About Elliott Westhoff
As Head of Sustainability Programme at University College London Hospitals NHS Foundation Trust (UCLH), Elliott Westhoff leads the Trust's journey toward its net-zero targets. Drawing on more than thirteen years of experience across public and private healthcare, Elliott brings deep knowledge of healthcare transformation and practical sustainability solutions. His work at UCLH encompasses everything from strategy creation to project delivery, helping establish UCLH as one of the NHS's foremost advocates for sustainable healthcare.
How do you balance immediate healthcare requirements with long-term sustainability when making investment decisions?
At UCLH, we've taken a bold stance by establishing sustainability as non-negotiable – placing it on par with other critical priorities. This approach is implemented through several strategic initiatives, with sustainability now fully integrated into our procurement processes, and a part of the cover sheet summary of every internal board paper. Every new purchase, regardless of scale, undergoes a sustainability assessment. For major tenders, at least 10% of scoring criteria is allocated specifically to sustainability and corporate social responsibility metrics.
We're also exploring innovative funding mechanisms. While I'm cautious about using the term "tax," we're investigating internal pricing mechanisms to encourage sustainable purchasing. Our focus is on positive incentives, particularly subsidies for sustainable alternatives. When we identify reusable products with stronger sustainability credentials but higher upfront costs, we can draw on sustainability grants or charitable resources to support early adoption.
The challenge of long-term planning within the NHS's annual budget cycle has sparked some creative solutions. When other capital projects can't be completed within the financial year, we're able to secure funding for sustainability initiatives. Recently, we secured £500,000 for solar panels this way, and we maintain a ready portfolio of business cases to capitalise on similar opportunities when they arise.
How do you approach implementing and measuring the success of new sustainable technologies and innovations?
Being a world-renowned research institution puts us in a unique position to trial innovative solutions. We receive daily approaches from technology providers looking to test their solutions with us, which allows us to actively participate in developing and fine-tuning these technologies.
Our approach to implementation is methodical and evidence-based. We're currently testing new electromagnetic motors for air handling units in one building. This controlled environment allows us to verify claimed results, assess maintenance cost reductions, and compare energy savings against our existing systems over a couple of years.
The support of our executive and non-executive team, particularly our CFO, Tim Jaggard, and our Director of Innovation and Executive Lead for Sustainability Luke O’Shea, has been crucial in enabling this innovation-focused approach. While many directors naturally want proven ROI before committing funds, we've built an environment that supports calculated risk-taking for sustainability initiatives. This is particularly important when dealing with newer technologies like heat pumps or innovative building management systems.

We've taken a bold stance by establishing sustainability as non-negotiable – placing it on par with other critical priorities.
What role does the circular economy play in your sustainability strategy?
As founding members of the Circular Economy Healthcare Alliance, and co-led by Joseph Burton, Sustainability Transformation Project Manager, we've committed to only procuring products that embrace circular principles. We partner with manufacturers who manage waste streams or offer buy-back programs.
We're already seeing success with this approach. In our theatres, we've implemented a program where expensive equipment like harmonic scalpels, which were previously single-use, are now bought back by suppliers, refurbished, and resold to us at a lower cost. Our surgeons have confirmed they can't distinguish between new and remanufactured items, validating the quality of this approach.
We've partnered with innovative waste management companies to address hard-to-recycle materials. We've established an award winning program to collect and transform aluminium foil suture packaging into building materials, creating benches, chairs, and wall dividers from what would have previously gone to landfill.
We are also moving to a model of reusable first. We have successfully launched reusable theatre hats trust wide, and have live pilots for reusable anaesthetic face masks, tourniquets, slide sheets, theatre warming jackets. Reduction is a key part of the circular economy and we have saved over 2 million single use gloves being used unnecessarily through the promotion of hand hygiene campaigns. We are soon to roll this out to reducing unnecessary single use aprons and paper on examination couches.
How are you addressing the challenges of accurate carbon footprint measurement, particularly for Scope 3 emissions?
Our current spend-based model for Scope 3 emissions, which account for 90% of our carbon footprint, presents significant challenges. The assumption that higher spending equals higher carbon footprint is fundamentally flawed. We've implemented an inflationary adjustment back to our baseline year to enable more meaningful year-on-year comparisons, but this is just an interim solution.
Looking ahead, we need two major developments: more accurate carbon footprint data from our suppliers, and a shift toward product-level carbon footprinting. However, this is complex – major manufacturers have shared that it currently takes them six months to carbon footprint a single product, and the data often becomes outdated quickly due to changing costs or technologies.
We're particularly interested in the potential of AI to revolutionise this space, potentially enabling real-time carbon footprint calculations based on ingredients and manufacturing processes. This would be transformative for our ability to make informed decisions about sustainable procurement.

Our focus is on positive incentives, particularly subsidies for sustainable alternatives. When we identify reusable products with stronger sustainability credentials but higher upfront costs, we can draw on sustainability grants or charitable resources to support early adoption.
How are you integrating biodiversity initiatives into your sustainability strategy, given your urban location?
Despite our challenging central London location, we've developed creative solutions to enhance biodiversity. We have long established volunteer-managed and UCLH charity supported, rooftop gardens across most of our buildings, offering valuable green spaces for both patients and staff. Our dental hospital features themed plots maintained by different teams, encouraging engagement with nature while promoting wellbeing.
We're currently developing a new garden at our head office, transforming a concrete yard into a beautiful space with water features, funded through charitable grants to support biodiversity and enhance staff wellbeing. We're also focusing on air quality improvements, revamping our idling policies, and collaborating with Transport for London on developing green routes between our facilities and major transport hubs.
A new initiative we're launching called 'green walks' will provide guided routes for mobile inpatients, highlighting pleasant areas with gardens and taking advantage of nearby green spaces like Regent's Park. While our central location presents certain limitations, we're committed to maximising every opportunity to enhance biodiversity and create healing environments for our patients and staff.

The challenge of long-term planning within the NHS's annual budget cycle has sparked some creative solutions... we maintain a ready portfolio of business cases to capitalise on similar opportunities when they arise.
About University College London Hospitals NHS Foundation Trust (UCLH)
University College London Hospitals NHS Foundation Trust (UCLH) stands among Britain's premier healthcare institutions, combining advanced medical research with exceptional patient care. From its central London location, UCLH provides care to more than one million patients each year through its 11,300+ strong workforce. The Trust maintains close academic bonds with University College London and has set an ambitious target to achieve net-zero direct carbon emissions by 2031, notably ahead of wider NHS timelines.