Towards net zero healthcare
Rachel Stancliffe, Aarti Bansal, Georgina Sowman, Frances Mortimer
Abstract
Reduce use of health services and improve healthcare efficiency by integrating the following principles into daily clinical practice and quality improvement: prevention, patient empowerment, lean systems, and low carbon alternatives Encourage sustainable healthcare principles in all populations (including those currently under-served) to reduce health inequalities Consider strategies to reduce duplication and waste, for example, when booking appointments, requesting investigations, prescribing, allocating resources, and arranging patient or staff travel Case-A 47 year old woman who takes metformin and amlodipine for type 2 diabetes and hypertension visits her GP to discuss her HbA1C levels, which have been steadily increasing. She is a single mother with two children at school and works full time in an office. They discuss the option of increasing her diabetes medication and how. High quality control of long term conditions with medication has a lower burden on patients' physical, mental, and social health-as well as a lower carbon footprint-than poor control, which may result in complications and admissions. However, the patient doesn't want to increase her medication as she experiences several side effects from the medicines she already takes. Our essential life support systems-water, air, food, and a stable climate-are being destroyed by the global climate and ecological emergency. This is claiming millions of lives and its impacts are disproportionately felt by people who are poorer and more vulnerable. 1 A report from Health Care Without Harm suggests that the climate footprint of healthcare worldwide is equivalent to 4.4% of global net carbon emissions-ie, if the health sector were a country, it would be the fifth largest emitter on the planet. 2 The authors of this article are based in the UK, but the content is relevant for all healthcare teams worldwide, providing sustainable clinical healthcare principles that can be integrated into daily practice, healthcare improvement activity, education, leadership, and research. It also introduces a series of papers, Towards net zero healthcare, written by groups in various countries and aimed more directly at specialty teams.