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John Burnside is the Environment & Sustainability Manager with NHS Highland. He sets out below how NHS Highland have piloted a climate change risk assessment toolkit across their operations and estate.

NHS Highland has responsibility for over 230 buildings spread across an area equivalent to the size of Belgium. Many of the communities that we service are remote and rural, which creates particular challenges when thinking about climate risk. To ensure that we are able to provide high quality health services to the diverse communities in the Highlands, we are piloting a climate change risk assessment toolkit. The initial approach to assessing climate risks was developed in collaboration with NHS National Services Scotland as part of a cross sector Risk Assessment Working Group, which brought together Scottish Water, Aberdeen City Council and Historic Environment Scotland and was facilitated by Adaptation Scotland. An internal NHS working group was then established to oversee the development of the risk assessment tool, ensuring that it is user friendly for Health Boards.

At NHS Highland, we were the first Board to use the risk assessment tool to undertake a comprehensive regional assessment of current and future climate risk to health care facilities. SEPA data on flood risk and a high level Climate Change Impact Assessment for NHS Highland were used to inform the process. We also undertook internal workshops to understand how past extreme weather impacted on the delivery of healthcare services across our Estate. Over the past year, the risk assessment toolkit has been tested and reviewed by our estate managers. Their practical insights and feedback have helped us to develop an easy to use resource that can be applied to our main regional hospitals and smaller community health centres. We have also spent time building internal capacity around climate change risk and adaptation.

Our estate is managed to a 12 month maintenance cycle, and staff are used to thinking about their roles their workplaces within this 12 month context. This can make it difficult to think about long term challenges of climate change in their day to day jobs. As we roll out the climate change risk assessment toolkit, we’ll be working with staff on site to ensure that climate risk and adaptation are well understood, and adaptation is integrated into the way we manage our health care facilities.

Once we have collected information on the climate risks relating to the estate, these will be incorporated into site-based risk registers, which will feed into our corporate risk register and strategic risk register.

Building a strong evidence base for climate risk and embedding it into our risk registers will give us a clear understanding of the long term challenges and opportunities of maintaining healthcare facilities across our estate.