Sustainability and Quality Improvement
The current climate crisis is one of the greatest challenges of the 21st century. It is a global emergency. Changes associated with climate change are already having significant impacts on human health. And extreme weather events are threatening health service delivery.
Climate Change: Health & Social Care
Health and care services are part of the problem. The way we currently deliver our services is a significant contributor to climate change and carbon emissions. A 2018 report by the Sustainable Development Unit highlights the largest contributors to CO2 emissions from services across health and social care and the opportunities to reduce the carbon footprint.
We must adapt our practices to reduce our negative impacts on the planet. Towards net zero healthcare | The BMJ examines how to reduce use of health services and improve healthcare efficiency.
Sustainability should be part of our thinking in all our improvement projects. This is the case even when the improvement is not immediately identifiable as climate change or carbon emissions.
A National Priority
Scottish Government has set out plans through the NHS Scotland emergency and sustainability strategy 2022 – 2026 for the NHS to reduce its greenhouse gas emissions and impact on the environment, working towards net-zero emissions by 2040. The strategy sets out five priority areas for NHS Scotland:
Sustainable Buildings & Land
Sustainable Travel
Sustainable Goods & Services
Sustainable Care
Sustainable Communities
Everyone is responsible for suggesting or making changes to their area of practice. The Sustainable Care workstream outlines national priority initiatives in response to the NHS Scotland strategy. This includes activities related to:
Medical Gases
Respiratory Care
Green Theatres
Sustainable Prescribing
Click here to find out more information and the project lead for each of these initiatives
Quality Improvement Journey and Sustainability
Quality improvement methodology can support efforts to reduce the environmental impact of services and improve sustainable value of care, with the Quality Improvement Journey providing the framework to support any improvement initiative or project. Find out more on the Using the Quality Improvement Journey for Sustainability page.
Sustainability as a domain of quality
Quality, defined by the Royal College of Physicians, has 7 domains including sustainability and is applicable to care settings and public services.
With a focus on sustainability there is also an opportunity consider the sustainable value of the service alongside outcomes for service users and the wider population, also known as the triple bottom line: environmental, social and financial impacts.
Adapted from SusQI resources based on publication by Royal College of Physicians, 20211: Defining the RCP’s approach to quality | RCP London (accessed Nov 2022)
Useful External Links to Resources and Strategies
This document sets out plans for NHS Scotland to reduce its greenhouse gas emissions and impact on the environment, adapt to climate change and to better contribute to the United Nation sustainable development goals. It has been developed by the Scottish Government and NHS Scotland Assure.
A web-based resource promoting sustainability as a priority within NHSScotland and offering support for anyone working on a sustainability-related topic.
This document includes an appendix of greenhouse gas emission factors for a range of supplies (medical and non-medical), modes of travel and resources associated with the delivery of health care. Theses can be used to estimate the carbon footprint (carbon dioxide equivalents – CO2e) of specific care-related services and activities and any associated changes through improvement activity.
Since 2008 the Centre for Sustainable Healthcare has engaged healthcare professionals, patients and the wider community to understand the connections between health and environment and reduce healthcare’s resource footprint. work is guided by the principles of sustainable clinical practice:
Prevention
Patient empowerment and selfcare
Lean systems
Low carbon alternatives
SusQI is an approach to improving healthcare in a holistic way, by assessing quality and value through the lens of a “triple bottom line”. In SusQI, the health outcomes of a service are measured against its environmental, social and economic costs and impacts to determine its “sustainable value”.
This SIG brings together people who are passionate about sustainability and interested in improving the sustainable value of the NHS and also a forum to discuss the challenges and opportunities for improving sustainability within healthcare. You do not need to be a Q member to join this group.
Reducing Healthcare Carbon Emissions: A primer on measures and actions for Healthcare Organizations to Mitigate Climate Change (AHRQ September 2022)
Supported by the Carbon Literacy Project, these toolkits have been developed to maximise the ease and speed of adoption of Carbon Literacy and can be filtered by sector.
Using carbon footprint data, calculate the carbon footprint by examining the different elements of your pathway