Net Zero and Beyond: Building a Culture of Sustainability at Clinical Research Sites

Sustainability in clinical research does not have to be overwhelming. In this episode of SCRS Talks, Lauren Stockwell is joined by Paula Underhill of PPD part of Thermo Fisher Scientific and Clare Grace, CEO of EMS Healthcare and the 2025 Excellence in Site Sustainability Award recipient. Claire walks through the concrete changes EMS implemented across its mobile unit model, including solar integration, employee-led sustainability committees, and science-based targets aligned with the Paris Agreement. Paula adds context on what the judging panel found compelling and how CROs can serve as true sustainability partners rather than just cheerleaders. Whether your site is just getting started or well on its way, this conversation will leave you with a clear message: start small, start now.

Transcript

Lauren Stockwell 0:00

Welcome to SCRS talks provided by the Society for Clinical Research Sites. Thank you for joining us as we explore the latest insights, trends, and innovations shaping clinical research today. I'm Lauren Stockwell, the Education and Engagement Manager with SCRS, and I'm thrilled to be joined today by Paula Underhill, part of Thermo Fisher, scientific and Clare Grace of EMS healthcare today. We're so excited to dive deep into sustainability across our industry and how we can work to better enhance that together. Paula, why don't you go ahead and introduce yourself briefly as well as your role within the Site Sustainability Award.

Paula Underhill 0:36

Hi Lauren. So I'm Paula Underhill and the head of Strategic Site Collaborations at PPD part of Thermo Fisher Scientific. And my role in the team is ostensibly to look after the PPD Select Global Partnership Program. And that means really working with global sites and networks and healthcare providers to build sustainable partnerships and to elevate their advocacy within PPD to our sponsors.

Lauren Stockwell 0:59

Beautiful. Thank you so much for your advocacy in that space. I think it's one of those important things that sites are often unaware of how to start and often unaware that they may even be doing and implementing. So now we get to speak to 2025's Excellence, in Site, sustainability Award. Clare Grace, why don't you go ahead and introduce yourself.

Clare Grace 1:17

Thanks so much, Lauren. I'm Clare Grace, and I'm CEO of EMS Healthcare. I've been on the site side now for two years, but prior to that my career was really based in pharma and CROs.

Lauren Stockwell 1:27

Thank you very much, Clare. We appreciate that. So Clare, why don't you walk us through some of the specific sustainability changes that EMS made and implemented in order to actually win this award?

Clare Grace 1:38

So EMS healthcare is the largest community-based SMO in the uk. And we run predominantly out of movable units that we place across the uk. So we have a very different model from most, um, SMOs and most sites that you may come across. And so for us, sustainability was really, really key. 'cause as we're moving around the country a lot, burning lots of fuel and things like that, it was really important for us that we weren't doing any additional damage that was unnecessary to the environment. Um, so the first thing that we did was we set a target. Lauren, we actually said we wanted to be net zero by 2035. So that's just. Nine years away. Um, but we are well on that journey. So I think the fir very first thing that we did was set a target to aim for. And then we looked at some key elements, particularly our energy use. So one of the first things we did was change our energy provider to be a sustainable energy provider. And then we looked at how we could reduce our energy. And I think the thing that made us most successful in that was we included our employees in it. So very early on. We developed an employee committee that was focused on sustainability and energy reduction, as well as other things like water reduction and things like that, water usage. But I think that was one of the key things that really made it much more successful in all honesty, is that we, we took the hive mind and we engaged some of our most brilliant, uh, team members to really help us find ways that we could be more sustainable.

Lauren Stockwell 3:05

And I think that's an excellent lesson in change management and change empowerment really at the end of the day is how do we empower folks to think differently about the practices that we're building out within the organization. Paula, do you have any commentary on that?

Paula Underhill 3:19

Yeah, I just wanted to kind of supplement what, um, Clare was just saying because I think it's really important that what impressed the judging panel. It wasn't the fact that it was just one project. It was the mindset, which you just alluded to, and I think that's really powerful in this area. So they didn't just wait for someone to tell them what was good, you did it yourselves. And I think that's what we're trying to empower through this sustainability group that we set up with the SCRS and I think. Doing things such as integrating solar into mobile units, um, setting up science-based targets, particularly aligned with the Paris agreement, which isn't easy, and I think that's really where they're thinking long term, and that's something that really stood out in the application.

Lauren Stockwell 3:56

Beautiful. And Clare, what do you hope other sites take away from the efforts that EMS Healthcare has put forth?

Clare Grace 4:04

I think Lauren, that they take away that it is possible. In fact, it's very doable. You know, as, as Paula mentioned, we use mobile units and we have a system of batteries that power those mobile units that are predominantly served through the solar panels. And then we have generator backups, which. However, we rarely need to use those generators, particularly in the summer because the systems that we have on board are low energy use, are all tailored accordingly. But I think the main thing is it's just, it's doable. Just break it down into small chokes. You don't have to, you know change the world in a day, but you can make some very straightforward. Easy changes. So some of the things that we did with them were really easy is change energy provider to or, or energy tariff to one that's from green energy sources. That's very easy if you own your site. It's really difficult if you are actually leasing space in a larger. Center like many of our site partners do. So for those sites out there in SCRS that are doing that, look at how you can reduce your energy. Look at your fridges and your freezers and what energy rating they have. Look at your lighting systems. Look where you can use solar, if you can. Things like, electric cars for staff. If you support that, you know, there's, there's lots of places where you can just make small changes. Recycling is a big one. You know, make sure you are recycling effectively, recycle your food waste and things like that as well. Reduce your water usage. There's so many ways that you can really be a lot more sustainable, very simply, very easily, and with minimal cost impact.

Lauren Stockwell 5:33

And I think that that's the challenge, number one that I hear in this conversation is just look at it broader and see the little tiny tweaks. It doesn't need to be net zero in the next nine years, like Clare and her team, but it needs to be net less and we need to work to get to a lower number each and every single day. And it needs to be that thought process that's baked into the cake, not just frosting on top. So outta curiosity. Paula, I'd love to understand you obviously evaluated many applicants for this particular award this last year, but you've also worked with many sites that are working towards getting towards net zero. What barriers do research sites face when really trying to implement these sustainable practices?

Paula Underhill 6:13

I think to a degree, it's sometimes the assumption that it's just one more thing to try and achieve and do that feels too overwhelming to start. And I think, as Clare says, it's starting small and building that momentum because once you start small, the conversation starts and it becomes to be much more integrated as a culture and bring in this, the. Workforce along, and I think that's something you really clearly demonstrated and just have. So I think it's, you know, being realistic about what you can do. It's calling a utility provider and asking what offers can be made. It's starting small and then that builds that momentum over time and then it's work. We want to be able to support our sites very much. We want to support them. What can we do? What can Thermo Fisher bring to that conversation? What can we do to elevate their advocacy to sponsors? Because sponsors are in this as well. And we're all patients at the end of the day ultimately. So, you know, it's all for all of us to be able to do things in a different way. But I would just say start small. And, and again, as Clare alluded, recycling, PPE, recycling, et cetera, food waste is a great example because that can become a community in itself of doing things like that. Yeah. But I think it's sometimes the assumption that it's just too big to even start. Mm-hmm.

Lauren Stockwell 7:23

Yeah. It's not a whole cake that you have to chew off. Yeah. Just pull off a slice. So Paula, you alluded to, we want to support you, right? Industry wants to support sites to make these kinds of efforts. Clare, I'd love to hear from the site perspective how you feel. Best supported in that space, right? What sponsors and zeros can do to enable sites like yours to be a part of this type of work.

Clare Grace 7:46

I think the first thing is recognize that some of these things do. Mean that you have to work in a slightly different way, which can affect your costing somewhat. So particularly for us as a mobile provider, we make sure that we work at the same sort of rates as any normal standard site, but that's tough for us. So realizing that sometimes if you want extra move around things like that, it just costs sometimes a little bit more. But one of the big things I would say is, so all of our sponsors, either if they're a big CRO, like PPD, Thermo Fisher have a lab, um, solution that they provide themselves or use a central lab service. And that can create a lot of waste if not effectively designed. Now I know those lab providers have done a lot to reduce. Volume and that, but you know, really taking a look at that and I think it would be really nice if some of those labs actually offered a standard, a recycling service or a return service. I think that would be huge, to be quite honest. It's then, it's not left with the science to deal with or those unused lab kits and sometimes they can be very difficult to recycle. Mm-hmm. Um. So that's one thing that I think would be very, very helpful that if sponsors could look into and provide with their service partners that provide labs, but really just, um, accepting that sometimes things are done a little bit differently, I think would be helpful as well. And many of our sponsors do, and they, they commend it in particular, like PPD, Thermo Fisher actually support this with the award through SCRS. You know, that is just amazing that you support in that way. Um, but I think getting together with other sites and bringing sites together to share best practice as well, I think it would be really helpful.

Lauren Stockwell 9:22

Yeah. Paula, outta curiosity, from your perspective, what's your challenge to other industry partners in this space? Because at the end of the day, as an industry as a whole, we should work towards net zero and we should want this all together. This is something we can all get behind. So from your perspective, what types of championship do you need at a, at an organization like PPD, Thermo Fisher to be able to bring forth this type of conversation and empower sites like EMS.

Paula Underhill 9:47

Yeah, I think it's, again, as Clare just slightly alluded to, it's about partnership, not by prescription. So it's actually building that, and I think, it's acknowledging the fact that sites are doing. So much more than we assume necessarily from an industry perspective. And that's what this world is here to demonstrate and highlight and help those that are starting on that trajectory. So I think it's, you know, as part of all of that, it's bringing that connections together so that we are able to elevate that as a CRO to our clients, to our sponsors, and actually bring that conversation to them. And that's being proactive rather than reactive and waiting for the sponsors to ask. And I think that's also, it sounds very simple, but it's actually pretty key to that communication. And just around, you know, what Thermo Fisher can offer and PPD, Michael Cohen, who co-leads this with us, um, is instrumental to this because he can be directly reached out to, he's very contactable and will be able to make those connections around what offers what can be offered from a support perspective from Thermo Fisher PPD, but also where those links could be given from others, from other vendors, from other utility providers. Some guidance. You know, we are wanting to develop a RACI through our advocacy group. To be able to demonstrate the fact that this isn't just an award, it's about building into recommendations, um, based on where you are in that setting up of what you might want to be achieve from the beginning as an entry point to maybe more intermediate or more advanced. So that's really where we want to lead.

Lauren Stockwell 11:11

uh, and I think that that's wonderful. And just to double down on what you just said, Michael is not only a fabulous and reachable resource, but he also is so knowledgeable in this space too. Uh, so not to bombard his email or anything like that, but, uh, make sure to reach out to Mike. For any questions generally about sustainability, but also to be able to understand how PPD can support in that space too. Alright. To wrap us up here, I would love to hear from both of you, where do you see the biggest opportunities for sustainable clinical trials over the, for the next three to five years? Right. Let's take a small chunk of the pie, obviously ideally net zero in nine years for, for EMS, but, uh, in the next few years, what can sites do and, and what do you think are the biggest opportunities? Let's start off with Clare.

Clare Grace 11:55

Thanks so much. I think a lot of it is in that electricity piece in reducing electric, um, your reducing your electricity usage, but also utilizing green providers for, for electricity. That's something that is reasonably straightforward to do. I think the other piece that requires more of an industry effort is that recycling of single use plastics or. Maybe not recycling, but you know, recycling of the disposal of the more effective disposal of them, shall we say. Um, I think that's something that could really help. And then also, you know, SCRS has started a great thing here, um, and I'd really like to see that continue. You know, I'm happy to share in, in future podcasts, Lauren, about how we've done it specifically in advising guide sites. I think sharing how we've done it is really important across the site community. So those are the things that I think we can reach really quickly and easily that would help enormously.

Lauren Stockwell 12:43

Paula.

Paula Underhill 12:43

Yes, I agree. I think it's the green initiative in terms of fuel consumption, recycling, PPE as well as well as food and general recycling. I think it's also though, around how we want to work responses. This is a real shift in the industry and it's not just an intersection between, um. Corporate responsibility, it's around what we are doing as part of those partnerships. And I think that's where it becomes us to cohesively together as groups rather than individually as silos. 'Cause we want to be able to support that evolution of the sites. We can't have necessarily all the answers as a CRO, but we really want to drive that change.

Lauren Stockwell 13:21

So I think what I'm hearing today is that it is incredibly important that an entire industry gets behind going green. I think as we continue to drive forward these types of thought processes, these types of initiatives, this type of change, really we all need to continue to be vocal about the small and big ways we are going green. And so if you're doing something, here's the call to action. Say something. Talk about that process with your colleagues at these conferences. We can talk all day long about budgets and about KPIs and AI and all the things, but really this is one of those conversations that is so foundational to setting up a site. And if these organizations are coming in and starting green from the very beginning, it's gonna be way easier than coming and being green at the very end. So my challenge for everybody listening today is to think green from the get go. Is what I'll say. I wanna thank once again, Clare Grace and Paula Underhill for joining us today. Uh, we are so grateful for your advocacy and your partnership inside of this. This is also a secondary challenge for everybody listening to look at the 2026 Global Site Solutions Summit Awards programs. PPD is so gracious to have extended this awards program to be a conversation in 2026 as well, and we encourage everybody who is also leaning into the sustainability process to apply for the 2026 award too. So thank you also very much, and we appreciate you.

Clare Grace 14:42

Thank you so much, Lauren. Thank you Lauren.