The World Class Commissioning process involves a large component of performance management, whereby the PCTs will present the results of their Commissioning to a panel led by the SHA, who then can offer them feedback on where they stand in relation to other PCTs. The feedback presently looks at a number of clinical and financial markers, but increasingly has the capacity to look at other aspects of corporate governence. I propose that the NHS should be using this process to guide PCTs on the impact their commissioning decisions have on the environment, particulalry with respect to CO2 emissions.

For this to work, we will need a range of metrics for the PCTs to be measured against, which will measure their performance in sustainability terms (in adition to the obvious clinical and financial measures already in place).

This begs the question - what metrics should we use? The following is a list I would suggest as a starting place. I welcome any feedback or discussion on this list.

1. Evidence that the PCT has worked through the Good Corporate Citizen model and is working to progress through it
2. Evidence that the PCT expects organisations they commission from to be using the GCC model and to show progress against it.
3. Report on the energy use in the Display Energy Certificates for all buildings used by the PCT and for all buildings used by the PCTs providers, and provide evidence that the PCT/ provider organisation are acting on the recommendations in the accompanying Advisory Report to reduce building energy consumption.
4. Evidence that the PCT has produced a sustainable development action plan in cooperation with their LSP partners, which addresses the following;
a. A green travel plan promoting active transport, public transport and lift sharing schemes with an aim to minimise single occupant car journeys;
b. A waste management plan aiming to reduce the need for new products, and to maximise re-use and recycling before finally aiming to recapture energy in waste, with a goal to minimise waste to landfill;
c. A sustainable procurement plan which encourages use of the PASA whole life costing model
d. A water management plan which aims to minimise water use and sets targets for reduction in water consumption.
5. Record of the number of organisations the PCT commissions from which have also developed a sustainable development action plan as described above
6. Evidence of the proportion of energy the PCT purchases that comes from renewable sources (aiming to surpass the PASA minimum of 10%)
7. Evidence of the proportion of renewable energy purchased by organisations the PCT commissions services from (aiming to surpass the PASA minimum of 10%)
8. Evidence that the PCT is assessing its procurement behaviours against the DEFRA procurement task force Flexible Framework, aiming to achieve a minimum of level 2 in all areas, and to show year on year improvement.
9. Evidence that the PCT has achieved the Carbon Trust Carbon Standard

10. Evidence that organisations the PCT commission services from have achieved the Carbon Trust Carbon Standard.