medical device remanufacturers provides a platform to
promote the highest standards in remanufacturing.
While reprocessors
saved their hospital and
surgical center partners
$20 million in 1999, the number
grew to $471 million by 2018 —
more than doubling savings
every year for 20 years. In
2018, over 8,000 hospitals and
surgical centers in the United
States, Canada and Europe
partnered with commercial
reprocessors.
dollars saved in 2018 by hospitals and surgical
centers in the United States, Canada and Europe,
thanks to AMDR-member reprocessors.
percent of reprocessed devices are inspected
and/or function tested. Reprocessors spend
millions of dollars to meet or exceed FDA and
European medical device manufacturer
requirements.
Remanufacturing Overview - AMDR

68. | 68
❖ Initially reverse engineered.
❖ Full product identification and traceability.
❖ Thorough cleaning and decontamination.
❖ Material and performance testing.
❖ Electrical integrity testing.
❖ Packaging and sterilsation as per industry standards.
Innovative Proprietary Process
cost saving
safety and
quality
sustainability

69. | 69
End to End Volumetric Monitoring
Our patent protected cleaning and disinfection machines
have automated monitoring of the processing media flowing
through the lumen for each individual medical device and in
each process step of the cleaning and disinfection process
Microbiological testing
procedure with the reference OPA method
according to EN 15883 implemented as
standard practice to ensure and document
the effectiveness of the cleaning
procedure
Standardised testing of each device
for integrity and function: ensures device is
fully functional and meets specifications
Innovative Proprietary Process

70. | 70
❖ “Single use” applied by OEMs.
❖ Supported by key regulatory bodies.
❖ EN ISO 13485 EU MDD 93/42/EWG compliant.
Regulatory
cost saving
safety and
quality
sustainability

71. | 71
❖ Clinical efficacy.
Regulatory
cost saving
safety and
quality
sustainability

72. | 72
Diagnostic Catheters
Fixed Curve, Loop, Steerable
Ablation Catheters
Non irrigated, Irrigated
3D Mapping Catheters
Loop Diagnostic, Irrigated SF
Surgical and Orthopaedic
Instruments
Endoscopic and
Further Medical Devices
Biosense Webster, Boston Scientific, Abbott, Biotronik
Webster, Lasso 2515, Dynamic XT/ EP-XT, Viking, Inquiry,
Inquiry Optima/AFocus, Multicath, AcuNAV
Biosense Webster, Boston Scientific, Abbott, Medtronic
Celsius, Navistar, Celsius/EZ-Steer Thermoccol, Thermocool,
Blazer, Intella TIP/NAV, Therapy, Arctic Front
Biosense Webster, Boston Scientific, Abbott
Lasso 2515 NAV, Navistar, Thermocool Smarttouch,
FlexAbility, Advisor SE, IntellaNAV, SoundStar eco
Ethicon, Medtronic, Smith & Nephew, DePuy Synthes
Harmonic ACE+/+7, HD1000i, Sonicision, VAPR Electrodes,
Arhtro Wand Electrodes
Carl Storz, Richard Wolff, Olympus, Abbott
COBRA, OES Viber, Transseptal Needle BRK/BRK-1,
Agilis Introducer
Not all listed products are available as CE products.
Portfolio

73. | 73
■ Diagnostic Catheter: Webster, Dynamic XT, EP-XT, Inquiry, Inquiry
SoftTip/ AFocus, Optima, Lasso 2515, Viking, Webster CS, AcuNAV
■ Ablation Catheter: Celsius, Celsius DS, Celsius/EZ-Steer
Thermocool, Thermocool SF, AlCath, Artic Front, Flexability
■ 3D Mapping Catheter: Navistar Thermocool, Thermocool SF NAV,
Lasso NAV eco, Navistar, Flexability SE, Thermocool Smarttouch,
SoundStar eco
■ Surgical Products: Harmonic ACE+/+7
■ Further Products: Transeptal needle BRK, Cables
Expected availability from mid 2020
80
43
44
4
Current number of CE products
Diagnostic Catheter
Ablation Catheter
3D Mapping Catheter
Surgical Products
147
71
82
4
20
Number of CE products mid 2020
Diagnostic Catheter
Ablation Catheter
3D Mapping Catheter
Surgical Products
Further Products
171
324
Portfolio

74. | 74
Headline figures from DH research on cost savings from
remanufacturing for selected cardiology devices:
Over £30mn saving p.a. for NHS England
❖ £8.8mn p.a. – from Class II and III devices
❖ £1.7mn p.a. – from OEM price deflation
❖ £10.8mn p.a. – from Class 1 devices
❖ £9.4mn p.a. – with use of SUDs harvested from other CE
countries
❖ £1mn p.a. – avoided waste disposal costs
This is just phase 1. The savings grow significantly as our portfolio of
available CE products expands.
❖ EP catheter lines are due to expand 2x in May 2020.
❖ Tower 2 has already identified £4m savings p.a. via using
remanufactured devices (available now) within the surgical
direct energy market.
Savings Analysis UK

75. | 75
Savings Analysis
❖ Up to 50% savings per line item!
❖ Plus OEM price reduction.
❖ Plus waste reductions savings.
cost saving
safety and
quality
sustainability
OEM Product Code
Annual
Volume
OEM Price
Total OEM
Expenditure
Volume to
VG
New OEM
Expenditure
VG Price VG Expenditure
New Overall
Expenditure
Saving
36N57R 42 410.00£ 17,220.00£ 50% 8,610.00£ 170.20£ 3,574.20£ 12,184.20£ 5,035.80£
M0042011010 80 204.00£ 16,320.00£ 50% 8,160.00£ 115.00£ 4,600.00£ 12,760.00£ 3,560.00£
M0042011030 101 181.00£ 18,281.00£ 50% 9,140.50£ 78.20£ 3,949.10£ 13,089.60£ 5,191.40£
35Q53R 97 734.00£ 71,198.00£ 50% 35,599.00£ 257.60£ 12,493.60£ 48,092.60£ 23,105.40£
D134301 162 706.00£ 114,372.00£ 50% 57,186.00£ 368.00£ 29,808.00£ 86,994.00£ 27,378.00£
D133601 60 1,345.00£ 80,700.00£ 50% 40,350.00£ 694.60£ 20,838.00£ 61,188.00£ 19,512.00£
D133602 299 1,345.00£ 402,155.00£ 50% 201,077.50£ 694.60£ 103,842.70£ 304,920.20£ 97,234.80£
D132705 48 1,345.00£ 64,560.00£ 50% 32,280.00£ 694.60£ 16,670.40£ 48,950.40£ 15,609.60£
D134701 15 1,345.00£ 20,175.00£ 50% 10,087.50£ 542.80£ 4,071.00£ 14,158.50£ 6,016.50£
D134702 83 1,345.00£ 111,635.00£ 50% 55,817.50£ 694.60£ 28,825.90£ 84,643.40£ 26,991.60£
D134805 56 1,345.00£ 75,320.00£ 50% 37,660.00£ 694.60£ 19,448.80£ 57,108.80£ 18,211.20£
34A-35M 54 720.00£ 38,880.00£ 50% 19,440.00£ 492.20£ 13,289.40£ 32,729.40£ 6,150.60£
M004 400035 0 578 186.00£ 107,508.00£ 50% 53,754.00£ 115.00£ 33,235.00£ 86,989.00£ 20,519.00£
900,933.00£ 450,466.50£ 240,221.20£ 690,687.70£ 274,515.90£

76. | 76
Collections
❖ Establish account.
❖ Collection materials supplied.
❖ Training.
❖ Ongoing support.
❖ Quarterly payments.
❖ Waste reduction gains.
cost saving
safety and
quality
sustainability

77. | 77
❖ 25 locations.
❖ 595.4 kg in Q1 or 2.38 tonnes projected for 2020 of single use devices diverted.
❖ £57,262 in Q1 or £229,048 projected for 2020 paid for collected devices.
❖ 50% cost down on remanufactured line items used in Trusts.
Working Examples
❖ 36.8 kg
❖ £5,000+
❖ 40.0 kg
❖ £4,000+

78. | 78
Remanufacturing in your hospital
❖ Quality assured.
❖ Savings.
❖ Reducing healthcare’s environmental footprint. cost saving
safety and
quality
sustainability
Stakeholders
Procurement Lead
Sustainability Lead
Lead EP Physiologist / Theatre Manager
Physicians
Lab / Theatre staff
Infection Control
Waste Manager

79. | 79
Establishing Collections 1
cost saving
safety and
quality
sustainability
Discuss with Procurement and
Sustainability Lead.
Engage Lead EP Physiologist or
Theatre manager.
Ensure Infection Control are
happy.
Waste manager needs to be
versed.
Paperwork completed with
Vanguard.

80. | 80
Establishing Collections 2
cost saving
safety and
quality
sustainability
Vanguard provide collection
materials.
Vanguard train relevant staff.
Collections begin.
Collection materials continually
topped up. Ongoing training as reqd.
Reports sent and monies for
collections paid.

81. | 81
Establishing the use of remanufactured devices
cost saving
safety and
quality
sustainability
Approval from Procurement and Lead
EP Physiologist or Theatre Manager.
Physicians versed and onboard.
Paperwork completed, devices on
ordering catalogue.
Vanguard support Physicians with first
cases.
Vanguard send savings reports and
provide ongoing support as reqd.

82. | 82
Objective + Next Steps
❖ To offer an option for reducing single use plastics in theatre and the
cath lab via remanufacturing.
❖ To talk through what remanufacturing is.
❖ To think about when to introduce re-manufacturing into your
hospitals sustainability/savings workplan? How about now!
cost saving
safety and
quality
sustainability
1. Contact me for more details.
2. Opportunity assessment.
3. Build an implementation plan together.

83. | 83
Thank you.
Vanguard Medical Devices Ltd.
paul.broadberry@vanguard-healthcare.com
www.vanguard-healthcare.com
+44 (0)7976313530

84. Comfort Break
@dayforaction #sustainability

85. Afternoon Session
13.45 elemental Healthcare
Speaker: Geoff Miller, Regional Sales Manager, North, elemental
Healthcare
14:00 Panel session - How do we tackle single-use masks?
Chair: Scott Buckler, Campaign Manager, NHS Sustainability Campaign
Panellists:
Alexis Percival, Environmental & Sustainability Manager, Yorkshire
Ambulance Service NHS Trust
Clare Nash, Senior Nurse, Clinical Procurement, University Hospitals of
North Midlands and The Royal Wolverhampton NHS Trust
Steve Hynd, Campaigns Manager, City to Sea
14.25 Conference close

86. SUSTAINABILITY INTHE OPERATINGTHEATRE

87. ELEMENTAL HEALTHCARE
 Introduction
 Why we are here –When did the Focus ‘get real’
 How has Covid 19 had an Impact on Sustainability in the NHS
 Single Use Plastic – MovingAway
 Sustainable solutions for the OperatingTheatre
 A Review of the Data
 Case Studies – illustrative example of a large NHSTrust
 Open ForumQuestions & Answer session

88. WHAT IS THE
PROBLEM?

92. IMPACT OF COVID-19
 UK Manufacture – Resilient SupplyChain
 Climate Change recognised due to the impact of lockdown
 Considerable interest in sustainable solutions
 Supporting the NHS Climate emergency will help prevent illness, reduce
pressures on A&E and help to save the lives of tens of thousands of people in the
UK

93. COMBATING PLASTIC

94. THE SOLUTION

95. WHAT IS RESPOSABLE™?
 ATrade Mark of Surgical Innovations
 ATrue Sustainable Solution
 Surgeon Designed / Clinically Supported
 UK Manufacture
 Clinical Excellence
 Used Globally
 Fit for Purpose - 20 years InThe Market
 Cost Effective / innovative solutions (Kits)
 A Hybrid
 Reduce Plastic entering the OR

96. THE PROBLEM /THE SOLUTION

97. THE PROBLEM

98. MICROLINE CLIP APPLIER & INSTRUMENTS

99. A MOUNTING PROBLEM…

100. REDUCING PLASTICWASTE INTHEOPERATINGTHEATRE – POWER ET AL 2020
44,000Kg of
Plastic
Waste
88,000KG of
CO2

101. 3.6 MILLION PLASTIC BOTTLES!

102. CASE STUDY
 An NHSTrust performed 900 LaparoscopicCholecystectomies (one procedure)
 Saved 567kg in plastic
 40,000 plastic bottles
 £73,000 before we include the cost of waste

103. “If a surgical instrument is equally effective,
costs less than what is currently used and
has the crucial benefit of dramatically
reducing plastic waste produced, then it is
important to consider this change”

104. THE DATA

105. THANKYOU
Geoff Miller – Regional Sales Manager, 07887 402287

106. Panel session
How do we tackle
single-use masks?
@dayforaction #sustainability

107. Thank you for joining
us today, we hope
you enjoyed the
virtual event!
@dayforaction #sustainability