By Yasmina Hamdaoui, Pre-Operative Assessment Pharmacist at Betsi Cadwaladr University Health Board (BCUHB)
Climate change is the greatest threat to global health in the 21st Century. If the healthcare sector was a country, it would be the fifth largest emitter of greenhouses gases. With COP26 this year set to highlight the drive to reduce emissions and be more sustainable, it’s now time for the healthcare sector to collaborate and actively improve its sustainability.
That’s why we have set up a range of initiatives in Wales.
Green with envy
Drugs and pharmaceuticals account for 23 per cent of emissions in NHS Wales, according to NHS Wales Carbon Footprint report. The Green Group was founded in our hospital following a Bevan Commission Exemplar Project - it's a multi-disciplinary team open to all clinical and non-clinical staff working in healthcare. The aim of the group is to provide an effective forum to enable collaboration and cross-departmental working – we need everyone on board to reduce our emissions and become more environmentally sustainable, so collaboration is key! By connecting the right people through good engagement with all stakeholders, as well as raising awareness and providing educational resources, this then enables us to achieve the aim of transforming healthcare services to be more sustainable through various improvement projects. Having noticed lots of pockets of good work in Wales, but still seeing many examples of disconnect and fragmented work, Green Health Wales was launched in June 2021 – a national network for sustainable healthcare.
Time to Act
The Wellbeing of Future Generations (Wales) Act 2015 is a piece of legislation which mandates that all public bodies in Wales think about the long-term impact of their decisions and ensure our practices do not negatively impact tomorrow's generations. Part of this Act is considering impacts of climate change and NHS Wales as a public sector body - and therefore we as employees and part of NHS Wales - must ensure we consider this at an everyday decision-making level.
What YOU can do
The NHS Wales Decarbonisation Strategic Delivery Plan was released in March 2021 and outlines Welsh Government ambitions for a net zero public sector by 2030. There are a range of initiatives to note that can be implemented by pharmacists, including optimising our use of inhalers and anaesthetic gases. As a core part of the MDT, I'd encourage all pharmacy teams to engage with this agenda and help drive the improvement projects needed to reduce our emissions. A great place to start in secondary care is to see what work is underway with your anaesthetic colleagues - have you assessed use of desflurane and considered switching to sevoflurane? Sevoflurane has a similar clinical effect, a much lower global warming potential and switching is often a cost-saving too. Locally in Ysbyty Gwynedd Hospital, our anaesthetics team have switched to sevoflurane, saving 10,366.33Kg CO2 equivalent per month – the same as flying to New York 9.58 times! Another emerging project is the wastage of Nitrous Oxide as identified in pioneering work by pharmacist Alifia Chakera. Nitrous Oxide is a COSHH regulated medical gas, has a high global warming potential, and is also ozone-depleting. It is used much less clinically these days, but ordering practices haven’t changed and better oversight from pharmacy teams could identify over-ordering, waste and other losses to reduce harm from this medical gas. Community pharmacies also have great initiatives, including looking at delivery fleet and reducing plastics. Principles of prudent prescribing and optimising medicines use which are at the core of our profession are also essential across sectors. But we need more. I recommend pharmacy teams to join a network, such as Green Health Wales or the RPS Climate Declaration push, to connect with others, learn about green initiatives, and be inspired to undertake your own transformational projects.
How can I get involved?
Green Health Wales envisions Green Groups across the country sharing good practice, but we need you to get involved to make it happen. Collaboration and proactivity are key to reaching net zero ambitions and drive improved environmental sustainability. We will be hosting a webinar on November 11 for anyone who'd like to find out how to establish their very own green group to attend and get the tools they need.
This blog is in support of the RPS Declaration of Climate and Ecological Emergency.