Sustainability

This video features three speakers.

00:00:30 – 05:23:24 – Andrew Urquhart, ICB Sustainability Lead
05:29:07 – 07:15:24 – Isla Kaye, ICB Information Governance Officer
07:21:21 – 09:49:24 – Dr Vasandhara Thoroughgood, Essex GP
09:50:18 – end – Andrew Urquhart

Transcript

So, the purpose of my role is to look at limiting the impacts of climate change from our health perspective and our care partners’ perspectives, certainly in relation to population health and the impacts that climate change has on population health. What does that entail? Well that’ll entail pulling numerous strands of information and people together to form a green plan, a strategy, and that will be our sustainability strategy moving forward.

So sustainability itself is not one single thing, it’s a paradigm of thinking, it’s thinking holistically, it’s considering the environment, it’s considering social, and it’s also considering economic benefits. So it’s triple bottom line benefit thinking and it’s holistic and the thing they all have in common is they’re all integrated so you don’t consider one without the other. Now that’s quite an overarching paradigm of thinking and to try and break that down, the United Nations have developed 17 sustainable development goals, and that tries to break down an overwhelming amount of information into smaller bite-sized chunks that we can start to tackle. And what is the purpose of those sustainable development goals? Well, they are by the UN, accepting that actually, if we’re going to tackle poverty – poverty and the associated things with poverty such as poor education, poor diet, poor health and so on and so forth, that goes hand-in-hand with developing an economic strategy that also doesn’t just consider both social elements but it also considers the environment and tackling climate change. So all three things together in one overarching paradigm. When we consider the UN’s sustainable development goals and what my role entails in tackling population health issues, there is a link with climate change. And not just sustainability itself, so climate change um is or has come about from the release of greenhouse gases primarily through humans releasing hydrocarbons burning fossil fuels and so on and so forth and the issue with that is that global climate has changed. Our um the temperature has increased by one degree over the last century and if this goes unabated, the science, the consensus is that by the end of this century temperatures would have increased by three degrees which is completely unsustainable for us. So with that in mind, what is the impact on that? So as global climates are changing that’s leading to more extreme weather events and those extreme weather events are actually starting to put a pressure on our frontline services. So to give you some examples we’re having and experiencing a lot more heat waves. And those heatwave episodes are actually having an impact on the most vulnerable and people in our society that have cardiovascular and respiratory issues so we’re seeing a spike in hospital admissions. We see spikes in mental health cases with more flooding and we’re seeing that as temperatures change that disease vectors and pathogens are now starting to transfer more. So climate change itself is having an impact not just on the weather, that’s in turn having impact on frontline services. It’s been described, climate change, as a climate emergency – which it is – and a health emergency. But actually what I prefer to do, and what I like us to think is, let’s strike the word emergency out and let’s call it an opportunity because it is an opportunity. It’s an opportunity to frame and do things differently certainly in a post-Covid world. So in terms of taking really complex and wide scale global issues – sustainability, climate change, the impacts on health – we have to distil them down into something which is tangible and recognizable and something that we can act on at a more local level. So we take those issues, we develop our green plan, and our green plan uses those in that information into several key areas like carbon, estates, care pathways, travel, greening space. It marries those issues and climate change mitigation activity together and then that becomes our green plan – our strategy. And we will look at things which will really help at a local level. So for instance limiting our business use of cars and embracing active travel and transport. That has a direct impact on helping the local population air quality.

Other elements such as sustainable production and consumption -wasting less and delivering more value for our local population as we embrace a more circular economy, and rather than just reuse, reuse, recycle and then it gets thrown away.

I’m a member of our steering group engaged in travel and transport. Our aim is to encourage sustainable and active travel wherever possible and to only travel when it’s absolutely necessary and to expand the virtual technologies for both patients and staff in order to reduce the need for travel overall. But this isn’t just about traveling to work. We also want to support staff to improve sustainability at work and at home and to empower them to make sustainable choices in their everyday lives. Immediately post-Covid, we’re concerned that people will revert back to using their car instead of using public transport due to fears of contamination and concerns around social distancing. Which is why we’re making active travel a key element of our approach. We know from studies undertaken that 65% of UK road trips are less than five miles. So by embracing active travel when people do go back to work can help target and tackle those habits. Encouraging cycling will help us reduce those making shorter commutes and tackle perceptions around using public transport. It has a dual benefit to keep people out of cars to do this we’re now working with cycling UK. Their support will include bike doctor sessions to repair your bike, you can bring your bike in and the bike doctor will help you get it road-ready. Confidence boosting lead bike rides to get people back in the saddle, a webinar to give tips hints and advice on safe cycling, grant support for some equipment and we’re also looking at our offices to see if we’re active travel friendly enough. Things such as lockers, showers and bike storage. And we also have some great staff activities to encourage active travel and exercise. We’ve had a virtual trip to Lapland and we’re currently on our way to Mexico so once you start logging your miles it really does encourage you to do more.

So from a sustainability survey that we sent out last year we know that over 90% of healthcare professionals, so that includes GPs and nurses felt that general practice has a role in reducing its carbon footprint. Obviously as clinicians within general practice we’re part of the partnership of a wider ICS – delivering the sustainability steering group’s goals. So last year I set up a group of interested GPs who want to help general practice reduce their carbon footprint. We’re called Greener Practice Essex and Suffolk and we meet monthly to try and come up with ideas to support practices to do exactly that. There are so many things that GP practices and clinicians can do to make an impact on their carbon footprint and it’s something that you can apply in your practice tomorrow. So we know that the biggest part of our carbon footprint in general practice is prescribing and it’s not about saying to patients you can’t have your medication but thinking about other ways to help them manage their problems that actually might be better for them and good for the planet. So I’d like to mention social prescribing here because we know that being connected to other people is such a key part of our health and we’ve got great social prescribers in our area with community360, so getting them involved to support our patients is a great idea. Also making use of other professionals who work with us such as our health coaches to support patients with lifestyle changes such as getting more active, eating more healthily, looking after themselves, managing stress. All of that helps to improve their health and reduce their reliance on medication. Now as prescribers what can we do – I’ve got some inhalers here to show you. So most of us are prescribing these aren’t we? Metered dose inhalers and we need to shift over to ones like this – dry powder inhalers. Lots of our patients will be able to use this and by doing this we know that we can massively reduce the carbon footprint of our prescribing in general practice. And finally, I want to talk about waste because within the NHS we all know that waste is a big problem. Lots of our patients ask for medication that they never use. Apparently a lot of people flush it down the toilet because they think it’s safer than putting it in the bin, but actually that’s poisoning our water. So just talking to patients about medication they’re not using, asking them to be honest with us and if they don’t want to take it, stopping it and reminding them to return it to chemists for recycling and incineration would also make a big difference.

And we often hear people say when we talk about sustainability, “if I only do a little bit it won’t make a difference”, actually the flip side is true. It will make a huge difference, and the reason for that is if you consider lots of small local activities by everybody bound together for our CCGs and then think of each CCG up and down the country as a patchwork quilt, put those patches together in the quilt and then you start to get local actions and activities which actually address local issues but also then help to have a global impact and that’s what our green plan will start to do.