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  • Climate change: why it needs to be on every Trust's agenda

    Angela Hayes


    The NHS has declared climate change a health emergency, but are trust leaders and healthcare staff talking and acting on this? Angela Hayes, Clinical Lead Sustainability at the Christie Foundation Trust, discusses climate change and the impact it has on all of our lives and health. She believes healthcare professionals have a moral duty to act, to protect and improve public health, and should demand stronger action in tackling climate change.


    Climate change: a health emergency

    The NHS has a huge carbon footprint, producing around 25 million tonnes of carbon a year – equivalent to all the emissions from Sri Lanka! Carbon dioxide emissions attributable to the NHS in England are greater than the annual emissions of all the aircraft leaving Heathrow, and if healthcare was a country, it would be the fifth largest polluter! The NHS declared climate change, ‘a health emergency’ – it undermines the foundations of good health, deepens health inequalities and threatens to undermine the gains made in public health over the last 50 years. As trusted messengers, healthcare professionals have a moral duty to act, to protect and improve public health, and should be demanding stronger action to tackle the problem.

    The human cost of climate change is enormous – resulting in poor air quality, extreme weather events, scarcity of resources (safe drinking water/cultivatable land), conflict and war, displacement of people and exploitation of the most vulnerable members of society. Climate change will result in increased disease, cancers, malnutrition, mental disorders, and threatens the lives of millions. We‘re likely to experience frequent pandemics that spread more easily. Covid-19 and its impact will seem like the ‘warm-up act', dwarfed by the devasting effects of climate change.

    Those who contribute to the problem the least, are likely to be the most affected by the impact of climate change. Those whose carbon footprint is the lowest, are those who are far less resilient to its effects. Termed ‘climate injustice’ – the most susceptible groups are children, the elderly, minority groups, women, the poor and the sick.

    Global temperatures are rising. We are seeing the effects of this already. We see forest fires, floods, trees torn up by their roots and wheely bins flying round in storms! We’ve experienced unprecedented temperatures this summer. These events are happening here and now, and are literally on our doorsteps. They are almost not news worthy, they happen so often these days.  My own hospital is in an area that has flooded twice in the last 2 years. If the area is flooded, supplies can’t get in, staff can’t get in and patients can’t be treated.

    We are trying to limit global temperature increases to 1.5 degree. If temperatures rise beyond this, we can expect irreversible damage to our planet which will be catastrophic in terms of health. If we see global temperatures rise by 2–3 degrees, three-quarters of Spain will be ‘desert-like’. Ninety-nine percent of Cyprus will turn to dust. We are on course to reach a 1.5 degree warming in less than 8 years! My children will be 22 and 25 years old. Climate change will affect our own lives and is certain to have a huge impact on our children and grandchildren's health.

    The NHS has declared climate change a health emergency – but many healthcare professionals have not even talked about ‘sustainability’ in their working lives, let alone are acting in response to an emergency.

    We have a moral duty to act, to protect lives and promote social justice. We need to act as Greta Thunberg says, ‘like our house is on fire!’

    What can we do?

    There are things we can do in our home and working lives to reduce our carbon footprint. Reducing meat and dairy consumption is the most effective way an individual can reduce their carbon footprint (by up to 70%!). Eating less meat is better health wise and lighter on the pocket. Taking more exercise and not using our cars as often, is better for the environment and brings health benefits too.

    There are movements in healthcare to reduce our carbon footprint, but we could see significant improvements if healthcare professionals were aware of the problem and considered the carbon costs of their clinical decision just as much as we think about what we spend. Some of these actions are easy wins that staff probably do in their own homes but don’t even think about at work – turning off lights, computers, fans and air conditioning when not in use are all simple things we can do. When sending emails, we can consider our electronic carbon footprint, when sending large files, attachments, or even just whether ‘replying to all’ is necessary. Working on a laptop uses a third of the energy of a computer – could this switch be made?

    As prescribers we can consider alternatives with lower carbon footprints. Dry-powder combination inhalers are a great example of how to effectively reduce our carbon footprint; not only are they much kinder to the planet, but they bring about health benefits with better asthma control and, therefore, less need for healthcare services. The benefits of ‘social prescribing’ should be considered – prescribing ‘exercise regimes’ rather than more medications, which may positively influence our patient’s lives as they benefit from being generally in better shape.

    We can share these messages with our patients too – as greener ways of living are just generally better for the environment and good for our health. As healthcare professionals, we can influence not only our patients, but our friends, colleagues, managers, suppliers and politicians to act and bring about positive changes. Sustainability needs to be on the agenda – literally! We need to be acting like we’re facing an emergency.

    Initiatives at Christie's

    I got myself involved with sustainability by just asking questions about what we were doing in my Trust. Since first approaching my CEO, things have taken off massively and I’ve got involved in a number of initiatives around green projects, and I now get funding to work on sustainability each week. I’ve worked with local school children to create ‘No Idling’ signs around the Trust to improve air quality around the site and hospital nursery (I even asked a policeman to turn off his engine when idling outside the Trust!). I’ve used the hospital nursery children to create green Christmas decorations, help with 'Clean Air Day', and have even enlisted their singing talents – performing a song I wrote: A Note from Greta - starring the Christie's Nursery kids.

    We’ve now secured funding to run the Green Ward competition, which encourages sustainable ways of working in both the clinical and non-clinical areas with prize money and support provided by The Centre for Sustainable Health Care. We have plans to join the Royal College of Nursing's 'Gloves Off Campaign' to reduce the PPE wastage; we have sustainability training in place for all new staff and plan to introduce Board level training too.  I’ve lectured about climate change in and out of my hospital, we have a well-attended and passionate Sustainability Committee and have plans to include sustainability our Trust’s corporate objectives.

    I’d urge you to think and talk about sustainability and climate change in everything you do. I’d encourage you to do one green think today and start your own green journey. Who knows where it might lead you…

    We would love to hear what you and your trust are doing about sustainability and climate change. Is this something you've discussed at work? Share your good practice and ideas in the comment field below.

    Further blogs from Angela

    About the Author

    Angela is a Clinical Nurse Specialist employed within Specialist Supportive and Palliative Care at The Christie Foundation Trust in Manchester. She has a background in Intensive Care, Management and Teaching. She leads on Corneal Donation and Advanced Care Planning in her Trust.

    Angela is also a Climate Change activist – both at home and in work. She is passionate about the environment and getting the health message out to other healthcare professionals – presenting on this subject both inside and outside her hospital. Carbon Literate, and one of 4 Carbon Literacy trainers, she leads on Clinical Sustainability in her Trust.  

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