Greener Practice: Addressing climate change and sustainability within general practice

Publication date: 16 March 2023

Climate change is universally known as an environmental emergency. However, not many know that the climate crisis is also a health emergency. The Lancet went even further, stating that responding to climate change is “the greatest global health opportunity of the twenty-first century.”

This may seem like a big statement, but climate change underpins all social and environmental determinants of health. Healthcare is both affected by the climate emergency and contributes to exacerbating it.

The RCGP itself is a founding member of the UK Health Alliance for Climate Change (UKHACC). We have emphasised the importance of climate change by including this as a strand of the proposed new College strategy for 2023 to 2026: "Building a sustainable future for general practice”.

General practice's impact on climate change

The NHS as an organisation contributes to 5% of the UK’s total carbon emissions. To put this into context, 5.9% of total emissions are from the air travel industry.

In general practice, most carbon emissions (60%) are from clinical work. Prescribing is by far the largest contributor to clinical emissions - metred dose inhalers (MDIs) use propellants that are 3,000 more potent that greenhouse gases such as CO2.

Why addressing climate change matters

There are many benefits to addressing climate change in general practice:

  • Reducing health inequalities – climate change disproportionately affects poorer populations;
  • Improving patient health – by improving air pollution and increasing active travel;
  • Reducing GP workload - improving patient health and reduced prescribing;
  • Reducing costs to Practices - with rising energy bills and procurement costs;
  • Protects our future health – mitigating the physical and mental effects of extreme weather, air/water quality and changing vector-borne diseases.

What can we do?

We asked ourselves this question as ST3s working in general practice. We realised the health burden that climate change brings, and the challenges for our local population. We want to try and do what we can by making our practice greener.

To start off, we had to understand the problem. We started by looking at our practice's carbon footprint. The GP Carbon Calculator is a free and easy to use online tool that mapped out the non-clinical carbon footprint at the practice. Considering that 40% of emissions in primary care are non-clinical, it allowed us to identify areas that we could work on to reduce our footprint.

Another helpful tool was the Green Impact toolkit, a free online toolkit that has been developed by the RCGP. It has a list of over 100 actions that can improve the environmental sustainability of your practice. The toolkit also has a selection of quality improvement ideas related to climate change, such as switching patients on MDIs to more sustainable alternatives. 

Prompted by the toolkit, we also introduced many team building activities at the practice, such as healthy practice lunches and group exercise. This has been great for morale especially at a time in which burn out in the profession is at an all-time high.

Our achievements

The toolkit has access to many awards which your practice can obtain by working through the various actions. At Market Street Medical Practice, we've already achieved the Green Impact for Health Pioneer Award and the Bronze Impact for Health Pioneer Award. These achievements are shared by all our staff, and it’s nice to have something to show for all our efforts! 

In addition, we've also managed to save on our energy bills during a time where prices are soaring.

We're now looking for ways to further improve our sustainability, and achieve the next award in the toolkit.  

Summary

Climate change is a health emergency, presenting many challenges for the future of primary care. Together, we can start making changes which will not only improve our patients' health, but help us address the many challenges we will have to undoubtedly face in the future.

References and resources

About the writers

Dr Jawad Haq and Dr Vik Puri are RCGP AiT co-leads for North West England, LMC West Pennine GPST representatives, and HEE GPST representatives. 

Have you got any comments or feedback? If so, please feel free to contact us - we would love to discuss any points.

Dr Jawad Haq

Dr Haq is a GP Registrar at Market Street Medical Practice. Contact: jawad.ul-haq@nhs.net

Dr Vik Puri

Dr Puri is a GP Registrar at St Andrews Medical Practice. Contact: vikram.puri1@nhs.net