According to the Centre for Sustainable Health Care, The four principles of sustainable health care are:
Prevention
The best way to improve patient care whilst reducing emissions of any illness is to prevent it. Primary Care plays a key role in disease prevention within the health service, and we at Greener Practice believe that Primary Care needs both to have a stronger voice in Greener NHS discussions, and to be funded in a way that supports health promotion and disease prevention more effectively. Primary Care can also play an important role working with local communities (for example on air pollution, active travel, sustainable healthy food, use of green spaces etc).
Patient empowerment
A Greener Practice approach to good healthcare is one which ensures that decisions about prescribing are focused on patient-centred approaches. This supports better treatment concordance and patient education and empowerment. There is therefore overlap between a green approach and agendas such as person-centred care, shared decision making, over diagnosis and over treatment.
Lean pathways
Clear and appropriate diagnosis (with appropriate computer coding); careful consideration of appropriate investigations and treatment; streamlined systems to avoid duplication of care, reduced hospital attendances and avoidance of wasteful practices are all examples of lean systems.
A further example of a lean pathway is the shift towards patient taken cervical screening samples by self taken swab or urine testing, which is often more acceptable to patients and, according to this study can lower the carbon footprint of testing by a factor of 6.4 for urine sampling and 8.7 for vaginal sampling.
Low carbon alternatives
We can reduce the carbon footprint of care, with no detriment (and often with benefit) to patients by considering low carbon alternatives, such as reusable PPE, reusable surgical instruments, and lower carbon prescribing options. In asthma care for example, we could prioritise choosing the right inhaler for the right patient. Many patients find a low-carbon dry powder inhalers easier to use than metered dose inhalers. For more information see the asthma toolkit section.