Anya de Iongh: What role can patients play in promoting environmentally friendly healthcare practices?

We all have a part to play in making a difference to the environment. What does that look like when we are patients, and consumers of healthcare resources? 

Healthcare organisations are vulnerable to the effects of climate change due to the health implications of poor air quality, extreme weather, and other climate related factors. But the healthcare industry itself has a substantial carbon footprint, and is responsible for a quarter of carbon dioxide emissions in the public sector in the UK. 

Patients’ first hand experience of healthcare gives them an unparalleled perspective of the waste in healthcarewhere it happens, and how it can be tackled. Single use plastics have been widely criticised, and while many plastics in healthcare are single use for important infection control reasons, there are many other opportunities to rethink healthcare’s use of some items. For example, I remember collecting monthly prescriptions in small plastic bottles, and offering to bring last month’s container to be refilled. I was told that wasn’t possible. I never understood why, while they were also simultaneously encouraging me to decant medications into dosette boxes, making each month’s container even more short lived. Other people have mentioned the plastic cups they see on wards, the cardboard trays going into normal bins rather than recycling, and inconsistent and baffling policy around what can and can’t be washed—for example, expensive single-use hoists apparently can’t be washed and therefore re-used, while bed linen is washed and reused. There are examples of plastic aprons on rolls not tearing off properly, leaving patients watch as staff go through and discard two or three aprons before they have even been used. 

Is there a strong evidence base behind the policies for all the instances of single-use plastics in hospitals, or is it just “what we do?” At home and beyond a clinical setting, patients often have to innovate to manage their care safely and practically without the layers of equipment found in hospitals. 

Wider societal approaches to climate change can have a significant impact on patients. One recent example has been the removal of plastic straws. For many people with conditions that affect their ability to swallow, straws are vital to enable them to drink safely. Banning plastic straws, without suitable alternatives, places them at risk of harm, as well as judgment from other people. An opinion piece in The Guardian highlights the challenges of banning plastic straws and disposable wipes. Seemingly sensible plans to reduce the number of cars in urban areas can unwittingly penalise patients who have reduced mobility, and leave them vulnerable to judgments from others. 

Many of the solutions to these problems rest with healthcare organisations to assess their policies, and with manufacturers to source alternative greener materials, but what can patients do to help environmental causes within healthcare? 

With the wealth of knowledge and experience that patients have as advocates, activists, and campaigners, we are natural champions to help drive these changes in healthcare. 

Some of the things that patients have already championed, have environmental benefits, such as virtual appointments which reduce the need for travel, and electronic notes systems which reduce paper use. People with respiratory conditions have been vocal on issues relating to air quality and pollution, and have championed greener alternatives for inhalers.

But the environmental impact of healthcare needs to be addressed directly, and as with any other change to healthcare, it is vital that patients’ perspectives are heard and they are given the opportunity to share the many potential solutions they see, as well as highlight any challenges that policy changes can pose. To shine a light on the role of patients in promoting a more environmentally sustainable approach to healthcare, we are running a Twitter chat on Wednesday 18th September, at 8pm BST. Some questions are included below to get you thinking, and we’d love to hear your thoughts in the comments section below, via Twitter, or as part of the chat! 

  • Patients have a unique perspective on healthcare⁠—what have you seen or experienced that struck you as being not environmentally friendly?
  • What policies or practices do we need to protect, so that we don’t penalise patients and genuine healthcare needs?
  • What suggestions or ideas do you have that could help make healthcare more environmentally friendly? 
  • What role can patients play in promoting and encouraging more environmentally friendly healthcare practices? 

The responsibility for sustainable healthcare doesn’t sit solely with patients⁠—its something we all share. For innovative, out of the (plastic)-box thinking, involving patients is a great place to start.

Anya de Iongh is patient editor for The BMJ and works nationally and locally around person centred workforce development and self-management support services.

Competing interests: Full details here.