Efficient use of resources

Providing healthcare entails working to make people healthier. We therefore consider it part of the trust placed in Capio by society that we operate on a sustainable basis, also from an environmental perspective. The ambition, over time, is to make efficient use of resources and reduce the Group’s environmental impacts.

Environmental impacts of healthcare

In most countries in the world, healthcare account for a significant share of the overall economy and the activities in this sector thereby also have environmental impacts. The general environmental impacts primarily relate to heating and other energy consumption, waste generation, transport and consumption of materials. The more specific areas in which environmental impacts are especially related to healthcare activities concern, for example, the discharge of pharmaceuticals to the environment, disinfection/sterilization, and the widespread use of materials containing PVC/phthalates.

Capio’s environmental guidelines

Capio’s approach to environmental work is summarized in the Group’s Code of Conduct, which supports long-term sustainable development. We strive for high efficiency in the use of energy and natural resources and promote systems for the recycling and reuse of materials, and work to prevent and minimize pollution. The environmental initiatives in each business area must be adapted to the type of activity and its environmental impacts. The Group’s environmental work focuses especially on energy consumption, waste management, procurement, transport and chemical products.

Over time, Capio’s ambition is to reduce the environmental impacts of its activities, and compliance with existing environmental laws and regulations in the countries of operation is considered to be a minimum requirement. In addition, Capio Sweden, for example, operates within the framework of an environmental management system. Most of the Swedish activities, including the single largest unit, Capio St Göran’s Hospital, are certified in accordance with ISO 14001:2004, the international standard for environmental management systems.

A few smaller Swedish activities hold environmental diplomas instead. In 2014, Capio initiated an ISO certification process in Norway, and at the end of 2015, half of Volvat’s medical centers held ISO 14001:2004 certification. The rest of the medical centers are expected to complete their certification during the first half of 2016.

Environmental work at Capio

An initiative was launched in France a few years ago to reduce the French clinics’ environmental impact via greater awareness and improved procedures. The measures include reducing water consumption, improving waste management and increasing use of ecolabelled products, and this work proceeded during 2015. For example, all of Capio’s hospitals i France began to recycle food waste in 2015, partly as a consequence of new statutory requirements concerning the four largest units. During the year, Capio St Göran’s Hospital continued to focus on serving patients nutritious and tasty meals. The hospital is gradually using more and more organic ingredients, which accounted for around 30% of the total volume in 2015. During the year, portion packs were replaced by a more ecofriendly alternative, which has reduced the consumption of plastic by just over 70%. Food waste is recycled as biogas in six departments and recycling is estimated to increase to include all food waste in the future.

All of Capio’s business areas are working to reduce their energy consumption, including by using low-energy light bulbs, automatic switches to save energy in areas that are not used continuously, and energy-saving technology. During 2015 Capio worked with an external firm of consultants in France to review the ventilation and heating system and identify potential improvements. Also in 2015, Capio commenced the work required to fulfill the Group’s obligation to map its energy consumption and identify areas for improvement in accordance with the EU Energy Efficiency Directive and the respective countries’ legislation. The time schedules for the implementation of the Directive in their national legislation varies between the EU member states. In France, Capio undertook this energy mapping in 2015, while the review of Capio’s German activities will be completed in the first half of 2016. In Sweden, data was registered by the Swedish Energy Agency in December 2015, while the energy mapping of the Swedish activities will commence in 2016.

Environmental issues are also important in relation to the Group’s new construction and conversion projects, such as recent years’ real estate projects in France and Germany. For example, the modern new hospital in Bayonne in France was constructed according to principles which made it the first of Capio’s hospitals in France to fulfill the requirements of Haute Qualité Environnementale, a French standard for environmentally sustainable construction. In conjunction with the merger of three hospitals in Bayonne to the new Belharra hospital, Capio in France donated more than 200 m3 of materials and equipment to a hospital in Cameroun. Capio Clinique de Provence also donated equipment to hospitals in North Africa in conjunction with the move to Capio Clinique d’Orange.

Other examples of new environmental measures within the Group during 2015 are that Capio in France adopted a new printing policy, to reduce the volumes printed and paper consumption. To achieve this objective, software to track the volumes printed has been installed and photocopying machines have been replaced. In 2015, Capio St Göran’s began to use a new collection of patient clothing, whereby the environmental impacts of both the choice of materials and manufacturing processes were a key aspect of this work. For example, the patient towels used today are made from cellulose from beechwood. Compared to cotton, this reduces use of both insecticides and water in the manufacturing process.

Within Capio Proximity Care, central environmental coordinators drive the environmental work, together with environmental representatives in each unit. The procedures for this work are compiled in the business area’s environmental handbook, including targets and guidelines to reduce the discharge of pharmaceutical residues to the environment. Examples of measures to achieve this target include choosing pharmaceuticals that have a lower environmental impact, issue of medicine bags to hand in superfluous and obsolete pharmaceutical residues to pharmacies, and avoiding large packs for occasional medication. In 2015, Capio Proximity Care took the initiative to launch cooperation with a major pharmacy chain in order to enhance awareness of the problem of pharmaceutical residues in the environment, and to increase the return to pharmacies and hence the recycling of such products. Evaluation of the pilot project in the late spring of 2015 showed good results and this initiative was therefore expanded to additional primary care centers in the second half of 2015. Capio St Göran’s Hospital also works systematically to reduce the negative environmental impacts of pharmaceutical residues in the environment. For example, a method is used to make maximum use of anesthetics, with the least possible waste. This methods halves consumption, and thereby the environmental impact, while still administering the same doses to patients. Capio St Göran’s trains doctors and other key staff members in the environmental effects of medical products and pays a lot of attention to the ”Wise List” of the medical products recommended for the treatment of common illnesses, including from an environmental perspective.

Increased follow-up in the future

Some of Capio’s activities have come far in measuring and setting targets for their environmental work, and we are working on providing combined follow-up for the overall Group. We view this as a development area, where our objective for the next step is to gather data on, in the first instance, the Group’s energy consumption and waste handling, which will then be a key aspect of our continuous improvement work.