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The NHS standard contract 2021/22 and sustainability, what does it mean for your Trust?

1st April 2021.

Following a recent consultation with Trusts, NHS England has recently confirmed the new Standard Contract for 2021/22 which includes a greater focus on sustainability in order to deliver the ‘Net Zero’ health system goals outlined in October 2020.

The standard contract is used by Clinical Commissioning Groups and NHS England to contract for all healthcare services bar primary care. It’s likely the next 12 months will be another challenging year for the NHS given the continued impact of COVID 19.  However, the new contract indicates a willingness to push on regardless with other key NHS priorities.

One of those key priorities is to address the NHS’s carbon footprint. The report published in October, ‘Delivering a Net Zero National Health Service’ outlined the steps Trusts must take to achieve the net zero carbon goals set for 2040 and 2045 but the document had no legal standing to make its recommendations mandatory. Section 18 of the new contract – ‘Green NHS and Sustainability’ includes stronger targets and other changes to the previous years’ contracts.

We have found that the impact of the standard contract can be overlooked when a Trust is considering its sustainability measures. However, section 18 should now be addressed when setting your goals and writing your green plan to ensure compliance.

A stronger focus in this year’s contract

We’re going to highlight some of the key conditions outlined in the new standard contract and discuss their potential impact on your Trust….

18.2 The Provider must maintain and deliver a Green Plan, approved by its Governing Body, in accordance with Green Plan Guidance and must:

18.2.1 provide an annual summary of progress on delivery of that plan to the Coordinating Commissioner; and

18.2.2 nominate a Net Zero Lead and ensure that the Co-ordinating Commissioner is kept informed at all times of the person holding this position.

The development of a Green Plan was included in last year’s contract however in a recent survey of NHS Trusts conducted by Inenco 40% of respondents stated they do not have a Green Plan in place. Each Trust is mandated to have a plan which is approved by the board; with a summary of progress against the targets provided to the Coordinating Commissioner.

New to this year’s contract is the requirement to appoint a Net Zero lead for your Trust and then notify the Commissioner of who that is. Does your Trust currently have a nominated Net Zero Lead?

18.4 As part of its Green Plan the Provider must have in place clear, detailed plans as to how it will contribute towards a ‘Green NHS’ with regard to Delivering a ‘Net Zero’ National Health Service commitments

Section 18.4 describes in further detail the actions each Trust needs to take in relation to air pollution, climate change and single-use plastics & waste. The following updates have been made to section 18.4 in this year’s contract:

  • Your targets must now be aligned to those set in the ‘Delivering a Net Zero National Health Service’ document.
  • Reduce the proportion of desflurane to sevoflurane used in surgery to less than 10% by volume, instead of the 20% target in last years contract. Nitrous Oxide has also been added to the list of environmentally damaging gasses which must be addressed.


In our recent survey 47% of Trusts who responded stated they did not know what their current carbon footprint is. Data collection and analysis is crucial to not only knowing what your Trusts carbon footprint is but also to set realistic goals and be able to measure against those goals in accordance with the updated contract. Even those who do have a green plan in place will need to review the targets they’ve set and update them to ensure they comply with the standards outlined in section 18.4.

18.5 The Provider must ensure that with effect from the earliest practicable date (having regard to the terms and duration of and any rights to terminate existing supply agreements) all electricity it purchases is from Renewable Sources.

New to this year’s contract is the requirement of Trusts to procure green energy, which is a necessity from April 2021. Is your Trust procuring 100% REGO back renewable energy?

Section 18.6 covers the requirement of Trusts to set broader sustainability-based targets that take the local community into consideration, these will also need to be agreed upon with the Coordinating Commissioner. For a full overview of what is required of your Trust moving forward, the standard contract for 2021/22 can be viewed here.

Driving the agenda forwards

The message is clear that despite the current challenges facing the NHS, environmental sustainability is increasingly a key priority for NHS England and this is likely to be just the beginning of contractually required processes each Trust must undertake to be fully compliant going forward. Ensuring you have a comprehensive Green Plan in place will help to focus your Trust on the steps required to ensure you meet the targets outlined in the ‘Delivering a Net Zero National Health Service’ document.

To speak to one of our experts about developing a strategy for a net zero future for your Trust contact us on 01253 785294