14th December 2020
Dr Vasu Siva
Having worked nearly 20 years at Hillview Surgery as a GP Partner, I have seen my staff grow and develop new strengths. What I realised at the beginning of the COVID-19 pandemic was that many of us are busy in our lives with no work life balance. We don’t set time aside to reflect on our lives and what we want to achieve to make a difference to ourselves and to the world!
In addition,the majority of our staff lack courage or even self-esteem to take an idea forward. Many of us, through no fault of our own, are not great at frequent verbal expressions of our gratitude. Whilst financial rewards are well received, they are not sufficient. On-going communications, staff recognition (individual and collective) and staff involvement is vital to improve staff morale and general well-being which in turn promotes performance.
I have always been interested in understanding the impact of climate change on human health. During the first lockdown, I decided to invest my time in finding out how as a practice we could make a difference towards a reduction in our carbon footprint. We are at the forefront of patient management so we are ideally placed to influence health-led environmental change. By engaging and embedding our values in our staff, we can make behavioural changes in the practice, which in turn would help engage with patients in our community. With a green approach, we not only collectively help improve care and wellbeing, and support our patients and staff, but also ease GP workload and help tackle climate change. In addition there is an overall financial benefit.
I spent some time thinking about how I would motivate and engage my team to get involved in the green agenda!
We are “educators” in our day to day working lives, and with this in mind I introduced the initiative, “Hillview Going Greener” early in July 2020 – I registered with the Green impact for health Audit created by the RCGP and NUS. Early on in the preparation of how I wanted to engage with our staff, I decided to initially discuss with the partners and management team (include business manager, practice manager, clinical manager, clinical pharmacist) to understand how the team felt and to see if this was a good initiative to take forward at Hillview. Partners identified the importance of behavioural change in our staff and patients to achieve this goal. When I received the positive encouragement and support, I gave a pictorial presentation of why Hillview should “Go Greener” in the staff meeting. I feel the following two facts made a huge difference in understanding the importance of carbon footprint reduction among my clinical and non- clinical team; the carbon footprint of metered dose inhalers and the huge carbon footprint of pharmaceuticals in primary care.
Staff were shocked to learn the most commonly used inhaler in UK, Ventolin Evohaler, has a carbon footprint of 28Kg per inhaler – the same carbon footprint as the tailpipe green house gas emissions of driving 175miles (or from London to Sheffield) in a small car. The NHS is responsible for about 5% of UK’s carbon footprint equivalent to all the planes taking off from Heathrow in an average year. I felt the staff could relate to this information and understood the concept healthy people and healthy planet. Staying healthy to protect our planet was welcomed and identified as a must among all staff at Hillview.
The team also found a quiz, to list the carbon footprint in GP from highest to lowest (Prescribing, Travel, Energy, Waste) fascinating. This prompted interesting, productive, open wider discussions among the clinical and non-clinical team – review of each of our daily activities contributing towards carbon footprint and how it is easy to make small changes towards contributing to net zero carbon footprint.
What I found encouraging was that the team took to the initiative like a duck to water. The main thing that I had to do was to set achievable goals by involving the staff, and give directions as how to achieve them in the set time frame. This strategy worked in our practice, as the majority of our staff had ideas but did not know how or where to start. Our message was clear in that we can achieve a lot by working together compared to doing things individually. In addition, this initiative was welcomed by staff as it is much more fun working as a team!
By having “Going Greener” as a recurring item initially in our clinical meetings and regularly in our staff meetings, I felt we constantly reminded our staff of our goals and achievements. Weekly “Heads Up For a Head Start” emails by our Business Manager further added value to our discussions. We also frequently thanked everyone for contributing towards reducing our carbon footprint. This certainly encouraged and energised our staff to openly discuss or even listen to ideas that we could implement.
The topic of discussions (PowerPoint presentation) included WHO aims to achieve net zero carbon footprint by 2050, BMA’s sustainability and environmentally friendly general practice report which has a specific emphasis on GP, NHSE ambition to reach net zero by 2045 – each and every individual has the responsibility towards helping to reduce carbon footprint, otherwise there will be a health emergency more than the climate emergency.
In one of our talks, I talked about how Prince William and Sir David Attenborough joined forces and introduced the initiative Earthshot prize demonstrating the seriousness of the climate emergency. I felt these bite size talks lasting 5-10 minutes during our staff meetings helped the whole team to realise that each and every individual has a part to play (however small) towards carbon footprint reduction to make a difference.
Each member of our staff was requested to look at their work and see if they could come out with suggestions that would help towards our goal. We reminded all that some of the recommendations might take longer to achieve (eg: changing all lights to eco-friendly lightbulbs) than others but at least we are making small changes. Bearing in mind how some of our staff might not be forthcoming in a group, I requested my team to either email or verbally inform me of any ideas that they feel we could implement. Introduction of “Climate Champions” in each team helped facilitate discussions and take any practical ideas forward.
In addition to contributing towards net carbon zero, this initiative has certainly brought the whole team, clinical and administrative staff, working together as “One Hillview Team”. The ultimate objective is to engage in every opportunity we can with our patients, and with the support of our PPG group, we hope to contribute towards reduction in our carbon footprint at Hillview Surgery.