General Practice and Primary Care
The Gateway to UK Healthcare
How Is Climate Change Affecting General Practice?
The workload in primary care is already increasing due to different aspects of climate change.
Extreme weather events such as flooding cause physical injuries which can lead to acute and chronic problems presenting to primary care, as well as the mental health impacts.
People’s mental health is affected by heatwaves, increasing rates of suicidal ideation and psychosis. Our most vulnerable populations are most at risk of dehydration such as the elderly and young babies.
Increases in air pollution with climate change lead to impacts on all body systems, with the highest impact on cardiovascular diseases.
In addition, the primary care estate is often not equipped to deal with heatwaves or flooding, due to the often old buildings with lack of funding for upgrades. This puts working conditions for primary care staff at risk, as well as our vital medical supplies and equipment.
The UK Health Security Agency (UKHSA) released a report in 2023 further highlighting the risks to health from climate change.
How is Primary Care Affecting Climate Change?
We see 90% of NHS contacts in primary care. Our carbon footprint makes up 23% of total NHS carbon emissions. Around 60% of this comes from the clinical aspects such as prescribing, from medicines and metered dose inhalers. The rest comes from the non-clinical aspects such as our building energy and patient and staff travel.
Metered dose inhalers (MDIs) have been in the spotlight as the propellant contains a greenhouse gas (HFC) which has a high global warming potential. Evidence shows that most of these inhalers are prescribed to those overusing salbutamol inhalers. We have some of the worst asthma outcomes in Europe, and many European countries use much more of the Dry Powder Inhalers which are generally more intuitive to use.
We could reduce our carbon footprint by reducing overprescribing and overdiagnosis, as well as improving our patients asthma control.
Discussion Ideas with Patients and Colleagues
Patients:
“How would you feel about changing your diet to reduce animal products such as meat and dairy and moving to an increasingly plant based diet in order to reduce your cholesterol?"
"How do you feel about changing your inhalers to ones that are better for the environment but have the same effect on you?"
Colleagues
"How can we make our surgery become more environmentally sustainable?"
"Are there any ways we could better support nature in our outdoor spaces?"
Plant-Based Health Professionals has created multiple evidence summaries of the benefits of plant-based diets for different chronic conditions and how to support patients to transition to a more plant based diet. Click below for more information and discussion ideas
Highest impact actions for General Practice
Non-Clinical
- Move the practice finances to an ethical bank account
- Invest in renewable energy infrastructure such as insulation and solar panels, and consider switching to a renewable energy supplier.
- Encourage a plant-based diet in the workplace
Clinical
- Encourage patients to switch to dry powder inhalers over MDIs
- Encourage patients to adopt a more plant-based diet
- Complete audits and QIPs to reduce overprescribing
The Royal College of GPs has developed a Toolkit to help practices to reduce their environmental impact. Click below for more information.
For More Information
Greener Practice is a network of people encouraging action on sustainability in primary care by providing information, convening groups to share learning and speaking up on the national stage.