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Relevance to Primary Care

The climate crisis is a public health emergency. Globally, the healthcare sector is responsible for approximately 4-5% of greenhouse gas emissions and is therefore contributing towards the problem. If the healthcare sector was a country, it would be the fifth largest emitter of greenhouse gases.

According to the NHS Wales Decarbonisation Strategic Delivery Plan 2021-2030, the NHS Wales 2018/19 Carbon Footprint has been calculated as approximately 1 million tonnes of CO2e, which represents around 2.6% of Wales’s total greenhouse gas emissions.

The health risks associated with climate change are clear and  healthcare professionals and providers have a significant role to play in taking the necessary action to reduce their contribution to climate change in all its various forms.

In order to tackle the effects of climate change we propose that the actions require a three prong approach:

  • Individual responsibility
  • Professional responsibility
  • Organisational responsibility

Mitigation efforts will not only result in reductions in emissions, but can often lead to enhanced patient care, staff satisfaction, and cost savings. These benefits occur in part by preventing the initial health impacts of climate change, while also improving wellbeing through health co-benefits, such as cleaner air, increased physical activity, and more nutritious diets. Importantly, these co-benefits can help to offset part of the costs of mitigation interventions.

Over three quarters of residents in Wales believe that climate change will damage mental health. Other major concerns of climate change include reduced access to health and care services, increased spread of infectious diseases, and greater levels of physical illness.

Climate Change and Health in Wales: Views from the public (2022)

The impact of primary care on the climate

Primary care professionals and services can contribute to tackling the climate emergency through their own actions and influencing the actions of others such as their staff and patients. Actions tends to fall into either clinical actions or non-clinical actions.

Most of the non-clinical carbon footprint of primary care comes from patient and staff travel, followed by energy use and the procurement of services.

However, there are a multitude of opportunities for professionals, services and providers to act during clinical interventions (actions). For example, by:

  • Preventing ill-health and promoting healthy behaviours (e.g. reducing health inequalities, sustainable diets, active travel, social prescribing and MECC)
  • Reducing harm and waste (e.g. reducing over diagnosis, avoiding harmful polypharmacy, and minimising non-clinical waste)
  • Empowering patients and increasing their self-management (e.g. sharing decision making through co-production and delivering person-centred care)
  • Prescribing lower carbon medicines (e.g. using dry powder (DPI) or soft-mist inhalers (SMI) rather than metered dose inhalers (MDI) where appropriate)
  • Providing optimal care whilst avoiding unnecessary patient and staff travel

The impact of climate change on healthcare and primary care

If we do not act then climate change threatens to disrupt the ability of health systems to deliver high-quality care and undermine the gains made in public health.

Climate change will lead to:

  • more intense heatwaves
  • higher risks of flooding and damaging storms
  • a changing pattern of emerging infectious diseases
  • increased air pollution
  • food safety risks

Some of these consequences will directly impact healthcare services e.g. flooding disrupting access to and functioning of community practices, whereas other consequences will be indirect e.g. increasing air pollution will cause more frequent exacerbations from respiratory conditions which will therefore lead to increased presentations to primary, and potentially secondary care, for management.