While I have always strived to be mindful of our environment, it is in recent years that I have taken more active steps, even if it meant personal inconveniences and financial investments. The driving force for this was no single event, but the momentum of various campaigns such as Friday-for-Future school strikes and TV documentaries, which weighed on personal and public consciousness.
I have come to realise that while individual efforts can make a difference, an amplified impact can be achieved by advancing sustainability at the systems level. Charge 5p for a plastic shopping bag and they will stop being used. We can cast our votes to be heard at the political level or lobby for policy changes and hope for the best. However, as healthcare professionals, we have much more influence at our workplace, be that hospital or primary care. I realised that as a GP partner in a semi-rural practice with over 80 staff members looking after 15000 patients I am in the fortunate position where my vote counts, and my voice will be heard.
Personally, I have a strong aversion to preaching to others about their choices, and I believe leading by example and working together is more effective. My preference is to be part of a collective effort, rather than being singled out as ‘the green one. This led me to the decision of forming a ‘Green Team’, which I believe is not only effective but also inclusive, particularly when it has members from various corners of the practice.
During our annual practice away day, where all staff members were present, I took the opportunity to share my aspirations. However, I deliberately kept it as a simple announcement, without requesting a show of hands or soliciting public comments. This choice was driven by my desire to avoid being perceived as ‘the green one’” and to cultivate a sense of inclusivity. Maintaining this approach throughout our green team journey, I specifically embraced anonymity when it came to the surveys. To gauge the staff’s interest and gather suggestions for change, I initiated an anonymous survey. The response we received was incredibly humbling, and it was inspiring to see a dedicated group of motivated staff members ready to join our multidisciplinary green team.
We used the RCGP’s Green Impact for Health Toolkit to guide our efforts in distributing roles and responsibilities to team members. Our approach has been to focus on achievable goals and areas that resonate with the passions of our team. This would not necessarily result in the biggest impact on the practice’s carbon footprint but tackle easy wins and get the momentum going for change. We established monthly virtual meetings over lunch and connected with a local Greener Practice group (a group of like-minded motivated healthcare workers, part of a UK-wide network), opening doors for idea-sharing and potential collaborations.
Our commitment has provided encouraging results. Through a free energy assessment, we made simple adjustments such as optimising heating and hot water settings, leading to a noticeable reduction in our gas bill and carbon footprint. We implemented a policy of turning off computers overnight, resulting in a significant reduction in wasted energy. The positive outcomes have benefited our practice both in environmental and financial terms.
To maintain team engagement, we conducted regular anonymous surveys, ensuring the green agenda remains a shared priority. We made it a standing item in our rolling business meetings and dedicated a section in our practice newsletter to the Green Team. Generously donated trees from the RCGP allowed us to contribute to the NHS forest, and involving our staff in the planting and naming process added a sense of ownership.
We conducted interactive quizzes focused on waste management, which led to the dual effect of raising awareness and a healthy sense of competition. During casual coffee breaks, it was interesting to observe that staff members had voluntarily purchased oat milk for themselves, not necessarily due to environmental motivations. Encouraged by this observation, we decided to survey the team to gauge their willingness to switch from cow’s milk to oat milk in their hot drinks. The results were heartening, as a significant number of individuals expressed openness to the change. As a result, we have now introduced oat milk as a supplementary option, much to the delight of some staff members and the entire green team.
Our commitment to sustainability extended beyond our practice walls. We organized a memorable gardening day, revamping existing green spaces and creating new ones with plant donations from staff, patients, and local nurseries. It was inspiring to witness our dedicated staff actively participating in the design process, further strengthening our bond as a team. We also forged meaningful connections with local garden centres, wellbeing hubs, and schools, fostering community engagement and leaving a positive impact on our practice’s presence in the community.
The local primary school has been particularly generous with teachers getting their hands muddy when their children came to plant their sunflowers in our car park. They have also donated their school drawings relating to the NHS and healthcare. Rainbows, sunflowers, nurses, ‘Get Well Soon’ wishes, which are now framed and decorate the reception area. In return our advanced nurse practitioner and paramedic visited them to give a workshop on how to treat their teddies’ nose bleeds, grazes and ingrown toenails. We tried to empower them with a sense of self-care, whilst also introducing some of our newer roles in the primary care team.
Our patients have shown encouraging engagement in their willingness to switch inhalers to lower carbon alternatives. The response to invitations to develop a bee garden and the green spaces around the practice was not as positive as we had hoped. However, I feel some of this engagement will require time and as changes happen within the practice team they will ultimately reach our patients. A journey from deprescribing to social prescribing.
We also implemented significant changes that required investments of time and resources. These included the introduction of cycle-to-work schemes, electric car salary sacrifice schemes, solar panel installation (quotes so far), inhaler switches, deprescribing practices, and the implementation of tiger bin bags. These investments are best seen as an investment to save. Save staff by retention. Save money by self-sufficiency. Save patients by better care. And cue the corny finale…Save the planet by all the above.
Through community collaboration and teamwork, we have modestly nurtured a culture of sustainability within our practice. Witnessing the impact of our collective efforts, I encourage others to embark on their own green team journeys, as every small step contributes to a greener future.
Author
Lorenz Kemper
Lorenz studied at St George’s university of London and completed his GP training in the Oxford Deanery, where he is now a GP trainer.
Declaration of interests:
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests:
- Director of Medlink Solutions a primary care productivity solution
- Director of a pharmacy