Climate change is a health emergency and an existential threat to us all, with more than 13 million deaths around the world each year due to avoidable environmental causes (World Health Organisation, 2022).
The links between health and climate change are well established, with climate change exacerbating food insecurity, health impacts from extreme heat, the risk of infectious disease outbreaks and life-threatening extreme weather events (Romanello et al, 2022). Climate change also widens health inequalities by most affecting those already vulnerable to ill health.
“As nurses and midwives we have a key role to play in tackling climate change”
Global healthcare, if it were its own country, would be the fifth largest emitter of green house gases on the planet (Health Care Without Harm, 2019). The NHS in England was the world’s first health system to commit to reaching net-zero carbon and to embed this in legislation through the Health and Care Act 2022.
As nurses and midwives we have a key role to play in tackling climate change. In many ways, it is already at the core of how we practice and aligns with our duties enshrined in the Nursing and Midwifery Council Code to protect patients, preserve safety and act without delay if there is a risk to patient safety or public protection. We are the most trusted professions, work with individuals across their lifespan and have incredible reach. We also understand and witness the public health impact of climate change on the communities we serve.
Nurses and midwives across the country are already leading and contributing towards a more sustainable NHS. One trust has even piloted a role where a registered nurse or midwife combines their clinical role with protected time for sustainable quality improvement projects, relevant to their services and aligned with the Greener NHS programme.
Local green plans focus on reducing their onsite and indirect carbon emissions as described in the ‘Delivering a Net Zero NHS’ Plan (NHS England, 2020). Alongside elements such as energy consumption and estates, significant work has taken place in lower carbon clinical pathways. We are exploring whether a hybrid role could enable further development of clinical sustainability and carbon reducing practice within clinical services, giving long-term health benefits for service users and aligning with international and national priorities aimed at supporting nurse and midwife retention and career progression.
What can be achieved in this type of role? Rhea Conn, intensive care nurse at Sandwell and West Birmingham NHS Trust, shows how one person with ideas and dedicated time can really make a difference. Rhea’s department and trust supported her to pilot a role which includes the whole time equivalent of 0.2 protected time for sustainability. With the help of bespoke support and coaching from NHS England, in a short time Rhea improved the sustainability of different domains, achieving both departmental cost and carbon savings. She also enhanced her leadership skills and her sense of wellbeing at work, as well as inspiring and connecting others locally to take forward the green agenda.
For example, one measure she introduced was changing to a UK-supplied shower gel where the company takes back the empty containers and refills them. This will save the department around 125kg of carbon emissions a year and halves the cost per wash. It also lessens the impact on the oceans by replacing a product shipped from China. This might seem like a small change, but imagine changes like this scaled-up across the whole health service.
We recognise the contribution nurses and midwives can make to the sustainability agenda through leadership, innovation and a commitment to increasing sustainable practices for the benefit of patients, colleagues and society. Rhea’s role is an example of how trusts can take forward sustainability issues and benefit from the opportunities around sustainable nursing and midwifery.
Emma Pascale Blakey is clinical lead for sustainability, nursing directorate, NHS England. Rhea Conn is senior sister and clinical sustainability lead, critical care services, Sandwell and West Birmingham NHS Trust
Health Care Without Harm (2019) Health Care’s Climate Footprint: How the Health Sector contributes to the Global Climate Crisis and Opportunities for Action. Health Care Without Harm.
NHS England (2020) Delivering a ‘Net Zero’ National Health Service. NHSE.
Romanello M et al (2022) The 2022 report of the Lancet countdown on health and climate change: health at the mercy of fossil fuels. The Lancet; 400: 10363, 1619-1654.
World Health Organization (2022) World health day 2022. Who.int (accessed 18 July 2023).