There are a number of different initiatives being trialled all over the country. CCGs and trusts are highlighting the issue and creating documented guidance. In Leeds, programmes are being such as ‘ditching the car’, recycling, and ‘thinking before you print’. These are very simple interventions, but nationally these policies and plans are fragmented and executed differently. To be beneficial there needs to be fluency with feedback and monitoring regularly completed and data accurately collected and analysed, for example the Lancet Countdown.
Sustainability can be achieved by many initiatives and an ingrained positive attitude towards its many aspects such as:
|Transportation||‘Bike to work’ schemes, use of public transport|
|Impact on the environmental||Considering carbon dioxide emissions and energy usage i.e. proactively turning lights off|
|Waste production||This includes disposal, recycling, reducing waste output, special chemical/medical waste
The most common examples of first steps in companies:
|Interaction with the environment||E.g. Green spaces near the workplace to which staff and patients have access|
|Human resources||Policies for equality, inclusion and diversity in the workplace|
|Wider community impact||It is important not to forget about the impact to health of using sustainability to promote a healthy lifestyle and increase satisfaction in the workforce|
There is clearly an individual responsibility to change our own attitude and incorporate sustainable actions into our own lives. Companies with successful sustainability programmes usually have a dedicated officer, good education strategies, and a good positive ethos. This involves an assessment of where potential improvements can be made as an ongoing process rather than a one off.
This has been implemented on a small scale in General Practices and individual wards, which have seen improvements. Large scale public health campaigns and trust policy directives are the other place where improvements are required and are starting to be seen. Education about sustainability are also key to enable its implementation. However, on a national level, the policies on sustainability in healthcare are still chaotic and ineffective. A more unified strategy based on these existing projects would allow a platform for quick improvement and benefit for the NHS. This is more than a simple change it is a responsibility that the NHS needs to implement these at both national and trust levels.
A new/changed department and appointment of specific officers would seem an obvious place to start and pilot ideas created from the top, in a unified strategy dictated in part by Public Health England. There is a Sustainable Development Unit (SDU), designed to work across NHS England and Public Health England, however these have not trickled through to be implemented. This push for sustainable healthcare is an on-going project, which needs further development.
An increased awareness and good knowledge of sustainability by healthcare professionals has the potential to stimulate and guide good behaviour in patients. There is little research on the attitude of healthcare professionals towards sustainability, and what is out there focuses on the opinions of specific groups of healthcare workers. However, the research that was done showed a willingness to learn more, but an apparent lack of willingness to act or knowledge of how to do so. Obstacles to being sustainable in the workplace, included professional identity, lack of knowledge, limited resources, time and clinical priorities. Development is needed to educate, enable and support healthcare professionals in reducing climate change and become more sustainable.
Sustainable practice is in its infancy, and although existing efforts have improved our position significantly over recent years, this is an area with huge potential impact, and massive room for development.