With just under 7,000 GP surgeries in England seeing millions of patients each week, family doctors can also have a dramatic impact on reducing emissions in the NHS.
According to the NHS Sustainable Development Unit, pharmaceuticals are the biggest cause of emissions in primary care and make up 18% of the NHS’s total emissions. Reducing unnecessary prescriptions and single-use plastic blister packs for small medicines will make a big difference, as well as cutting costs, says Karen Creffield, practice manager at Frome medical practice, in Somerset, which is trying to cut its carbon footprint.
The practice has identified a number of areas where it hopes to “de-prescribe”: opioid reduction, hypnotics and antidepressants and reviewing patients taking seven or more medications. It is also promoting inhaler recycling and switching to more sustainable inhalers. Most asthma sufferers use metered dose inhalers, which use hydrofluorocarbons to propel the medicine into the airways. But these gases are much more potent than CO2. They make up 70% of inhalers prescribed by the NHS, but only 10% in Sweden. The National Institute for Health and Care Excellence wants doctors to follow the Swedes’ example and consider prescribing dry-powder inhalers that provide the same medicines without the greenhouse gas emissions instead. Simply switching to lower carbon inhalers would reduce total emissions by 4%, according to the NHS long-term plan.
The Royal College of GPs funds a green impact for health toolkit to help practices reduce their environmental footprint. “We want to promote actions in our practices for ourselves and our patients that are good for youthem and good for the planet,” says Terry Kemple, the former RCGP president and sustainability lead.
In Frome all the practice staff are asked about their contribution towards sustainability in their appraisals, while a green impact policy emphasises the importance of turning off lights and electrical equipment. Its procurement policy prioritises working with suppliers who are committed to reducing their emissions. “All our tea and coffee is fair trade, we only use local companies for catering who are committed to locally sourced, fair trade and organic produce (where possible), says Creffield. “This includes healthy snacks at meetings (avoiding palm oil for example).”
By sending more text messages to patients instead of letters, it has cut paper use significantly. Staff are encouraged to walk or cycle to work and the practice has two electric vehicle charging points.
