Engaging With Sustainability Guidance And Tools Within The Primary Care Setting

Sean Owens, Aoife Benton

Keywords: Sustainability, Toolkit, Climate, Carbon

Introduction:

All healthcare professionals, globally, have a role to play in planetary health, including in primary care. The healthcare sector must be sustainable into the future, so that it continues to have capacity to respond to healthcare needs, and to promote and maintain the health of people and the planet. It is imperative for all to act now to increase self-awareness that healthcare activities have their own carbon footprint and to mitigate same where possible and where it is safe to do so. As one of the first primary care colleges to endorse the new and evolving concept of planetary health, Irish general practice is ideally placed to demonstrate leadership within the medical profession and in partnership with the general population.
In April 2023 the Irish College of General Practitioners published a Green (or Glas in the Irish language) toolkit to better demonstrate where the carbon footprint may be found in daily delivery of primary health care. The toolkit contains evidence-based information on the activities that GPs and the practice team can undertake to improve the sustainability of their activities in the practice. It also includes ideas and templates for clinical audits and quality improvement projects e.g., guidance on rational prescribing and disposal of inhalers, antibiotics, and medication reviews.
Prevention and reversal of medical conditions such as obesity, hypertension, hyperlipidaemia, anxiety and depression through evidence-based lifestyle changes and incorporating wellbeing activities into patients’ lives takes effort, time and needs a multidisciplinary team approach and educational resources. Part of the challenges post publication of this toolkit will be educating practitioners how to implement some of the ideas in this toolkit within their consultations and working day. Recent changes in Irish general practice such as the structured “Chronic Disease Management” Programme addresses long-term conditions through lifestyle changes, self-management plans and active management of prescribing and referral to community supports and hospital services. This is one example where existing primary care works in tandem with the core tenets of planetary health.
Hence there is an opportunity to demonstrate to GPs and practice nurses that planetary health is not something new, rather asking us to practice evidence based and patient centred medicine. This workshop aims to demonstrate how the time poor and busy practitioner can make subtle changes in their consultations to great effect from a planetary health point of view.

Method:

Attendees will be welcomed and reminded of the context of planetary health i.e., the most recent IPCC and biodiversity reports, Ireland’s legally binding plans to achieve reductions in emissions and the worrying declining trends of Ireland’s general health (Healthy Ireland report) (5mins). The ICGP Glas toolkit will then be formally launched (5mins) and a workshop with willing participants will be run. A mock afternoon surgery will be run with one of the presenting team acting as a doctor and either a willing participant (or another presenter) as the patient. A typical scenario will be played out that is thereafter broken down with the aid of the toolkit to see where the opportunities arose to act upon planetary health. Existing published audits and other resources will be utilised to show how the toolkit may be woven seamlessly into daily practice for a multitude of patient, planet and practitioner benefits. There will be time for 2-3 scenarios (10mins each) with protected time for discussion and exchange of ideas and future challenges thereafter (20 – 30 mins). A scribe will take notes to feedback to the ICGP toolkit authors and also to write-up the workshop.

Aim:

Attendees will be reminded of the pressing need to act now to mitigate the worst predictions of the climate crisis and to see what their role might look like in their working lives. Attendees will become familiar with the layout and content of the Glas toolkit e.g., where it is located online, how to use it, how sample audits may be used, how to engage. Furthermore attendees from other European colleges will be given a chance to engage and cross pollinate ideas going forward. Feedback will be incorporated into future versions of the toolkit and challenges explored will better inform the future). A scribe will take notes to feedback to the ICGP toolkit authors and also to write-up the workshop to better inform future roll-out of green health initiatives.

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