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Quality Our Environment

 

Environmental management

Managing the impact of Life Healthcare’s business activities on the environment

Environmental policy

The Life Healthcare Group is committed to being a world-class provider of quality healthcare for all. As part of our quality service delivery, we are committed to the conservation of the environment and to limit any harmful impact on the environment through our business activities.

We believe that sound environmental management contributes to our competitive strength and indirectly benefits our customers, shareholders and employees by contributing to the overall well-being and economic health of the communities we serve.

The policy confirms our commitment to comply with all environmental legislative requirements and to ensure continual improvement through the implementation of responsible environmental management processes and preventative measures in order to control, minimize or eliminate environmental risks and impacts across all our business units and facilities.

Life Healthcare undertakes to:

  • Identify and comply with applicable legislation and regulations
  • Identify and manage the risks relating to the use of natural resources and reduction of waste products in our business
  • Identify and manage the impact of emissions and its effect on climate change
  • Develop and apply solutions to environmental risks in accordance with international requirements and standards, and to apply improved technologies as these become available
  • Educate employees on good environmental practices
  • Continually assess all our business activities against environmental objectives and targets to minimise the negative impact on the environment
  • Ensure responsible reporting to our stakeholders on our environmental performance

Follow the link to view the full Life Healthcare environmental policy.

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Climate change position statement

Life Healthcare acknowledges that climate change is an issue that requires urgent attention and action. Climate change poses both risks and opportunities to our business and we believe in investing in energy efficiency projects that will reduce carbon emissions into the atmosphere. Our initiatives will hold long term benefits for the company and the environment.

Whilst we are a low impact organisation in environmental terms, we endorse the need to manage the consumption of our natural resources in a sustainable manner; to conserve energy and water, and to recycle in an effort to reduce our carbon emissions in line with international best practice.

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Group environmental and climate change forum

The Life Healthcare board and executive management team has identified the need for central co-ordination of the various environmental and climate change initiatives across our business units and facilities. To this end we have constituted our group environmental and climate change forum, which is a conduit to and from the group’s social, ethics and transformation board sub-committee, which sub-committee has a responsibility to monitor the group’s sustainability initiatives and impact on the environment.

The group environmental and climate change forum will be responsible for:

  • Ensuring the effective coordination of sustainability initiatives across the group
  • Providing a platform for information sharing and driving international best practice
  • Ensuring consolidated group internal and external reporting
  • Driving the group’s strategy in terms of the management of our carbon emissions

The forum is chaired by the group nursing and quality executive and includes executive and senior representation from our nursing, quality, support services (procurement, engineering and pharmacy) and company secretarial departments.

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Sustainability initiatives and improvements

Life Healthcare’s progress on energy efficiency interventions

Life Healthcare has committed to reduce its carbon intensity, measured as tons CO2 per paid patient day (PPD), by 10% over five years (a reduction of 2% per annum over the period of 2013 to 2018).

This commitment was undertaken in line with the group’s environmental policy to be a socially responsible organisation which continually strives to minimise its impact on the environment whilst maintaining world class healthcare facilities for all its patients.

Life Healthcare has identified several key focus areas, which are in various stages of implementation, and continues to investigate further opportunities. Whilst a 10% reduction target has been set over the five year period, it is the intention of Life Healthcare to entrench a culture of environmental awareness throughout the organisation and continually strive for further efficiencies.

The current strategy, with all energy efficiency interventions, therefore encompasses a group-wide approach from executive level to hospital operations. Through this implementation approach, awareness amongst our employees is increased allowing for an improvement in behaviour when it comes to energy saving.

The graph below shows a downward trend in all measurement areas that relate to energy usage across the group. This is as a result of the group-wide energy saving projects that was completed during 2014 - 2015. The main contributors are heat pump installations and the Life Anncron PV project.

Carbon Intensity Figures

Metering project

In order to accurately monitor and trend the overall electricity and water consumption across the group, meters have been installed at every facility and are connected to the group intranet allowing for “real-time” energy and water monitoring from the group’s head office.

The system installed is modular which allows for, not only the total energy and water consumption to be monitored, but also (as individual energy saving projects are rolled out) specific areas to be sub-metered prior to and post intervention. This will allow Life Healthcare to verify the effectiveness and impact of the projects or energy saving behaviour of our employees.

The data collected allows for benchmarking of similar sites and quarterly performance is reported at group level to encourage new projects and behaviour changes. Metrics such as most improved sites will be published in the future, in order to drive a level of pride and recognition amongst the employees and management of these facilities, and to push underperforming units to strive for improvement.

In similar installations worldwide, awareness and behaviour changes have typically resulted in a major reduction in energy consumption simply through small changes in behaviour and use of technology.

Importantly, this metering system allows for the accurate reporting and tracking of the group’s carbon intensity and progress towards the 10% reduction target over the five year stated period.

A reduction of 150 kW will be noted on the dashboard below. This relates to the load demand on the Eskom network. Due to power being supplied by our 444kWp PV system, the demand reduced from a peak of 538 kW in January 2015 to 388 kW in March 2015 – this is a reduction of 35% on the National Power Grid.

Metering System Dasboard View - February 2015

Without the metering system it would be almost impossible to accurately track and monitor the impact of such an energy initiative.

Water consumption and reporting

Monitoring of our water consumption has become a critical focus for the group, due to the shortage of this precious resource. Our overriding objective, as a group, is to improve our water consumption per PPD.

The graph below reflects significant growth for the period July 2015 onward. This is due to the addition of further renal dialysis units, which have contributed to the upward trend indicated. To mitigate this increase in water consumption, we are focusing on grey water recovery from reverse osmosis units and autoclaves, which is then used for irrigation purposes.

Two Year Comparison of Water Consumption

Installation of next generation autoclaves, with smart water use ability, consumes between 60 to 70 litres per full load cycle as calculated on a standard 400 litre autoclave, being more efficient.

In addition, there is a renewed focus on under- as well as above ground leak detection. This process is driven at individual hospital level by the local engineering department

Life Healthcare is in the 3rd year of reporting on sustainability measures and performance. Our metering system puts us in a position where we can start to prepare the group for water disclosure, which is in addition to our participation in carbon disclosure.

Phase balancing

In 2015 we identified maximum demand as a key contributor of increased utility cost. This led to a focus on the maximum demand profile (KVA) of each site and a project was initiated to reduce and ultimately bring the demand per phase within a 5% variance.

35 out of 41 site profiles have been successfully completed resulting in a reduction of maximum demand (KVA) per site. The table below indicates the comparison of the pre and post intervention for four of our sites, to illustrate the savings.

Phase Balancing Impact

Green by design policy

As part of a revised internal growth and construction policy, a “green by design” policy has been developed which further focuses the group’s strategy towards reducing its overall carbon intensity.

This policy ensures that all new facilities as well as on-going upgrades and expansion of existing facilities are done with concerted focus towards energy efficiency.

Particular focus has been given to setting a minimum standard for all mechanical and electrical installations especially the various heating, ventilation and air conditioning (HVAC) systems which account for up to 60% of total energy consumption at some sites.

A primary focus, to assist with the selection of appropriate energy efficient technology in all building projects, is to consider the full life cycle costing of the various options, thereby ensuring a more strategic view is taken which aligns group goals and the requirements of our environmental management system.

Occupancy sensor pilot project

Significant savings were achieved by the installation of occupancy sensors. All lights and air-conditioning units within our head office were recently fitted with occupancy sensors as part of a pilot project. All units now switch off automatically after a set period of inactivity. This project has been a huge success with a confirmed payback within 3 months.

KWh per employee per month (head office)

As noted above, the load was reduced from 300kW to 200kW by this project intervention (between the periods of October 2012 to June 2015) even though staff numbers has increased over the same reference period.

Dedicated energy efficiency resource

By restructuring the group engineering department, energy efficiency and water conservation is now a primary focus for a dedicated engineer, who will continue to drive future efficiency and energy conservation projects, as well as monitor the effectiveness of current projects and progress towards various targets.

The current strategy is to ensure there is a continuous five year pipeline of efficiency projects in order that, each year, at least one (but ideally two) significant interventions are implemented to retain the focus on reducing the group’s environmental impact and that the group meets its undertaking as per the environmental policy.

Heat pumps

Life Healthcare began converting its traditional resistive element type hot water generation plants (conventional geysers) to heat pump installations in 2012 and has to date converted 32 of its 55 acute hospitals.

A typical domestic type geyser utilises 1kW of electrical energy for every 1kW of heat generated, while heat pumps on average generate 3kW of heating for very 1kW of electrical energy.

Heat pumps operate in the same manner as conventional air conditioners and extract heat from the ambient air, creating cool air. However the heat is collected through a heat exchanger and used to heat hot water.

Through careful positioning of the new heat pump units, the cold air, which is usually exhausted to the atmosphere, is being ducted into areas such as kitchens and laundries to provide “free” cooling to these areas further reducing energy consumption.

An illustration of the most recent savings recognised was that of the hybrid heat pump and solar combination hot water generation system at Life St Dominic’s Hospital which resulted in an annual 11.7% reduction in energy consumption.

Two year Comparison of Electricity Consumption

Hot water monthly savings 2013

Hot water monthly savings 2014

During 2015, a further 15 sites were identified for conversion to heat pumps. Provision has been made for the commencement of the conversions between 2016 and 2018.

Life Hilton Private Hospital

Life Hilton Private Hospital is the first new facility built in line with the Life Healthcare green by design policy. A target has been set for this facility to be 20% more efficient than any of the existing facilities thereby setting the new standard for future builds and setting a target for all existing facilities in terms of carbon intensity per patient day (PPD). Initial maximum demand figures show a peak of 380KVA for this 100 bed facility compared to an average of 550KVA for similar-sized facilities.

Through the incorporation of various technologies such as heat recovery from HVAC systems, occupancy sensors on both lighting and ventilation systems, LED lighting and heat pumps, it has been calculated that Life Hilton Private Hospital will use 890MWh less per year to run than if it had been built utilising the same specifications as other recently built facilities.

Architecturally, sun louvers and the positioning of areas that require maximum cooling on south facing areas have been incorporated into the design of the hospital. Increased thermal insulation and various other efficient designs to further aid in reducing the energy demand of the building have also been incorporated.

For further information regarding the features of Life Hilton Private Hospital, please refer to the following editorials:

PV pilot project

Life Anncron clinic was selected as the pilot site for the first photo voltaic (PV) installation in the group. Details of this installation include:

  • 1711x 250w panels installed
  • Capability of producing 440kW after losses
  • Additional capability of producing an average of 2291kWh per day dependant on environmental conditions
  • Expected production of 836,215kWh per annum

The system was integrated in February 2015 and will be remotely monitored by the group’s head office engineering team. The extent of the installation can be viewed in the picture below.

The illustration below is an example of the “live” dashboard from Life Anncron Hospital in Klerksdorp showing the actual power generation over a period of 9 months from February 2015 to November 2015. This information is a prime example of how we track the outcome and performance of energy initiatives with our SMA PV integration system.

The maximum demand was reduced from 538kW in February 2015 to 388kW in March 2015 with our average Eskom consumption reducing from 323kW in January 2015 to 222kW in March 2015, resulting in considerable savings and less strain on the National Power Grid. The savings achieved to date is on average R2,300 per day, and greater efficiencies were noted during the months of October and November 2015, as can be seen in the graph below.

Our total PV generated power of 598,603.10kWh resulted in a carbon saving of avoided CO2 of 607.5 tons over the given period.

PV generated power

Future investment in PV projects

One additional hospital has been identified as part of our environmental strategy and PV technology for the 2016 financial period.

Internal laundry strategy

In our continual endeavour to improve efficiency and reduce business and environmental impact and risk, the group invested in a central laundry model. The facility services our inland hospitals using state of the art industrial equipment and processes.

The Life Healthcare central laundry uses a new generation coal boiler that is estimated to be at least 17% more efficient than the old generation boilers that were used by our previous service providers. Emissions from this boiler are also less than the emissions from Eskom power stations.

The laundry washes on average 560,000kg linen per month, and uses 9.47 litres of water per kg of linen (530.3kl). Previous service providers reported water usage of approximately 13 litres of water per kg. The Life Healthcare central laundry therefore saves 197.6kl of water per month. A typical household use 250 litres of water per day. This is enough water to supply 263 households with water for a month.

The picture above represents the scale model of our central laundry, based in Midrand, Johannesburg

Conclusion

To ensure a pipeline of energy efficiency projects is always maintained, the group’s engineering team are continuously investigating projects for implementation, the next of which is heat recovery. This is applicable to hospitals which require large air conditioning plants to maintain operating theatres at suitable temperatures. Traditional chillers simply reject this heat into the atmosphere. Through installing heat recovery units, energy wheels and heat exchangers, this heat can be used to generate or supplement “free” hot water in the hospitals and in one of our pilot sites, provides 100% of the hot water during our summer months.

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Sustainability measures

Life Healthcare maintains a comprehensive group quality and sustainability scorecard which includes quality and environmental measures. Measures are risk-based and where applicable benchmarked against international best practice.

This scorecard is a management tool providing information for informed decision-making at all levels of the organisation. Scorecard measures are reviewed annually in line with the group’s performance.

For further information on our performance, please view the group's integrated report for 2015

Whereas we report on electricity and water, we have implemented a number of additional measures and will endeavour to report on these measures during 2016. These additional measures include usage of coal, diesel, anaesthetic gasses, healthcare risk waste and company care hire.

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Stakeholder engagement

Service providers

Life Healthcare promotes responsible environmental practices with its service providers in order to encourage compliance to the requirements of environmental legislation and to the reduction of their carbon emissions. To this end we have documented our group’s requirements in service and lease agreements with providers as well as tenants. Major energy users will be radiology or x-ray departments and oncology practices, who are major generators of healthcare risk waste. We encourage participation from our stakeholders in initiatives that will promote safety and reduce impact on the environment, such as:

  • Energy saving through behaviour and technology (LED lighting)
  • Water saving initiatives and awareness
  • Replacement of air conditioning units containing R22 gas with ones with more environmentally friendly gasses
  • Use of environmentally friendly chemical substances
  • Correct handling and destruction of healthcare risk waste
  • Management and recycling of general waste
FTSE/JSE Responsible Investment Index Series

The first FTSE/JSE Responsible Investment Indices have been constituted based on the FTSE ESG Ratings performed by FTSE Russell during 2014. Companies eligible for the indices are those that form part of the FTSE/JSE Shareholder Weighted All Share Index as well as the FTSE All World Index.

FTSE ESG Ratings provide multi-dimensional measures of environmental, social and governance (ESG) exposures and practices. The Ratings are utilised by the investment community as a tool for portfolio design and management, to investigate ESG criteria, or as a framework for corporate engagement and stewardship.

FTSE ESG Ratings form the basis for the FTSE4Good Index Series and also the FTSE/JSE Responsible Investment Indices.

Our group has achieved a sufficient ESG Rating for inclusion in the following:

  • the FTSE/JSE Responsible Investment Index
  • the FTSE/JSE Responsible Investment Top 30 Index

Please refer to the FTSE Russell website for further information:

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Staff communication and training

Awareness and communication sessions with staff and management have unpacked the requirements of the environmental policy and respective roles and responsibilities.

Most recently, our communication strategy has evolved to ensure we reach staff and management through a variety of monthly communication channels including the sharing of environmental ideas and success stories through a channel we call “Greenlife”. Contributions from the business – in the spirit of sparing precious resources and reducing our impact on the environment – are reviewed and the best contributions documented and shared across the group. Staff and management are in turn recognised for their achievements.

Formal environmental management training has been conducted and will be reinforced annually with key quality and engineering resources at facility level, in line with our journey to certification.

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Environmental management and continual improvement

Occupational health and safety is entrenched within the group’s culture and compliance is measured through the group’s quality management system implemented in 2006. Our approach to quality and safety management is an integrated one with strategic, operational and environmental risks being identified within our risk management process. This integrated approach includes standards for safety, health, environment and quality.

The group’s quality management system drives compliance across facilities, business units and functions to identify possible risks. In turn, standards are reviewed annually to ensure compliance to legislative requirements, as well as that of industry and of the group. Internal audits are performed using a unique healthcare specific audit tool which monitors compliance to all the above standards and requirements and to ensure continual improvement.

Our group’s external quality certification was obtained in 2006 against ISO 9001:2008 standards and has been maintained in all our acute hospitals, acute mental health and acute rehabilitation facilities to date. With this in mind, we believe that the implementation of an environmental management system is the next step in our journey to continual improvement.

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ISO 14001 Certification

The objective of our environmental management system is to comply with the requirements of ISO 14001:2004 and to obtain formal certification, a process which commenced with our 12 large / hi-tech hospitals. We are pleased to report that the group obtained its ISO 14001:2004 certification against these 12 hospitals in December 2015. These hospitals are listed below:

Hospital Region Hospital Region
Life Bayview Hospital Cape Life St George's Hospital PE
Life Vincent Palloti Hospital Cape Life Fourways Hospital Central
Life St Dominic's Hospital Border Life Flora Hospital Central
Life Entabeni Hospital KZN Life Eugene Marais Hospital North
Life Westville Hospital KZN Life Wilgers Hospital North
Life Rosepark Hospital West Life The Glynnwood Hospital East

Our certification will now be extended to the balance of the acute care hospitals during 2016 and beyond.

Implementation of an environmental management system enabled the group to focus on aspects of the business that impact on the environment. Many benefits have been alluded to in the sustainability initiatives which have been shared.

Reduction of our greenhouse gas emissions and our contribution to the global goal and objectives of decarbonisation will remain the focus of our environmental management actions in the years to come.

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