Climate-friendly practice in everyday UK general practice

In the face of escalating climate change, the need to contribute to global conservation efforts has never been more critical. One of the strategic priorities for the RCGP between 2023 and 2026 is to “respond to the climate emergency”. 

I attended a few online planetary health-related events during my GP trainee days. All I could take away at the time was the idea of changing pressurised metered dose inhalers (MDIs) to dry powder (DPIs) or soft mist inhalers (SMIs), because of their reduced impact on the overall carbon footprint of the NHS. In current day general practice, most of the asthma and COPD-related work rightfully goes to GPs with special interest in respiratory medicine and respiratory specialist nurses. So I've been pondering how else to participate in the global response to climate change during my everyday work life.

Not until recently did I begin to realize that GPs in the UK are uniquely positioned to contribute significantly to climate conservation through their daily practices. The specifics might vary for different localities and practices, but here’s how I am attempting to integrate climate-friendly practices into my typical work day, plus suggestions that might help at practice level.

Energy efficiency in the clinic

A GP clinic can adopt several measures to reduce energy consumption: 

• LED lighting: Replacing traditional lighting with energy-efficient LED bulbs reduces energy usage and costs.
• Smart thermostats: Installing smart thermostats to regulate heating can reduce energy waste, especially in the typically variable UK climate. 
• Energy-efficient appliances: Using energy-efficient medical equipment and office appliances helps lower the clinic's overall carbon footprint. 

 I ensure to shut down the computer system and turn off the lights in the consulting room at the end of my work day.

Sustainable commuting

GPs can lead by example by choosing sustainable commuting options: 

• Public transport: Using buses, trains, or other forms of public transport reduces the carbon footprint associated with daily travel. 
• Remote consulting: Offering remote consultations can reduce the need for patients to travel, cutting down on associated emissions.
• Cycling or walking: Where feasible, cycling or walking to the clinic promotes personal health and reduces emissions.
• Electric vehicles: Switching to electric vehicles for house calls and other travel needs can significantly cut down on greenhouse gas emissions. 

I currently drive a petrol-run vehicle, as my house is several miles away from the places I work. However, if I have a home visit within walking distance, then you can be sure that I am putting in the steps. I suppose many of us are hoping to migrate to an electric vehicle at some point, if we haven't already.

Waste reduction

Medical practices often generate substantial waste. GPs can implement strategies to minimise this:

•  Digital records: Transitioning to electronic health records (EHR) reduces paper usage and the environmental impact of paper production and disposal. 
• Recycling programmes: Establishing comprehensive recycling programmes for paper, plastic, and medical supplies helps divert waste from landfills.
• Reusable supplies: Using reusable medical supplies where possible, such as cloth gowns instead of disposable ones, can reduce waste. 

Electronic patient information leaflets and sending fit notes electronically, instead of handing out paper printouts, has been a big win for me. Plus, some information sources - like the British Association of Dermatology website for skin-related topics - have a QR code which many of my patients have been happy to scan directly.

Sustainable prescribing

 GPs can contribute to conservation through thoughtful prescribing practices: 

• Eco-friendly medications: When possible, prescribe medications which have a lower environmental impact, considering factors like packaging and the carbon footprint of production.
• Green pharmaceuticals: I'm no expert in this, but I hear that some GPs are able to advocate for the development and use of pharmaceuticals with environmentally-friendly production processes. 

Patient education and advocacy

 Educating patients on climate-related health issues and encouraging sustainable practices can have a ripple effect: 

•  Awareness campaigns: Running awareness campaigns about the health impacts of climate change, such as the effects of air pollution and extreme weather, empowers patients to support broader climate initiatives.
• Community engagement: GPs can participate in and promote community health initiatives which focus on sustainability, like local clean-up events or tree-planting drives.

I haven’t taken on any such projects yet, but I am keeping an eye out for opportunities. Some of you might already be involved in related projects, like having planting sessions organised by the social prescribing or health coaching team with interested patients.

Reducing single-use plastics

The medical field heavily relies on single-use plastics. This practice has been reported to contribute a significant amount to the carbon footprint of our industry, so I can't finish this post without touching on area. Is there much that can be done about this individually? I'm not sure, but I believe there are ways to mitigate this at an organisational level:

• Alternative materials: Using biodegradable or recyclable materials for items like gloves and syringes.
• Sterilisation: Investing in sterilisation equipment for reusing medical tools where safe and appropriate.

By integrating these strategies and more where possible into our daily routines, GPs can significantly contribute to climate conservation efforts. This holistic approach not only benefits the environment but also enhances public health, creating a sustainable and healthy future for all.

Find out more about climate change and sustainability efforts at the RCGP.