In recent weeks, members of the global environmental group Extinction Rebellion have stolen the headlines with their efforts to raise awareness about the irreversible damages that are being done to the planet. Traffic has been paralysed, buildings have been drenched with fake blood, and one protester even made it to the top of Big Ben, all in the name of the climate crisis.
Banging the same drum about the importance of taking immediate action to improve the health of the planet is Sheffield GP Dr Aarti Bansal, chair of the Greener Practice grassroots movement. She is speaking about the initiative at the RCGP annual conference in Liverpool this week and she wants delegates to understand how much GPs can do to help tackle climate change.
Greener Practice was founded in 2017 with the aim of developing and supporting win-win initiatives that help the GP community in South Yorkshire engage in greener practice. Dr Bansal has previously been involved with other environmental groups, but she jumped at the chance to lead the conversation among fellow GPs in the area following a conversation with RCGP South Yorkshire North Trent Faculty provost Dr Amar Rughani.
Engaging the GP community
The purpose of the Greener Practice movement, Dr Bansal says, is to ‘energise’ the local GP community around climate change by raising awareness and making it easy for colleagues to get involved with tackling these issues, both as individuals and on a practice level.
The group now regularly attracts between 15 and 20 GPs, who meet each month to discuss and pitch ideas. But she admits that it is not always been plain sailing, with plans to provide all GP practices in the area with cheap, renewable electricity just one idea that ran aground.
One area where the group has, however, enjoyed success has been in local medical education. Greener Practice has been involved with helping to develop initiatives in the medical school curriculum to enable the next generation of doctors to adopt a greener approach in medicine, such as the Green Impact for Health Scheme.
Established by the RCGP and the National Union of Students, the web-based scheme is designed to improve the environmental performance of general practice while saving money and ensuring that GP practices operate in a way that benefits society.
It guides GPs through a set of pro-sustainability actions, each of which earn points towards an overall award. This includes encouraging them to refer to social prescribing, facilitates the use of the GSK Inhaler Recycling Scheme and reduce office waste.
Steps practices can take
‘Some of these actions are really simple actions to take, they might involve energy and recycling, but a lot of them are health-based - for instance social prescribing,' says Dr Bansal. ‘Sometimes people think they have to do all or nothing, which they don't. They can just do some of it, but if you think of the number of GPs across the nation that's a lot of people.
The Greener Practice movement has also established an award in the local RCGP faculty, which celebrates the creative ideas of practices looking to go greener. Meanwhile, the RCGP has also accepted its motion to declare a climate emergency and commit to taking action.
With high levels of GP burnout and heavy workloads, some may argue that there are other issues besides the environment that deserve the immediate attention of the profession. Others may say that tackling environmental issues is beyond the remit of family doctors.
Dr Bansal strongly disagrees. She says that climate change is a health issue and that GPs are well placed to be influential figures in efforts to promote greener living, which should start with their own practice.
‘Caring about climate change and caring about what is our core job as GPs is effectively the same thing. It's core to our professional identity that we support people's health and wellbeing and acting on climate change is absolutely about supporting this,' she says.
‘As well as the direct impacts of increased temperature and extreme weather, there are indirect impacts, such as forced migration and there will be changes in vector borne diseases. The actions that we take to mitigate climate change are the very same ones that we would take to promote public health.
'We know the benefits of clean air, exercise and healthy diets for our patients, and promoting active travel, where you walk or bike to work, and a sustainable diet, low in meat and high in vegetables, will also reduce air pollution and reduce greenhouse gas emissions.'
Working in greener ways, such as making use of social prescribing services and getting involved in de-prescribing initiatives, can also benefit practices, Dr Bansal says – something she believes isn’t spoken about enough.
‘There are many benefits. For example, it could help to reduce GP workload because it will improve the health of patients now and in the future. But it could also be a route to increasing efficiency and reducing costs. So it's financially sensible to be acting against climate change.'
Above all, she says it is important that doctors use their status within their communities to help improve the health of the planet.
‘It's not really climate change we are talking about anymore, it's climate emergency, climate crisis - we've probably only got a decade to really cut down on our emissions. If we get involved in this conversation, if we can frame this as the health issue that it is, then we have a real opportunity to normalise this conversation and to shift it into being something that everybody sees as important.’