80% of the carbon footprint of the NHS is attributable to clinical decisions. Although adjusting clinical practice presents a significant opportunity to decrease carbon emissions, it's not that simple. Several factors come into play, such as supply procurement, availability of environmentally friendly alternatives, accuracy of environmental data, and most importantly, patient safety.
It is an overwhelmingly difficult task for one individual, and it's easy to overlook the long-term impact of a single decision on the environment. It’s understandable. Who is willing to water the seeds in the scorching sun with no guarantee of seeing the results of their efforts? Who wants to be responsible for planting the tree whose shade they may never sit in?
Everyone should bear this responsibility. Achieving net-zero goals will require a collective effort from all stakeholders, including procurement and pharmaceutical companies, management, clinicians, all the way down to individual patients. Each person has a role to play in creating a more sustainable future, and we must all be held accountable for our choices.
Are we heading in the right direction?
It's great to see that healthcare innovations are becoming more environmentally sustainable. However, for these innovations to have a lasting impact, they must be sustainable for all parties involved. If an innovation doesn't work for healthcare providers, they will revert to old unsustainable practices, and if it doesn’t work for the patient, it can lead to patients having to return for additional visits. Achieving sustainable healthcare for all requires everyone’s involvement.
And with this, clinician-centric innovations have emerged, as well as Patient and Public Involvement and Engagement (PPIE), which focuses on including patients in decision-making and shaping healthcare services.
Yet, while PPIE committees are increasingly prevalent within the design of healthcare innovations, current methods of PPIE are often ineffective and insufficient. Public involvement should be more than just a token gesture, it should be integrated into every stage of the innovation process as healthcare innovators can gain a wealth of valuable insights.
Patients have to be part of the conversation
At Open Medical, every member of the PPIE committee is actively involved in decision making; they are key stakeholders. They propose ideas that are taken into account, provide feedback that shape the projects, and are given appropriate training and educational tools.
For example, Paul Downes, a member of the PPIE steering committee at Open Medical and a survivor of malignant melanoma, is playing a vital role in an innovative project aiming to leverage cutting-edge technology to improve access to specialist care for patients suspected of having skin cancer. With his unique experience and perspective, Paul is ensuring the patients and public's needs are fully represented within the project's designs.
Involving the public and patients can bring a fresh perspective that may have been missed otherwise. Let’s say the innovation requires a digital questionnaire. It's essential to include everyone, and this can be a challenging task. For example, is there an audio option available for those who are visually impaired? If not, patients have to call and as Paul put it, you can end up “sitting on the end of the phone, waiting for half an hour trying to get through to someone, then trying to explain to them, then them not really getting the full picture, and when [you] do see the doctor they haven’t got a clue what’s going on.” And this then impacts the clinicians’ efficiency.
Help clinicians help patients
Efficient and inclusive processes are vital for patients to help make clinicians more effective, and the reverse is also true; sustainable processes for clinicians are essential for sustainable healthcare delivery for patients.
Paul and Karien Downes are part of Open Medical’s PPIE committee and are retired healthcare professionals with patient experience. They harbour invaluable life experiences and as a former dentist and a theatre nurse, respectively, they have first-hand experience with the intricacies involved in delivering sustainable healthcare for everyone.
Paul stresses the importance of creating a "win/win" scenario, where healthcare providers are supported with more streamlined processes to, in turn, benefit patients through improved access, efficiency, communication, and health outcomes.
Paul notes that when clinicians are overburdened, "it gets in the way of treating patients. [...] If you're working hard because you're helping patients, then that's different from working hard and being stressed due to the increasing burden of NHS red-tape and compliance. Clinicians and nurses should be able to refocus their clinical time on caring for their patients." It exacerbates the strain on healthcare providers and is pushing them to their limits, with many retiring early like Paul.
Karien elaborates that when clinicians are overworked, it ultimately impacts patient care. “Slowly but surely, lots and lots more paperwork comes in, and the paperwork sometimes takes you longer to fill in than to do the actual operation.” She stresses that this complicated and time-consuming paperwork adds further complexities, making it impossible to perform procedures any faster.
Sustainability is a multifaceted issue that requires everyone to be involved and accountable. Creating a sustainable healthcare system is not the sole responsibility of patients and clinicians; it requires a collective effort from suppliers to government bodies. The development of innovative solutions that cater to the needs of all stakeholders must be prioritised. This requires a collaborative approach that encourages knowledge-sharing, best practices, and mindset shifts towards sustainability to make better informed choices. Every individual action counts towards achieving a regenerative and sustainable healthcare system.