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How to make your practice more sustainable

2 October 2019

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The role of a practice manager is diverse and challenging, but one of the many responsibilities that they take on is to make their practice environmentally friendly – and come up with efficient ways of doing so.

Practice manager Karen Creffield made the unexpected move to Frome Medical Practice, Somerset, just over two years ago. Her previous role as head of sport at the University of Sussex, which she occupied for 23 years, taught her the value of relationships and connecting with others – a skill that would prove to be useful in her new position. Since taking up her post, Ms Creffield has been spearheading several strategies to make the practice greener.

Practice manager Karen Creffield made the unexpected move to Frome Medical Practice, Somerset, just over two years ago. Her previous role as head of sport at the University of Sussex, which she occupied for 23 years, taught her the value of relationships and connecting with others – a skill that would prove to be useful in her new position. Since taking up her post, Ms Creffield has been spearheading several strategies to make the practice greener.

Frome Medical Practice is one of the largest single-site practices in the country, with 148 staff and caring for approximately 30,000 patients. Luckily for Ms Creffield, the building itself was already doing some of the work for them in terms of sustainability:

‘We’re very fortunate that we work in an amazing building that was built in 2012. It’s a multidisciplinary building, right next door to the community hospital, which is on the same site and there’s very much a focus on the community as well,’ she says.

‘It can pull you in lots of different directions, so we work very closely with those different areas and the local community. That’s one of the really lovely things about working here, how strong the links are. The building was built with solar panels, which is great. It was also built with electric car charging points.’

All together now

Working with the local community, Ms Creffield says, is essential. Various organisations in and around the practice have the common aim of boosting public health, helping to strengthen that community and providing the strong foundations necessary to put plans in to action.

Ms Creffield has directed several strategies to improve the practice’s environmental impact that complement some of the practice’s clinical goals. As is so often the case, initiatives aimed at improving one area of practice life often spill over into others. In a move to increase deprescribing rates, social prescribing, or ‘health connector projects’ as Frome Medical Practice calls them, boost wellbeing as well as community ties – making efforts to improve sustainability easier.

‘We’ve got groups in the practice today like Parkinson’s support groups, macular degeneration groups, Weight Watchers might use us in an evening, even tai chi groups. The building is quite well-used. They are things that support health as well as direct care [we offer] with clinicians,’ explains Ms Creffield.

‘We’re often held up as a model of best practice – we don’t use the term social prescribing because we think it’s more about connection, very much focused on a demedicalising approach. We also have a really amazing community connector programme as well. From estate agents to local hairdressers, to people who work in the supermarket, to [make patients better] able to find posts and connect others to different groups.’

A greener approach

Inspired by the new building and the Royal College of General Practitioner’s green impact toolkit, Ms Creffield and the practice team have made considerable changes to their practice’s culture. Taking particular care with recycling and reducing carbon emissions, she shared with Healthcare Leader some successful schemes.

‘We used [the toolkit] to a look at what we were already doing and as a tool to make some improvements. When I came [into the role] we weren’t doing very much in the areas of recycling or looking at sustainability in terms of suppliers. [Using] green impact policies, bringing things into procurement and making different choices, that’s been quite important,’ she explains.

‘We redid our values as an organisation. Our values are around sustainability, responsibility and learning, which all are very much in-line with the green impact agenda. For example, we have a staff appraisal system that is linked to our values, so we actually do our staff appraisal process to reflect on what they’ve contributed to those and the sustainability agenda.’

The green impact toolkit is linked to the UN Sustainability Goals, which are quite wide-ranging. From recycling to energy efficiency, practices can take on more than one area of improvement at a time. Not only does the Frome practice prioritise text communication with patients, reducing paper usage, but their efforts to promote more sustainable and less carbon-emitting dry-powder inhalers over metered-dose inhalers has also been impactful. Added to that, working with other services to improve recycling capabilities has been successful:

‘We work very closely with the local pharmacies on the recycling scheme, as the pharmacies actually have the recycling units under a manufacturer scheme. We’ve worked closely to encourage our patients to use that when it’s available, also to encourage the pharmacies to offer it,’ says Ms Creffield.

‘I think one of the great things is, as it’s become more visible to patients, patients are actually asking ‘where can I recycle my inhaler?’ We’ve started to see changes in behaviour.’

Simply does it

Aside from inhaler choice and paper use, the practice has adopted several simple environmental strategies. Single-use plastics are an inevitable component of practice life, but when it comes to, for example, plastic cups in waiting rooms, easy changes can be made with little effort.

Collaborating with Refill Frome, a local initiative that is part of a national campaign to discourage single-use plastic cups, the practice makes it clear to all staff in newsletters what individuals can do to reduce their impact on the environment. All new starters in the practice also receive a stainless steel water bottle on arrival and a bottle-friendly water fountain has been installed.

From small switches to big reshuffles, every change counts towards making the practice a more sustainable and environmentally-friendly place to work, and it is proactive to keep looking for more ways to contribute, even on a larger, community-wide scale:

‘I think going forwards, we’ve got more of a focus on looking at how we can divest more in fossil fuels. We’re looking at energy suppliers at the moment to actually look at finding a green energy supplier. Period poverty is also an area that we’re quite keen to work on with the local council, and looking at Mooncups and washable sanitary products and how we can work with patients and maybe find some ways that we can provide those,’ says Ms Creffield.

‘The feedback that we got was as a practice when we won the national Green Impact Award was that we’re very good at taking a team approach. We have a group of people that really care. We are all working on different areas, and I think that’s starting to gather momentum. I think that’s been one of the key things.’

Frome Medical Practice is one of the largest single-site practices in the country, with 148 staff and caring for approximately 30,000 patients. Luckily for Ms Creffield, the building itself was already doing some of the work for them in terms of sustainability:

‘We’re very fortunate that we work in an amazing building that was built in 2012. It’s a multidisciplinary building, right next door to the community hospital, which is on the same site, and there’s very much a focus on the community as well,’ says Ms Creffield

‘It can pull you in lots of different directions, so we work very closely with those different areas and the local community. That’s one of the really lovely things about working here, is how strong the links are. The building was built with solar panels, which is great. It was also built with electric car charging points.’

All together now

Working with the local community, Ms Creffield says, is essential. Having various organisations in and around the practice, all with the aim of boosting public health, helps to strengthen that community – providing the strong foundations necessarily to put plans in to action.

Ms Creffield has directed several strategies to improve their environmental impact, that compliment some of the practice’s clinical goals. As is so often the case, initiatives aimed at improving one area of practice life often spill over into others. In a move to increase deprescribing rates, social prescribing, or ‘health connector projects’ as Frome Medical Practice calls it, boost wellbeing as well as community ties – making efforts to improve sustainability easier.

‘We’ve got groups in the practice today like Parkinson’s support groups, macular degeneration groups, Weight Watchers might use us in an evening, even tai chi groups. The building is quite well used. They are things that support health as well as direct care with clinicians,’ describes Ms Creffield.

‘We’re often held up as a model of best practice – we don’t use the term social prescribing because we think it’s more about connection, very much focused on a demedicalising approach. We also have a really amazing community connector programme as well. From estate agents to local hairdressers, to people who work in the supermarket, to [make patients better] able to find posts and connect others to different groups.’

A greener approach

Inspired by the new building, and the Royal College of General Practitioner’s green impact toolkit, Ms Creffield and the practice team have made considerable changes to their practice culture. Taking particular care with recycling and reducing carbon emissions, she shared with Management in Practice some successful schemes.

‘We used [the toolkit] to a look at what we were already doing and as a tool to make some improvements. When I came [into the role] we weren’t doing very much in the areas of recycling or looking at sustainability in terms of suppliers. [Using] green impact policies, bringing things into procurement and making different choices, that’s been quite important,’ she explains.

‘We redid our values as an organisation. Our values are around sustainability, responsibility and learning, which all are very much in-line with the green impact agenda. For example, we have a staff appraisal system that is linked to our values, so we actually do our staff appraisal process to reflect on what they’ve contributed to those and the sustainability agenda.’

The green impact toolkit is linked to the UN Sustainability Goals, which are quite wide-ranging. From recycling to energy efficiency, practices can take on more than one area of improvement at a time. Not only does the Frome practice prioritise text communication with patients, and reducing paper usage, but their efforts to promote more sustainable and less carbon-emitting dry-powder inhalers over metered-dose inhalers has also been impactful. Added to that, working with other services to improve recycling capabilities has been successful:

‘We work very closely with the local pharmacies on the recycling scheme, as the pharmacies actually have the recycling units under a manufacturer scheme. We’ve worked closely to encourage our patients to use that when it’s available, also to encourage pharmacies to offer it,’ says Ms Creffield.

‘I think one of the great things is, as it’s become more visible to patients, patients are actually asking ‘where can I recycle my inhaler?’ We’ve started to see changes in behaviour.’

Simply does it

Aside from inhaler choice and paper use, the practice has adopted several simple environmental strategies. Single-use plastics are an inevitable component of practice life, but when it comes to plastic cups in waiting rooms, easy changes can be made.

Collaborating with Refill Frome, a local initiative that is part of a national campaign to discourage single-use plastic cups, the practice makes it clear to all staff in newsletters what individuals can do to reduce their impact on the environment. All new starters in the practice also receive a stainless steel water bottle on arrival and a bottle-friendly water fountain has been installed.

From small switches to big reshuffles, every change counts towards making the practice a more sustainable and environmentally-friendly place to work, and it is proactive to keep looking for more ways to contribute, even on a larger, community-wide scale:

‘I think going forwards, we’ve got more of a focus on looking at how we can divest more in fossil fuels. We’re looking at our energy suppliers at the moment to actually look at finding a green energy supplier. Period poverty is also an area that we’re quite keen to work with, with the local council, and looking at Mooncups and washable sanitary products and how we can work with patients and maybe find some ways that we can provide those,’ says Ms Creffield.

‘The feedback that we got was as a practice when we won the national Green Impact Award was we’re very good at taking a team approach. We have a group of people that really care and are all working on different areas, and I think that’s starting to gather momentum. I think that’s been one of the key things.’


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