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Greening up: Environmental sustainability in general practice

Key non-clinical actions for an environmentally sustainable general practice

Green component Action
Energy: 
Heating, ventilation and cooling (HVAC)
  • Adjust your thermostat for the season – changing the space temperature set point by 1°C can affect the energy consumption of associated cooling or heating equipment by around 10%.
  • Recommended HVAC settings for maintaining acceptable comfort conditions with reasonable energy efficiency; ie for winter 20–22°C and for summer 24–26°C. (18)
  • Consider optimal start and stop times to ensure appropriate temperatures are reached when employees and patients arrive and leave the practice; this will vary between seasons and should be modified accordingly.
  • Schedule regular maintenance of your HVAC to ensure maximum efficiency.
  • Consider methods for reducing demand of HVAC, including:
    • improved building insulation
    • high‑performance window glazing
    • natural ventilation
    • external window shading
    • appropriate window coverings
  • Consider an upgrade if your HVAC system is more than 10 years old – new heating and cooling systems can be 20–40% more efficient than older ones. (19)
Energy: 
Appliances and lighting
  • Review the energy rating of all appliances and prioritise energy efficiency when purchasing appliances (such as refrigerators and dishwashers) – plugged in appliances can account for a significant component of a practices energy use. (20)
  • Install timers or motion sensors for lighting and other power outlets (such as instant hot water in the kitchen), where possible and safe to do so.
  • Turn off computers and screens when not in use; turn off standby power at the end of each day by turning off all appliances at the wall or power board.
  • Consider using standard laptops when possible because they consume up to 90% less energy than desktop computers and offer greater work flexibility.
  • Embed energy‑saving processes either manually through work protocols or via building management systems. Change globes to LEDs because these use up to 75% less energy than halogen globes (fluorescent globes are intermediate in energy usage but contain toxic mercury in small amounts and should be phased out due to environmental concerns).
  • Get more information on lighting and appliances can be found on the Implement energy savings webpage.
 Energy: 
Sourcing renewables
  • Consider changing your energy source to 100% renewables, which is relatively easy and immediately reduces your practice’s emissions and sends a strong message to the energy sector. Find a green‑energy provider on the GreenPower website (note: if cost is an issue, elect to only have a percentage of your electricity as renewable).
  • Install rooftop solar, a highly cost‑effective strategy if you own your premises. Pay‑back periods on panels can be as short as 3–4 years on a product designed to last 25 years. Explore some of the considerations before installing solar panels on the Energy made easy website.
  • Negotiate with your landlord to install solar panels if you don’t own your premises. Find more information can be
 

Energy audit

Benalla Church Street Surgery conducted an energy audit and implemented changes to reduce energy and costs over a 12‑month period.

Travel
  • Consider switching to hybrid or electric small vehicles when purchasing/leasing a shared vehicle for your practice, if possible.
  • Encourage staff and patients (when appropriate) to use methods of transport other than cars, such as walking, public transport or cycling.
  • Encourage cycling by providing bike racks and change facilities.
  • Ask staff to consider alternative/active transport and explore car‑pooling.
  • Be a role model by using alternative/active transport.
  • Have a dedicated ‘green team’ to promote active and alternative transport.
  • Offer telehealth to reduce patient‑transport impacts, if appropriate.
  • Lobby local governments to provide electric vehicle charging stations.

Bike racks

You could consider installing bike racks at your practice to encourage staff and patients to cycle to your practice rather than driving, thereby reducing carbon emissions.

Professional services*
  • Choose services with a smaller environmental footprint – you can research to compare and ask the service directly, if needed.
  • Consider choosing banks and investment schemes that include environmental‑impact criteria in their investment profiles, such as worldwide fossil fuel divestment. Market Forces, an advocacy group that analyses the environmental impacts of financial institutions, offer a bank comparison chart to can find out which banks have a history of funding the fossil fuel industry and a similar chart for superannuation funds
Minimise e-waste**
  • Avoid purchasing new electronic products that can’t be reused or recycled.
  • Reduce your consumption of electronic devices by repairing broken equipment before purchasing new items.
  • Re-use your electronic devices by donating items to charity, friends or family.
  • Discard e‑waste responsibly, including by engaging a recycling company to collect various types of e‑waste for recycling or dropping off your e‑waste at organisations that offer recycling free of charge – see Tech Collect,
  • Recycling Near You, Mobile Muster or Clean Up.
  • Develop an e‑waste recycling policy using the RACGP template
Note: Before discarding any electronic equipment, make sure all data have been removed from the device.

Privacy and security

Failing to properly delete data before disposing of any electronic device breaches patient information privacy and security requirements. Simply deleting your files doesn’t fully and permanently delete information from your storage device’s hard drive. Before disposing of any equipment, make sure all data have been properly scrubbed from the device.

Reducing paper usage
  • Move to fully electronic records and electronic communications. Refer to the RACGP’s Information security in general practice guidelines to ensure protection and preservation of your practice data.
  • Move to e‑prescribing.
  • Use recycled paper.
  • Reduce junk mail by putting a ‘No junk mail’ sticker on your mailbox.
  • Limit the amount of printed material distributed by your practice.
  • Subscribe to online editions of journals rather than ordering printed copies.
Recycling
  • Place recycling bins in the practice, 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 your local council.
  • Use recycled products, such as paper, toilet tissue and toner cartridges, as much as possible.
  • Ensure your practice doesn’t fill medical waste bins with materials that could be recycled or disposed of in regular waste because disposing of medical waste is costly and resource intensive.
  • Consider recycling other things in your practice, such as batteries, light globes and soft plastic via REDcycle.
Carbon offsets
  • After reducing all possible emissions from your practice, consider purchasing carbon offsets to achieve netzero emissions – many companies offer carbon offsets with a range of validation and verification standards. Purchasing offsets also puts a price on carbon, placing it clearly on the balance sheet and incorporating sustainability into your business plan. As your practice progressively decarbonises, this should also be reflected in a reduced need for offsets.
Water efficiency
  • Use products (such as dishwashers and fridges) with a high water‑efficiency rating.
  • Only run the dishwasher when it’s full.
  • If your practice has a garden, plant sustainable and drought‑resistant plants.
  • Install rainwater tanks or grey‑water systems.
  • Install low‑water‑use toilets.
  • Ensure water leaks are repaired rapidly.
Reduce food waste • Promote reduction of food waste for both practice staff and patients (and the financial benefits) by encouraging:
  • meal planning
  • storing food correctly
  • avoiding packaged food, when possible
  • shopping locally, where possible. (21)
Business planning
  • Embed sustainability in your business plan and incorporate sustainability goals in your financial objectives.
  • Perform an audit of your energy/carbon emissions to set a benchmark and establish a framework to reduce emissions based on data. You could 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.
Workplace culture
  • Ensure effective leadership on sustainability and encourage behavioural change by appointing ‘climate champions’ or a ‘green team’ to bring colleagues, staff, and patients on a journey. Implement regular reviews of interim targets and goals.
  • Become an RACGP parkrun practice to promote the health and wellbeing of staff and patients through increased physical activity, skill development, socialising and personal empowerment.
  • Encourage staff to bring lunch in reusable containers; avoid plastic wrappers and clingwrap; bring reusable drink bottles, coffee cups and cutlery; or purchase food from local businesses with certified sustainable compostable packaging. (22) Learn more about compostable plastic on The Conversation website.
  • Educate and support your patients using the RACGP’s print‑ready posters for your waiting room, which help alert patients to the effects of climate change on their physical and mental health.
  • Be patient – establishing new habits takes time, so start with small steps like encouraging staff to consider one car‑free day a week, if possible.

* ‘ Professional services’ are all the businesses and services your practice uses, such as phones, computers, general IT support, finance, accountancy, payroll, insurance and many others. Each has a carbon footprint.
** ‘ E‑waste’ is discarded electrical and electronic technologies. Electronic technology is made up of toxic material that is often not disposed of efficiently or safely. E‑waste contains many components that can be recycled and reused.
 
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