Greener Healthcare: a golden opportunity for primary care
11th March 2022
Hi! I’m Aarti. I work as a GP in Sheffield and four years ago I founded Greener Practice, the UK’s primary care sustainability network. I have 12 years’ experience working as a clinical academic and a few months ago I was appointed to work a day a week as Humber Coast and Vale ICS’s Net Zero NHS clinical lead.
For some years now I have been talking about how healthcare that is kinder to the planet is also better for people. Here's my talk at the SAPC North regional meeting last November. However, I generally find that most healthcare professionals place greener healthcare into the ‘important but not my job’ box. I think this is largely because people transpose the actions they take to reduce their personal carbon footprint (building, travel, food, waste) onto the workplace. This is what I did a few years ago. The actions I thought about were things like changing to a green energy supplier, installing solar panels, getting people on bikes etc. These are all important. However, then I learned that most of the carbon footprint in primary care comes from prescribing and so is directly related to our clinical care. It’s all about our core job.
The WHO has declared that the climate crisis is the single biggest health threat facing humanity. So, anything that mitigates the impact of the climate crisis will reduce the impact to our health. But it’s better than that. Greener healthcare is not limited to making sure we ‘first do no harm’ to our future health. Greener healthcare is doing all the things we would want to do to improve the health of our patients and communities, even if there was no climate and ecological crisis.
How so? Well I find it useful to think about Greener healthcare in the way that Frances Mortimer from the Centre for Sustainable Healthcare describes in her four principles of sustainable clinical care: prevention, patient empowerment, lean pathways and low-carbon alternatives. It’s basically about reducing the need for healthcare and improving the efficiency of healthcare. The lowest carbon healthcare is that which is not needed. This work can be seen as population health management at primary care network level and can also be enacted in individual consultations. How can we improve care of people with long-term conditions in a way that targets those who need it most and empowers people to self-manage their health? How can we reduce overprescribing and medicines wastage? How can we embed continuity of care, which we now know to be so good for health, into our health systems? How can our patients better access green spaces, social prescribing, physical activity, better diets? Importantly, transforming our efforts upstream and making them more effective will also reduce our excessive workload.
As GPs who have a holistic understanding of health, we want to take a holistic approach to healthcare. We would want to take the actions described here for the sake of patients and communities now. I think of greener healthcare as a lever to enact better health. Last year the NHS became the first health organisation to commit to net zero healthcare. The new NHS integrated care systems are currently writing their green plans. If these plans focus on what can be done at primary care and community level, they can be a huge force for good. Primary care needs investment in the resources that give us the time to think about and implement quality improvement
Greener healthcare can help us to invest in the models of healthcare that we have been talking about for decades. But we don’t have decades to act on the climate and ecological crisis, which is straining our planet’s life support systems. We have this decade and we need to act now. If you join us in acting on the climate crisis, I think, like me, you’ll find taking action is energising. You’ll meet a whole community of healthcare professionals across the country to support you in your journey, wherever you are and whatever you are interested in. Learn more at Greener Practice.