Foundations of general practice standard

F3 – Environmental sustainability and responsibility


      1. F3 – Environmental sustainability and responsibility

F3 | Environmental sustainability and responsibility


Consumer expectation statement: I expect that this practice is aware of its environmental impact and is focused on minimising this.

F3.A The practice is aware of and takes steps to address/improve its climate resilience.

The practice:

  • identifies climate-related risks to its operations
  • implements strategies to improve climate resilience.

F3.B The practice is aware of and takes steps to minimise its environmental impact.

The practice:

  • documents strategies aimed at improving its environmental impact and to reduce direct and indirect carbon greenhouse gas emissions.

F3.C The practice has at least one member of the practice team who has primary responsibility for environmental sustainability in the practice.

The practice:

  • has at least one member of the practice team who has primary responsibility for engaging in and promoting the environmental sustainability of the practice.


Climate change is a significant public health issue that poses risks to healthcare infrastructure and service provision(19, 20). Environmentally sustainable measures in a practice can:

  • safeguard public health
  • improve patient wellbeing and satisfaction
  • uphold ethical responsibilities
  • reduce operational costs
  • protect the long-term viability of a practice. 

Climate resilience is increasingly critical for general practices, as extreme weather events such as heatwaves, bushfires, floods and storms can disrupt service delivery, threaten patient safety, and disproportionately impact vulnerable populations.

Embedding sustainability and personal agency into practice activities, and clearly communicating sustainability and climate resilience principles, helps foster a workplace culture of sustainability.

Integrating climate resilience into practice operations also aligns with broader public health goals and strengthens the role of general practice in climate adaptation at a community-level.


Table 2 contains suggested actions that general practices could take to improve climate resilience in key operational areas. These actions support practices in meeting environmental sustainability criteria, as well as F2 – Response planning, by helping practices anticipate, prepare for, and adapt to climate-related disruptions such as extreme weather events, infrastructure failures, and supply chain interruptions. The table includes practical, non-clinical measures that could be embedded into business continuity planning to safeguard service delivery and protect patient and staff wellbeing. It also supports practices in meeting Criterion CG4.C, which relates to supporting members of the clinical team to adopt clinical practices that are environmentally sustainable and climate-resilient.


The practice could periodically review and test its climate resilience strategies so they remain effective and relevant. This could include simulated drills for extreme weather events, audits of infrastructure readiness (such as backup power and ventilation), and updates to operational plans based on emerging or changing climate risks. Regular testing helps identify gaps and supports continuous improvement in the safeguarding of service delivery during climate-related disruptions.

Table 2 Key actions to improve climate resilience

Climate resilience component

Possible actions

Emergency preparedness
  • Assess the climate risks in the practice’s location (eg temperature extremes, flooding, cyclones, bushfires, infectious diseases).
  • Integrate climate risks (for example, bushfires, floods, heatwaves) into response plans. See F2 – Response planning.
  • Develop mechanisms to maintain continuity of care during climate emergencies (eg telehealth readiness, offsite backups).
Infrastructure
  • Assess HVAC systems for heat resilience.
  • Install backup power sources for continuity during climate events.
  • Improve insulation and ventilation to reduce energy use and maintain safe indoor conditions.
Operational systems
  • Conduct climate risk assessments as part of strategic planning.
  • Document strategies to reduce climate-related health risks to patients (for example, heatwave alerts, monitoring of air quality).
Patient care and engagement
  • Identify patient groups particularly vulnerable to the health impacts of climate change (including Aboriginal and Torres Strait Islander people, people of certain culturally and linguistically diverse backgrounds, people with chronic conditions, older people, infants and children, and people experiencing homelessness or living in poor housing).
  • Inform patients about climate-related health risks and protective behaviours.
Staff training
  • Educate the team about climate-related health impacts and response strategies.
Collaboration
  • Engage with PHNs, local councils, and emergency services about climate adaptation.


The practice needs to:

  • identify the potential impact that the practice has on the environment
  • identify what the practice can do to reduce any negative impacts it has on the environment.

The practice team could support existing sustainability measures and actively contribute to reducing the practice’s environmental footprint. Change is more likely to occur when the whole practice is involved, and the required actions are understood and easily implemented.

General energy use makes up the largest component of the non-clinical carbon footprint of general practice. There are many ways the practice might avoid unnecessary energy use and increase efficiency, and these actions might also save the practice money.

When considering the practice’s policy outlining measures to address its environmental impact, some key areas of focus and examples of practical measures to address environmental impact are included in Tables 3 and 4 below. These examples are provided as suggestions for ways the practice could meet criterion F3.B. They have been adapted from the RACGP’s Greening up: Environmental sustainability in general practice, which can be referred to for further detail.

Table 3 contains suggestions that focus on behavioural, operational, and team-based actions that do not require the practice to own the building/s in which they operate, but which any general practice could undertake.

Table 4 contains suggestions relevant to owner-occupied practices and practices with significant control over their premises. These include actions related to building upgrades, energy sourcing, and water systems, which may not be feasible for tenants without their landlord’s cooperation.

Table 3 Key non-clinical actions to improve environmentally sustainability of the general practice

Sustainability component

Possible actions

Auditing for sustainability
  • Undertake a strategic-level review of the impact of environmental issues, the sustainability of service provision, and the possible mitigation of negative environmental impacts,
  • Conduct an energy audit to establish baseline consumption, and identify high-use areas (for example, heating, cooling, lighting). 
  • Apply the approach known as the energy hierarchy (shown below), which prioritizes actions that will reduce the environmental impact:
    1. reduce unnecessary use
    2. improve efficiency
    3. switch to renewables.
  • Use environmental-impact metrics to assess and manage overall environmental footprint (see aspirational criterion CQI1.C for further guidance).
Workplace culture
  • Promote effective leadership in relation to sustainability and encourage behavioural change by appointing ‘climate champions’ or a ‘green team’.
  • Educate and support consumers using digital posters that alert them to the effects of climate change on physical and mental health.
Energy: Heating, ventilation and cooling (HVAC)
  • Adjust the practice’s thermostat for each season, aiming to meet the recommended heating, ventilation, and air conditioning (HVAC) settings for maintaining acceptable comfort conditions with reasonable energy efficiency (for winter 20–22°C and for summer 24–26°C).
  • Consider the best times to turn on HVAC systems so that appropriate temperatures (based on the season) are reached when employees and consumers arrive and leave the premises.
Energy: Appliances and lighting
  • Review the energy rating of all appliances, and prioritise energy efficiency when purchasing appliances.
  • Install timers or motion sensors for lighting and other power outlets (such as instant hot water in the kitchen), where it is possible and safe to do so.
  • Turn off computers and screens when not in use, and turn off standby power at the end of each day by turning off all appliances at the wall or power board.
  • Embed energy-saving processes either manually through work protocols or via building management systems.
  • Change globes to LEDs, as they consume up to 75% less energy than halogen globes).
Travel
  • Encourage members of the practice team and consumers (when appropriate) to use methods of transport other than cars, such as walking, public transport and cycling.
  • Encourage cycling by providing bike racks and change facilities.
  • Provide consumers with public transport options, routes and timetables.
  • Ask members of the practice team to consider alternative or active transport and to explore car-pooling.
  • Be a role model by using alternative or active transport.
  • Have a dedicated ‘green team’ to promote active and alternative transport.
  • Lobby local governments to provide electric vehicle charging stations.
Professional services
  • Audit business services in order to identify high-carbon providers.
  • Choose good and services (for example, phones, computers, IT support, finance, accountancy, payroll, insurance) with a smaller environmental footprint.
  • Include sustainability criteria in procurement documents, and engage suppliers after considering their carbon reduction plans.
Minimise e-waste
  • Avoid purchasing new electronic products that can’t be reused or recycled.
  • Reduce the consumption of electronic devices by repairing broken equipment before purchasing new items.
  • Re-use electronic devices by donating items to charity, friends or family.
  • Discard e‑waste responsibly, (for example, engage a recycling company to collect various types of e‑waste for recycling, drop off e‑waste at organisations that offer recycling free of charge).
  • Develop an e‑waste recycling policy using the RACGP template.
Reducing paper use
  • Move to e-prescribing, where practical.
  • Use recycled paper.
  • Reduce junk mail by putting a ‘No junk mail’ sticker on the practice’s mailbox.
  • Replace printed material with digital alternatives.
  • Subscribe to online editions of journals rather than ordering printed copies.
  • Discourage laminating materials.
Carbon offsets
  • After reducing all possible emissions, consider purchasing carbon offsets to achieve net-zero emissions. Many companies offer carbon offsets with a range of validation and verification standards.
Water efficiency
  • Use products (such as dishwashers and fridges) with a high water-efficiency rating.
  • Only run the dishwasher when it is full.
Recycling
  • Place recycling bins, including for food waste, either in each room or in a common area.
  • Make sure recycling bins aren’t contaminated with non-recyclable waste, perhaps by displaying informational posters from local council.
  • Use recycled products (for example, paper, toilet tissue and toner cartridges) as much as possible.
  • Do not fill medical waste bins with materials that could be recycled or disposed of in regular waste, as disposing of medical waste is costly and resource-intensive.
  • Identify other items that can be recycled (for example, batteries, light globes and soft plastics), and set up easy collection methods.
Waste management
  • Reduce use of single-use items wherever possible (eg minimise use of gloves where not clinically indicated; procure sterile packs that don’t contain items the practice rarely uses).
  • When using single-use items, reduce the use of plastic products where possible (consider more eco-friendly options).
  • Reuse cleanable items where safe and appropriate, including non-invasive devices and equipment.
  • Recycle appropriately by segregating waste streams and centralising recycling stations.
  • Responsible disposal includes:
    • disposing of hazardous waste correctly
    • using recycling services for specific materials. This could include using recycling companies that specialise in processing materials like electronics, textiles, and metals.
  • Implement a workplace recycling policy, establishing guidelines for recycling using templates from local environmental agencies.
  • Conduct regular waste audits to identify avoidable waste and improve segregation practices.
  • Inform members of the practice team about initiatives, activities, or organised efforts on waste management and sustainability.
Waste management is also addressed by criterion CG9 – Infection prevention and control, including reprocessing, which requires practices to maintain an up-to-date practice-specific infection control policy that addresses waste management.
Business planning
  • Embed sustainability in business planning and incorporate sustainability goals in financial objectives.
  • Perform an audit of energy use and carbon emissions to set a benchmark, then establish a framework aimed at reducing emissions based on data. Use a free online carbon-footprint calculator. Professional audits can be expensive and are unlikely to be cost-effective for smaller practices.
  • Include sustainability as a standing item at practice meetings.
Disaster management
  • Prepare for potential disasters by assessing and planning for threats related to climate change, such as extreme heat, flooding and bushfires. The RACGP has resources and guides to help practices manage, prevent, prepare for, respond to and recover from emergencies and pandemics.



Table 4 Key non-clinical actions for an environmentally sustainable general practice – Owner-occupied practices

Sustainability component

Possible actions

Energy: Heating, ventilation and cooling (HVAC)
  • Regularly clean and maintain the HVAC for maximum efficiency, (for example,  regularly clean filters).
  • Consider ways of reducing demand of HVAC, including:
    • improved building insulation
    • high-performance window glazing
    • natural ventilation
    • external window shading
    • appropriate window coverings.
  • Consider an upgrade if the HVAC system is more than 10 years old.
  • Plan for long-term upgrades such as insulation, air source heat pumps, and solar PV (photovoltaic).
Energy: Sourcing renewables
  • Consider changing the practice’s energy source to 100% renewables (or as much as possible if the cost is prohibitive). Find green-energy providers on the GreenPower website.
  • Consider converting from gas to electricity.
  • If the practice owns its premises, consider installing rooftop solar.
Water efficiency
  • If the practice has a garden, plant sustainable and drought‑resistant plants.
  • Install rainwater tanks or grey‑water systems.
  • Install low-water-use toilets.
  • Promptly repair water leaks.


The practice team could support existing sustainability measures and actively contribute to reducing the practice’s environmental footprint. Change is more likely to occur when the whole practice is involved, and the required actions are understood and easily implemented.

Having a designated member of the practice team with primary responsibility for environmental sustainability supports coordination, engagement and promotion of sustainability initiatives within the practice.


 
 

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