Climate protection – energy and emissions

Climate change and its effects are also impacting Fresenius: for example, in health care facilities we have to prepare for rising temperatures or the increase in severe weather events in order to protect the health of patients at all times. Our production processes and the operation of health care facilities require a high level of energy input. Energy-efficiency measures can lead to short and long-term cost savings; in addition, through the increased usage of renewable energies, they also make an important contribution to climate protection.

Energy consumption and emissions

GRI 302-5 and GRI 305-1, -2

Fresenius continuously invests in new buildings and modernizations that meet the latest energy standards and legal requirements. Fresenius1 consumed a total of about 5.5 million MWh of energy in 2020; the main energy sources were natural gas (45% of total consumption, without liquefied gas), electricity (44% of total energy consumption), and district heating (3% of total energy consumption). When purchasing energy, we consider efficiency requirements and changes in demand. We are exploring the possible use of renewable energies and already generate our own electricity at numerous sites. In 2020, the share of renewable energy consumption was 2%. Among the main energy sources, electricity demand is our most material driver of CO2 emissions. Accordingly, Scope 2 emissions are higher than Scope 1 emissions in all business segments. In 2020, Fresenius generated a total of 1,521 thousand metric tons of CO2 equivalents (2019: 1.510 thousand tons of CO2 equivalents).

Our approach

GRI 302-1

In energy management and climate protection, our aim is to go beyond the legal framework to identify ways of minimizing the impact on the environment and to implement these in our management approaches. In 2020, the divisions focused primarily on the topics of efficiency enhancement, energy saving, and thus the reduction of CO2 emissions.

Disruption-free energy supply is a top priority for Fresenius in order to ensure patient safety and smooth production. We always examine possible energy-saving measures with the greatest care.

The energy management system is geared to the requirements of the respective business segments and is certified according to ISO 50001. In 2020, Fresenius Helios, as the largest private hospital operator in Germany, obtained the certificate for the energy management system in accordance with the ISO 50001 standard for all its companies, facilities, clinics, and medical care centers. At the same time, the certification was also carried out and achieved for the rehabilitation clinics of VAMED Gesundheit Holding Deutschland GmbH and their associated facilities.

Fresenius Medical Care

Fresenius Medical Care monitors the energy consumption in its manufacturing sites as well as the electricity consumption in its dialysis centers. The company introduced measures to reduce energy consumption in several of its production sites in 2020, including the installation of improved energy meters to identify potential energy savings. In addition, Fresenius Medical Care optimized engines and chillers to improve its production capabilities and adapt them better to environmental conditions. Fresenius Medical Care will continue to replace fluorescent lighting with LED lighting in selected warehouses and production areas to save energy.

As part of its Global Sustainability Program, Fresenius Medical Care assessed its renewable energy impact. To calculate this, the company used the country-specific average share of renewables needed to produce electricity. According to this calculation, renewables accounted for 21% of total electricity consumption in 2020.

GRI 305-1, -2
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Fresenius Group1 Greenhouse gas emissions (GHG) Scope 1 and 2
t CO2 equivalents in thou. 2020 2019 2018 2017
Fresenius Medical Care 769 774 776 n.a.
Scope 1 242 227 219 n.a.
Scope 2 527 547 557 n.a.
Fresenius Kabi 424 414 424 422
Scope 1 159 165 169 174
Scope 2 265 250 255 248
Fresenius Helios 287 285 296 255
Scope 1 112 107 114 103
Scope 2 175 178 182 152
Fresenius Vamed 41 36 38 9
Scope 1 24 18 19 3
Scope 2 17 18 19 6
Total 1,521 1,510 1,534 n.a.
Scope 1 537 517 521 n.a.
Scope 2 984 993 1,013 n.a.
GHG emissions in t CO2 e
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Fresenius Group1 energy consumption
MWh in millions 2020 2019 2018 2017
­Fresenius Medical Care 2.49 2.43 2.38 n.a.
­Fresenius Kabi 1.67 1.64 1.65 1.57
­Fresenius Helios 1.16 1.09 1.14 0.95
­Fresenius Vamed 0.19 0.16 0.17 0.05
Total 5.51 5.32 5.34 n.a.
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Fresenius Group1 relative energy consumption
in MWh 2020 2019 2018
Energy consumption / €1 million sales 152 150 159
Energy consumption / FTE 19.9 20.3 21.7
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Fresenius Group1 relative GHG emissions scope 1 and 2
t CO2 equivalents in thou. 2020 2019 2018
t CO2 equivalents / €1 million sales 42 43 46
t CO2 equivalents / FTE 5.5 5.8 6.2
1 Fresenius Medical Care figures include energy and water consumption at production sites, as well as electricity and water consumption at dialysis centers. Greenhouse gases are calculated based on energy data. Fresenius Kabi’s data includes all facilities worldwide. The data from Fresenius Helios encompasses as of 2018 all hospitals in Spain. Fresenius Vamed’s data includes all fully consolidated health care facilities and service entities, and, as of 2018, the German post-acute care business transferred from Fresenius Helios to Fresenius Vamed. If data of the business segments is not available in time, it is extrapolated on the basis of existing data. An adjustment will be made in the next report. Prior-year information was adjusted to conform to the current year’s presentation.
Fresenius Kabi

Fresenius Kabi sources energy from external sources, which includes the purchase of renewable energy. The business segment also generates electricity in its own facilities and uses, for example, combined heat and power systems.

Fresenius Kabi’s global environmental standard operating procedures include global instructions for responsible handling of energy in its own facilities. Each manufacturing site is required to evaluate the environmental impact, e.g., from emissions and consumption of natural resources.

In addition, the business segment uses an energy management system in line with the international standard ISO 50001 to improve its energy performance. A handbook for the management system as well as standard process guidelines provide all certified local units with a framework for their energy management. The focus of the management system at Fresenius Kabi is primarily on reducing energy usage and emissions – depending on the overall production volume.

Currently, 18 organizations are certified according to ISO 50001, 4 additional manufacturing plants have been included in the certification in 2020. Fresenius Kabi is working to introduce the energy management system according to the international standard ISO 50001 at all manufacturing plants worldwide by 20261. Certified organizations set local targets to continuously improve their energy performance.

Fresenius Kabi has a matrix certification for its global energy management system, which is audited and certified by TÜV Rheinland annually. Fresenius Kabi continuously monitors certified organizations to ensure that they comply with the standard process guidelines that are binding for them. To this end, globally appointed auditors conduct regular internal audits of the organizations. The local management reviews the respective energy management system at least once a year to ensure the continued suitability, appropriateness, and effectiveness of the system, and to identify potential for improvement. On a global level, the local management reviews of the energy management system are consolidated, analyzed, and evaluated on an annual basis. Appropriate corrective measures will be initiated if deviations from the requirements of the ISO 50001 management system are identified. The same applies to opportunities for improvement at a global or local level.

Responsibility for energy management lies with the divisional and local organizations; global management responsibility lies with the central organization, which reports to the responsible member of Fresenius Kabi’s management board. The responsible department analyzes and evaluates workflows and processes at the global and local levels, facilitating the exchange of energy management practices. Environment (Chapter Fresenius Kabi)

2 The certification roll-out is going to be concluded at all Fresenius Kabi manufacturing plants in 2026. The certification issuance from the individual certification companies may extend into the following year.

Fresenius Helios

The rising temperatures resulting from climate change are also affecting Fresenius Helios' business operations, especially in Spain. In recent years, refrigeration technology, which serves to cool technical equipment and hospital rooms, has become more important for hospital operations than heat generation. In addition, more frequent severe weather events such as heavy rainfall or flooding may pose a potential threat to the health care services of hospitals.

Further impacts of climate change on human health are likely: changes such as vector-borne infectious diseases (e.g., by mosquitoes, which are spreading into new areas as a result of climate change) can, for example, influence the range of treatments offered by the facilities.

Implementation of the energy management system in accordance with ISO 50001 was completed at all Fresenius Helios sites in Germany at the end of 2020.

In Germany, the Infrastructure business unit has established a central energy procurement and management system that records the energy consumption of each site. Helios Germany uses this system to compare consumption figures and to initiate improvement measures. Helios Germany’s own energy supplier, HKG Energiedienstleistungen GmbH, is responsible for energy procurement. The clinics of Helios Germany were audited until the end of 2019 according to the EDL-G in compliance with DIN EN 16247. With the introduction of the energy management system according to EN ISO 50001 in 2020, the EDL-G will continue to be operated seamlessly.

To further improve the energy efficiency of Helios Germany, the Infrastructure business unit set up several working groups, such as the working group energy AG Energie. They are looking into how energy can be saved in the technologies used in everyday hospital operations. Among other things, a night-time reduction in OR ventilation was introduced throughout the business segment in 2018, with the ventilation systems in the operating rooms switching to a resource-saving mode at night without sacrificing air quality during operations. At some sites with a combined heat and power plant, the operation of kitchen cleaning appliances such as conveyor belt sinks was also changed from purely electric heat generation to the use of waste heat from the combined heat and power plants

There are also local and regional environmental initiatives at Fresenius Helios in Germany. The Green North campaign called on all workers in the region to share their ideas on how to deal with the issue of sustainability. The ideas were collected and evaluated. Involvement is supported by award ceremonies for the best ideas which also encourages employees to get involved and draws attention to the topic.

A total of six Helios Spain sites employ an energy management system according to ISO 50001. These hospitals achieved improvements and optimized their energy consumption. In addition, improvements in energy efficiency shall be achieved in the Spanish hospitals not previously certified to ISO 50001. The division also plans to have further hospitals certified in the next few years. Helios Spain also analyses its energy management risks and uses renewable energy sources in some clinics.

In order to ensure an uninterrupted energy supply at all times, every Fresenius Helios hospital has a main backup system: in the event of a power outage, this system guarantees within a few seconds the security supply of the main energy consumers in the clinics. In order to safeguard this protection, these emergency power systems are inspected and tested regularly, at least once a year.

Fresenius Vamed

The respective management team is directly responsible for energy and emissions management of Fresenius Vamed's health care facilities. The effectiveness of energy management measures in the certified business segments is assessed by regular independent audits as part of the ISO 50001 certification. In Germany, the certification was implemented jointly by the Infrastructure business unit of the Fresenius Helios hospitals. The certification process was successfully finalized end of 2020.

Waste and recycling management

Environment – Progress and measures 2020