Clinical transformation

Less of the same is not the answer

The Centre for Sustainable Healthcare is working with clinical specialties to transform healthcare for a sustainable future.

Analysis of the NHS carbon footprint shows that even if hospitals were fully powered by renewable energy, total emissions would only be reduced by one-fifth. Other solutions are needed to tackle the 18% of carbon arising from staff and patient travel, or the 60% from purchased goods and services (mainly pharmaceuticals and medical supplies).

As the NHS commits itself to meet the Climate Change Act’s target of 80% carbon reduction by 2050, one thing is clear: less of the same is not the answer. A transformation in clinical practice itself is required.  In order to provide care at just 10 or 20% of current carbon costs, health services must display far greater rigour in identifying and pursuing value to patients, while discontinuing those interventions and activities which provide minimal benefit to patient outcome. 

In designing health systems of the future, the Centre for Sustainable Healthcare uses four principles of sustainable clinical practice:

1. Prevention
2. Patient partnership – supporting service users in managing their own condition
3. Leaner care pathways
4. A choice of low carbon treatment alternatives.

To read more about our model for transformation of clinical practice click here or see "The Sustainable Physician" - opinion piece by Dr Frances Mortimer published in Clinical Medicine 2010, Vol 10, No 2: 110–11.

The Green Specialty programmes

The Centre for Sustainable Healthcare has chosen to work with clinical specialties, because of their strengths as multi-professional communities focused on the care of specific patient groups. Specialties are uniquely placed to integrate sustainability – from design of the clinical pathway to organisation and delivery of care.  The first specialty to develop a green programme is kidney care.

Benefits

A green programme helps to strengthen a specialty, allowing patients, care providers and suppliers to develop a common vision and work together to achieve it. Care quality is improved as services are redesigned around the needs of patients, and low-value-added activity is minimised. A greater focus on prevention and healthy living not only reduces healthcare demand, but benefits society as a whole.

Creating a successful programme

CSH identifies the following elements of a successful green specialty programme:

1. Engagement of key partners. These could include specialty associations, patient groups, suppliers, representatives of the specialty’s different professional groups.
2. Setting a vision for high quality, low carbon care.
3. Analysis of environmental impacts. An understanding of current impacts helps to direct efforts at improvement, and provides a baseline for measuring progress.
4. Encouraging innovation in technologies and systems of care. Support for innovation may take many forms, including financial incentives from sustainable procurement and commissioning frameworks.
5. Skills and training. Providing specialty members with a core knowledge of sustainability, and the skills to deliver sustainable care.
6. Policy development. Building environmental factors into service planning and policy.
7. Celebration of achievements! Very important to the programme’s long-term success.

Contributions from partners to the shared programme reflect their individual strengths and can range from financial sponsorship to educational or publicity roles, staging events or setting up pilot projects. CSH provides initial support free of charge to specialties embarking on a green programme and, where funding can be arranged, is delighted to help in delivering elements of a specialty action plan.

 If you would like to learn more about our work with clinicians, you may be interested in these pages:

• The Carbon Addict
• Cornwall NHS pilots
• Doctors
• Green nephrology
• Medical education
• Public health - The Climate Connection
• Green occupational therapy
• SAP - sustainable action planning for clinical teams

You can download the CSH Green Specialty prospectus below.  For more information, please contact frances.mortimer@kintoa.org