Episode 056 | May 15, 2023 | 48:47
Guest: David Nri (Falck)
Published: May 15, 2023
Duration: 48:47
Description
Frederik van Deurs from Green Innovation Group discusses decarbonisation and preventive healthcare in emergency services with David Nri, Environmental Sustainability Lead at Falck. From reducing carbon emissions in ambulance fleets to the potential of drone technology — this episode highlights the need for collaboration and ambition.
Full transcript
About this transcript
This transcript was automatically generated and may contain inaccuracies, typos, or mistranslations. Episodes recorded before 2024 were transcribed by an on-site model and may have a higher error rate. The content reflects the original conversation to the best of our ability. For the authoritative version, please listen to the audio episode.
Hello and welcome. Today David Nri from Falck joins us.
David: Environmental sustainability lead at Falck. British, background in emergency call handling and climate change. Falck is an international healthcare company supporting public sector or supplementing it — ambulance, healthcare and other services across LA, Copenhagen, Barcelona. In Scandinavia we also run physiotherapy and psychology services. Roadside assistance is a side hustle now; we are focused on health. Private company owned by three foundations.
Our CEO has been talking about preventive healthcare since before there was an obvious business case. The most sustainable ambulance trip is the one that never happens.
On decarbonising emergency services: very difficult. Ambulances drive a huge amount, can’t predict where they’ll go (taxis can), and in Denmark must be able to drive cross-country in one go — further than any electric heavy vehicle today. Certification, range, weight (full trauma ambulances are mini-hospitals) all make decarbonisation harder.
Scope 1, 2, 3: technically Falck doesn’t have operational control of ambulances run on behalf of a customer (NHS, Danish regions, US hospitals), so they wouldn’t count as Scope 1. But we have 4,000+ vehicles — taking the “lawyer route” felt like greenwashing. So we made an executive decision to take responsibility. That means much more work — we can only deliver electric ambulances if customers ask us to.
Falck is the largest international emergency services company (second-biggest globally; the largest only operates in the US).
Material areas: fleet and operational tailpipe; then purchased goods and services. Less material than a hospital but still significant.
Fleet lifetime: not much control. Ambulance contracts are 5-7 years with customers specifying new vehicles at the start. We’re asking customers for flexibility — let us roll over older vehicles for an extra few years and we’ll add much more capable electric vehicles in three years’ time. Battery tech improves so fast that waiting is greener — but tenders rarely allow that flexibility.
End of life: we typically lease now. The greenhouse gas protocol means if you sell an old vehicle, you have to account for the rest of its life — odd in our accounting but important for the protocol’s full picture.
Four levels of innovation:
1. Existing: swap an existing technology for an existing greener one. Our electric ambulance running in Copenhagen — patient sees no difference, big CO2 cut. Infrastructure and vehicle-life questions remain.
2. Smarter: change the system. Example: dispatch. We place ambulances where we predict calls (A through F — A is full trauma, F is intra-hospital transfers). For A/B response time is essential, never sacrifice. For C-F we could weight CO2 alongside response time. Discussion is what is the trade-off between immediate safety and lower emissions — for many cases there is no trade-off, just optimise.
3. New: drones. Healthcare drones already running in Greenland, Stockholm, the Danish islands — transporting samples and medicine to hard-to-access areas. Used to be a vehicle and a ferry trip; drone is faster and lower emissions, patients get results sooner. We’ve also signed a deal in Stockholm for drones tracking traffic patterns so the authority can respond to crashes faster.
4. Transformational: health tech for chronic conditions to shift to prevention. 1/5 of Danes over 18 have at least one chronic condition. In one California contract, 40% of calls are to patients who don’t need a paramedic but lack access to non-emergency care. Multi-chronic patients in Denmark go to hospital 5+ times a month — separate specialists. If we treat and prevent, the whole system benefits and the patient gets dignity.
We’ve done this in Colombia for 15+ years — drive patients home from hospital and check on them regularly. Weeks less in hospital. Much nicer experience and saves CO2 and money. In Colombia 46% of our calls now get a telemedicine response; aiming for 60%.
Blanket example: in Denmark we can drop blankets at hospital, they wash them, send back. In the US disconnected private hospitals = single-use blankets. Joined-up thinking matters.
Falck is innovating in ways that effectively destroy our own (driving-people-to-hospital) business — because it’s the right thing.
Visitation cars (one paramedic to assess) in a Danish region: 25% still get an ambulance, 43% take their own transport, 32% treated on site. Huge CO2 saving and much nicer for the patient.
Thank you David. Thanks for listening — please subscribe and share.