Fears for patients in NHS net zero drive

Paramedics concerned recharging electric ambulances will delay response times

THE NHS is to introduce electric ambulances, raising concerns that its drive for net zero is being put above patient safety.

Paramedics fear patients will be forced to wait longer because of the hours lost recharging the vehicles, with particular concern about coverage of rural areas, given the limited range.

The move next month is part of a series of measures that whistleblowers fear are putting green credentials above medical priorities. The drive has created a bureaucracy that was diverting vast sums from the front line, and placing “grossly unethical” obstacles in the way of clinical decisions, one whistleblower warned.

NHS England has set up a Greener NHS team with a combined salary bill of £3million a year, leaked documents reveal. Officials created 48 roles, including five on six-figure salaries, as part of efforts to pursue an environmental agenda, which means every medicine and product has to undergo an “evergreen assessment”.

The 135-question process means that no decision can be taken without a product’s social values and contribution to emissions targets being considered. One supplier alleged that devices, such as plastic cannulas, were being rejected on environmental grounds, despite the fact they would improve patient safety.

An extra layer of bureaucracy will be added next month, with every NHS supplier asked to draw up a Carbon Reduction Plan. Other eco-initiatives being rolled out include “climate-friendly pain relief ” for mothers in labour and chemotherapy deliveries and GP visits via e-bikes.

A whistleblower told The Telegraph: “Every part of the NHS is underresourced and waiting lists remain historically high, but commitment to green zealotry remains unchanged. The amount of resources dedicated to the green agenda is astounding, and the fact that it is now impacting clinical decision-making is, I believe, grossly unethical.”

Next month, electric ambulances will be piloted across swathes of the country. Under the scheme, the ambulances will be trialled across the North West, East of England, Yorkshire, South West, and London at a cost of about £150,000 each.

The West Midlands has already introduced the vehicles, although last year board papers from the West Midlands Ambulance Service revealed major concerns. An evaluation of the scheme found the ambulances took up to four hours to charge and travelled an average of 70 miles between charging, with the papers warning “range and recharge time is a significant limiting factor”.

While the vehicles had a range of 100 miles, which would cover urban shifts, this would not be the case from most of its hubs, it states, adding: “Rural areas in particular are covering twice this mileage and more in a shift.” The report says that, as a minimum, ambulances need to be able to cover 160 miles.

Paramedics said they were fearful of the risks if electric ambulances were rolled out without a proper safety assessment. Richard Webber, a paramedic and spokesman for the College of Paramedics, said: “If I have got a very sick patient, someone who has had a heart attack and I am trying to get them to hospital I don’t want to be worrying about the battery.”

An NHS spokesman said: “NHS services must always put patients first when procuring products and it is also right we seek green alternatives, but only when they save the taxpayer money.”

IN October 2020, the NHS became the world’s first health service to commit to reaching carbon net zero.

Health officials were so inspired they dreamt up a whole new bureaucracy to drive the agenda.

Plans for the Greener NHS team, seen by The Telegraph, show 48 roles, including five officials on six-figure salaries, in a structure due to come into place next month. All are charged with overseeing efforts to pursue an environmental agenda that means every medicine and product has to undergo an “evergreen assessment”.

The drive comes right from the top, with Amanda Pritchard, NHS chief executive stating in 2021 that “climate change is a health emergency”. Her predecessor – then Sir Simon (now Lord) Stevens – had announced the pledge the year before, in the foreword to a 176-page report.

Yet many of those working in the NHS, and those trying to work with it, say that too often, clinical decisions are being distorted in a push to satisfy the green agenda.

All NHS suppliers providing a new medicine, service or product must undertake an Evergreen Sustainable Supplier Assessment, and meet criteria on emissions, including net zero, and “social values”. The 135-part questionnaire means no decision can be taken without a product’s social values and contribution to emissions targets being considered.

The principles aim to ensure the NHS has no carbon emissions by 2040. But the initiatives are diverting large sums from the front line. One whistleblower said the resources going into the initiatives were “astounding” and “grossly unethical”.

Competitions for funding of promising medical innovations, such as the Small Business Research Initiative (SBRI) Healthcare Programme, tell applicants to put “net zero at the core of the proposal”, a presentation seen by the Telegraph shows.

A whistleblower alleged that businesses with promising medical innovations were being ruled out for grant funding because of “net zero” and “diversity and inclusion” criteria. He said NHS leaders’ “pervasive eco ideology” meant they were putting “environmental concerns ahead of patient welfare”.

He cited an example where clinicians agreed a plastic cannula “would improve patient safety and comfort for a group of their patients, but could not use the product because it contained more plastic than the current product”. It is cheaper and safer than the metal needles used in patients requiring regular blood work, dialysis or chemotherapy, where the metal can damage blood vessels.

“I’ve never been in a situation [until now] where you can’t even get beyond that conversation. They said there were several products that they are no longer able to use, because the trust has decided that they’re not environmentally friendly enough,” he added.

The service has hailed eco initiatives including “climate friendly pain relief ” for mothers in labour. This will see mobile units used to supply gas and air. The machines, which women will breathe from and which are already in use in some NHS hospitals, are designed to collect and destroy nitrous oxide – a powerful greenhouse gas produced when gas and air is exhaled. There has also been a big push to “decarbonise” – or replace

– the inhalers of around five million patients with asthma for “dry powder” versions because leaders say they account for

3 per cent of NHS emissions.

The move is supported by Asthma and Lung UK, but the charity notes that those who are elderly, very young, or have severe asthma, may “find it hard” to use the dry powder versions, “especially when symptoms are bad”, because they require a strong inhalation force and new technique.

Meanwhile, virtual wards and smartphone consultations with hospital consultants and GPS have all been hailed as initiatives which can reduce the NHS’S carbon output. However, charities for the elderly have raised concerns that shifts dependent on technology risk excluding those who need it most.

A major shift to remote GP appointments during the pandemic meant that at some points, just half of consultations were face-to-face. After repeated calls from ministers, the proportion has crept up, with two in three appointments in person.

The health service has become an enthusiastic proponent of electric bikes – now being used by GPS as well as for chemotherapy delivery, despite concerns from fire chiefs.

In Oxford, e-bikes are used to deliver time-sensitive patient-tailored chemotherapy. The chemotherapies are made for specific patients, ready to be used within a short timeframe and needed quickly across town to deliver life-saving cancer treatment.

John Radcliffe and Churchill hospitals, part of Oxford University Hospitals NHS Foundation Trust, receives deliveries from a nearby manufacturer which claims the bikes are greener and quicker than driving the cargo across the city. GPS have also been using e-bikes to carry out home visits.

Their use comes despite warnings from authorities about the safety of the bikes, which can “start incredibly ferocious fires”. The service said it was called to put out an e-bike fire every other day on average in 2023.

Elsewhere, a drive by University College London Hospitals trust encourages staff to stop wearing non-sterile single use gloves unless truly necessary. The trust says more than half a million gloves have been saved from landfill since it launched the initiative last May.

Hospital chiefs insist that staff should still wear gloves if there is a risk from blood or bodily fluids, or if a patient is infectious. Nurses said it was “exciting” to see glove usage fall, suggesting that “putting on gloves to do anything for our patients had become a habit”.

Next month the green agenda will ramp up further. The Greener NHS Team – currently led by Chris Gormley, acting chief sustainability officer for the NHS – will ask every NHS supplier to draw up a carbon reduction plan.

Electric ambulances will be trialled across most of England, with the NHS in the North West, East of England, Yorkshire, South West, London introducing the vehicles from next month.

The West Midlands has already introduced electric ambulances, although board papers from the West Midlands Ambulance Service last year revealed concerns that they will need charging too often,

Paramedics state their concerns simply. “If I have got a very sick patient, and I am trying to get them to hospital, I don’t want to be worrying about the battery,” said Richard Webber, a spokesman for the College of Paramedics. He is among many frontline staff urging the service to “go very cautiously” in pushing the green agenda if patient safety is on the line.

Those trying to secure rollout of medical innovations and products often end up hiring consultants to work through the paperwork, at a cost of tens of thousands of pounds.

Smaller businesses end up pushed out of the market, the whistleblower says, while for larger ones it may just end up on the bill to the taxpayer.

He suggests the NHS may have forgotten its true purpose. “It just needs someone to ask the question: do we really want to enact policies that drive up the costs and reduce choice, with frontline clinicians thinking, ‘is this the most environmental option’ rather than ‘what’s right for the patients sat in front of me?’”

Meanwhile senior officials do not appear to be taking their own medicine. NHS England executives spent around £30,000 on domestic flights in 2023, including £440 for a single fare from London to Manchester, a Freedom of Information disclosure to Health Service Journal reveals.

Health officials said the use of domestic flights will be banned by 2025.

It comes as yet more funds are ploughed into the NHS. Announcing an extra £6 billion last week, Jeremy Hunt said £3.4 million would be dedicated to improving efficiency and technology, pledging to release £35 billion in savings.

An NHS spokesman said: “NHS services must always put patients first when procuring products and it is also right we seek green alternatives, but only when they save the taxpayer money. The new electric ambulances are benefiting thousands of patients, and they could help deliver annual operational savings of £59million.”

‘There were several products they are no longer able to use because the trust has decided they’re not environmentally friendly enough’

If I have got a very sick patient, and I am trying to get them to hospital, I don’t want to be worrying about the battery’