Due to the interconnections between climate change and worsening human health, it is essential that Physiotherapy graduates are equipped to manage the effect on patients. Meanwhile, healthcare is a significant contributor to carbon emissions and it is essential that physiotherapists lead environmentally informed clinical practice (Li et al, 2024). Internationally, there is an urgent need to embed environmental sustainability into Physiotherapy higher education curricula (Swardh, Palstam, 2025). The Environmental Physiotherapy Agenda (EPA) 2027 is striving to promote principles of planetary health and sustainability education in physiotherapy programmes across the world (Environmental Physiotherapy Association, 2025). In the UK, the Health Care Professions Council (2024) recognise the importance of sustainable practice and the Chartered Society of Physiotherapy (CSP) endorse that graduates must demonstrate a core knowledge of sustainable physiotherapy practice and consideration of the environment (CSP, 2025). The recent establishment of the CSP Environmental Physiotherapy Network (CSP, 2026) provides a key opportunity for advancement for the profession.
The University of Plymouth is a supporting organisation of the EPA embedding the ‘golden thread’ of environmental sustainability into Pre-registration Physiotherapy curricula (Council of Deans, 2023). Whilst successfully embedded in module content within the University setting, it remains a challenge to embed into Physiotherapy practice placements due to varied adoption of sustainable practice. Practice-based learning is an essential part of Physiotherapy training and offers learners the opportunity to gain hands-on clinical skills and develop leadership in diverse healthcare settings (CSP, 2022). As student numbers grow, there is greater demand for placement capacity, posing an opportunity for innovative placement models utilising role-emerging settings and alternative models of supervision such as long-arm approaches, where profession specific supervision is provided remotely (CSP, 2025).
In 2025, an opportunity was identified for the University of Plymouth in collaboration with Somerset NHS Foundation Trust to develop and pilot a long-arm supervision environmental sustainability Physiotherapy placement. Prior to the placement, planning involved effective alignment of expectations, consideration of potential measures of success and strategies for support for all involved. Placement learning outcomes were mapped to module learning outcomes and the common placement assessment framework (CPAF) assessment criteria.
Jaimie Osborne, MSc Physiotherapy (Pre-Reg) student
“As a Physiotherapy student, I had not expected to undertake a sustainability placement, which initially felt unrelated to physiotherapy practice. However, I quickly discovered how integral sustainability is to the NHS and to our profession.
Under the guidance of the sustainability team and my LAS from the University, I actively engaged in a range of learning opportunities and resources including the NHS Futures site which enabled national engagement and networking with physiotherapists and sustainability specialists across the country.
Although I felt nervous at first, I soon became motivated to make the most of the experience. My focus developed around mobility aid recycling and reuse. I designed and distributed a survey to local physiotherapists and presented my findings which showed the complexity across settings and supply chains and sparked meaningful discussions with colleagues. This process deepened my understanding of the challenges and variations in mobility aid recycling across trusts and hospitals.
This placement significantly broadened my understanding of sustainability within the NHS and highlighted its direct relevance to physiotherapy practice. I developed key skills in research, data analysis, and professional networking, and I am committed to continuing my learning in this area. I intend to apply these insights to improve patient care and promote sustainable practice throughout my future career.”
Alex Holly (Practice Facilitator) & Richard Harper (Head of Sustainability, Energy & Carbon) – Somerset NHS Foundation Trust
“With collaboration and innovative thinking, the University of Plymouth (UoP) and the Sustainability Team at Somerset NHS Foundation Trust developed and delivered a non-clinical placement providing real-life insight into the world of healthcare sustainability specifically within Physiotherapy services.
As a first trial of this placement model, open and honest communication around expectations, planning and support structures for the placement were essential. A long-arm supervision model was used to ensure the placement met profession specific learning objectives and provided profession specific supervision. This was crucial to ensure the placement took place as the onsite educator was not a registered Physiotherapist or AHP.
From the first week of placement Jaimie demonstrated leadership, autonomy, initiative and professionalism and thrived within this model of placement. The placement was a mix of virtual and face to face working both onsite and working from home. Jaimie adapted to this easily.
Jaimie completed a project around mobility aid recycling and equipment provision which included arranging meetings with other NHS trusts, producing a survey, gathering results, presenting findings on two occasions and chairing these meetings which were hugely successful in inspiring colleagues and engaging conversations. The sustainability team found having a Physiotherapy student very insightful and beneficial to understanding barriers for applying sustainable practice and change, on the ground and within front line healthcare.
We would encourage all sustainability teams across NHS trusts to support student placements to promote a more sustainable future workforce. Our advice would be go into the placement with an open mind and flexible approach, have a project or workstream planned for the student but also allow the student to explore their own interests alongside providing specific opportunities to engage with examples of sustainable processes and developments within your organisation.”
In summary, from the perspective of educators, supervisors and the learner – this role emerging placement in sustainability has been valuable and rewarding for all involved. With sustainability becoming an increasing priority for healthcare services, developing the existing and future workforce in this area is key. Placements at pre-registration level based within clinical sustainability teams provide an exciting opportunity to support the sustainability agenda and student development across the four pillars of Physiotherapy practice – Education, Clinical, Research and Leadership (CSP, 2024).
In the future, we would like to see environmentally informed practice included in the Common Placement Assessment framework (CPAF) to contribute to the assessment of the learner. There is no doubt that the future requires Physiotherapy learners, graduates and the workforce to be knowledgeable and confident delivering sustainable healthcare, to benefit people, profit and planet and that this can be interwoven at programme and placement level.
Thank you to all involved.
Authors:
Danielle Munford
Danielle is a Lecturer in Physiotherapy at University of Plymouth, UK striving to embed environmental sustainability in pre-registration curricula. She is also Chair of the CSP Environmental Physiotherapy Network. Linked in: www.linkedin.com/in/danielle-
Christie Robinson
Christie is a Lecturer and Academic Lead for the Physiotherapy programmes at the University of Plymouth. Her primary interests focus on practice‑based learning and preparing the future Physiotherapy workforce for contemporary clinical practice. Academic Profile.
Alex Holly
Richard Harper
Jaimie Osborne
Declaration of Interests:
No interests to declare.