Greening up: Environmental sustainability in general practice

Roles of the practice team

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The role of GPs

As highly trusted professionals, GPs are well placed to effectively communicate the health risks of climate change to their patients, the public and policymakers. ⁽¹⁴⁾ Through leading by example and advocacy, general practice can promote healthy, sustainable living and reduce carbon emissions. ⁽¹⁵⁾ Advocacy is needed for adaptation (ie healthcare support for the physical and mental effects of climate change) and mitigation (ie through government policies to reduce emissions), promoting urgent action to mitigate climate change through individual, practice‑based, and social and population‑based initiatives. ⁽¹⁵⁾

Key actions for GPs
Level of influence	Action
Individual	Use alternative transport. Minimise air travel. Reduce highly processed food consumption. Reduce meat consumption. Encourage use of smaller or electric vehicles; driven less often. ⁽¹⁶⁾ Lead, support and participate in new or existing sustainability measures in your practice; ie becoming a ‘climate champion’, recycling waste correctly, using alternative/active transport, meat‑free Mondays. Start a conversation with your practice team about its importance for you and your patients and sharing this resource with them.
Clinical	Identify patients who are particularly vulnerable to heat, ensuring they have a plan, take precautions and are monitored during heatwaves. Ensure patients and the local community understand public health advice, such as disaster and weather warnings from health departments and emergency services. Identify co‑benefits of action to reduce climate change in clinical consultations; eg encouraging alternative/active transport, promoting low‑energy diets (including less meat and processed food consumption when appropriate, depending on the patient) and promoting energy‑efficient homes. Adopt the use of social prescribing to support patients with improved wellbeing and lifestyle changes, such as increased physical activity. Consider the impact of prescribing and referring decisions – approximately two‑thirds of general practice’s carbon footprint comes from prescribing; eg metered‑dose inhalers account for a large part ⁽¹⁰⁾ – and reduce unnecessary prescribing also has co‑benefits for patients, such as by reducing problematic polypharmacy. Use telehealth appropriately may support better patient outcomes through improved follow‑up and selfmanagement, as well as reducing carbon output from unnecessary patient travel.
Population	Keep abreast of the issues and raise awareness with other health professionals, patients and the wider community about climate change and its impact on individual and population health. Support public health measures and institute systems to deal with the increase in climate‑induced diseases (such as malaria and Japanese encephalitis) when they arise. Lead the response to the burden of non‑communicable diseases that are the main cause of morbidity and mortality in Australia today, such as mental illness, and that may be exacerbated by climate‑related disasters, extreme weather conditions etc. Recognise that climate change exacerbates health inequities (eg through the unequal impacts of extreme weather events) and seek opportunities to promote health and social equality. ⁽¹⁾ Support community action; eg community gardens for local food production, public open space for outdoor recreation and physical activity, safe walking and cycle ways, high‑quality public transport systems, and the need for disaster management plans. ⁽¹⁰⁾ Use your general practice expertise and professional position as a trusted community leader to advocate on behalf of patients for effective climate‑change policy and action ⁽¹⁶⁾; eg write/talk to politicians, counsellors and mayors, write to newspapers (op‑eds, letters to the editor) and other businesses.

We discuss other key organisational and non-clinical dimensions in more detail next, such as reducing energy usage

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