Green Impact for Health

Green Impact for Health (GIFH) started in 2014 with a collaboration between the Severn Faculty of RCGP, Health Education England, the University of Bristol, and the National Union of Students (NUS). It is a free SusQI scheme for general practices that includes audit and awards. The scheme is currently funded by the RCGP, delivered by the charity Students Organising for Sustainability (SOS-UK) with its content written by volunteers from general practice led by Dr Terry Kemple (a past President of RCGP). The programme is regularly updated to provide ever more practical advice, improve its ease of use and its impact.

Green Impact for Health is part of the United Nations award-winning Green Impact programme designed to support environmentally and socially sustainable practice within organisations. The toolkit is being used by over 1400 (15%) General Practices across the UK.

For general information about the Green Impact scheme and how it works see the Green Impact website.

Any UK general practice can join Green Impact for Health.

If you are not working in a general practice you cannot join Green Impact for Health, there are other Green Impact toolkits available, including a toolkit for Dentistry. Find out more about the different Green Impact toolkits here. 

If you don’t want to register with GIFH you can view the 2022 criteria (but not any extra information) here, but you will not be eligible for an award.

The toolkit lists over 100 actions that can improve the environmental sustainability and quality of any general practice as well as saving money. The toolkit gives the reason for the suggested actions and gives tips about how to make the change. Practices can get points and awards for their achievements.

You can get an overview of all the 2023 criteria by viewing and downloading the summary spreadsheet. After you have registered and logged into the toolkit you arrive at the Dashboard page. Click on the toolkit icon in the top left-hand menu. In the toolkit page click on the green spreadsheet icon (next to the printer icon) in the top right-hand menu. This will download all the criteria and information on a spreadsheet. There are 100 points each in the Bronze, Silver, Gold and Diamond categories and 20 points elsewhere so the total number of points is roughly 420.

The new platform was released in 2023. Please contact giforhealth@sos-uk.org for registration information (please note, only General Practices in the UK can register to take part).

There is 5 minute video guide on the home page and a user guide here with the steps to register and access the actions.

You can submit your toolkit on the platform whenever you are ready, and will receive a student-led audit. Our next submission deadline is 30th September 2024. 

You can submit your toolkit at any time until, but won’t have an audit until after the deadline. This supports SOS-UK’s improved monitoring and evaluation process to capture impact, and the social value of working with students. If your practice has special circumstances, we can consider assessing your submission and making an award outside of this student audit schedule.

You can view past newsletters from February 2023 here:

• February 2023
• March 2023
• April 2023
• June 2023
• September 2023
• October 2023
• November 2023
• December 2023

SOS-UK is a not-for-profit educational charity created by students and staff from the student movement in 2019 in response to the climate emergency and ecological crisis. Green Impact is one of SOS-UK’s programmes that includes over 500 different organisations and over 158,000 people worldwide who are taking action on sustainability. The Green Impact for Health is our toolkit designed for General Practices.  By January 2023 more than 1450 UK general practices have signed up to take part and more than 100 practices have received an achievement award.

SOS-UK supports people to learn, act and lead for sustainability; has a wide range of programmes and campaigns which drive people, students, organisations and sectors towards a just and sustainable future. The highlight campaigns include Invest for Change which achieved 50% of UK universities divesting their investments away from fossil fuels and more recently, Teach The Future, a youth led campaign to reform the education system to include sustainability throughout the curriculum.

SOS-UK charges for its services to cover costs and to support other campaign work. The RCGP funds the basic GIFH programme to allow any General Practice from across the country free access to the GIFH programme.

You can donate or volunteer to support the GIFH programme. We ask all participating General Practices, to donate a minimum of £10 each year to allow the programme to develop and support SOS-UK’s wider sustainability work. Donating is also a way to acknowledge some of your past and current greenhouse gas emissions by supporting good works across the world. To donate, please do so via our charity PayPal account here and choose the Green Impact option from the drop-down menu. You will not need to create a PayPal account – you can donate either through a PayPal account or just use a credit or debit card. If you have any questions, please send these to giforhealth@sos-uk.org.

You can volunteer to review some of the criteria in the toolkit. Each year we review and update all the criteria. We ask for volunteers to each check a few of the criteria. Contact Terry Kemple via greenimpactforhealth@gmail.com.

The new Net Zero Hub from the RCGP can be found here. Further information for GPs about Sustainable development, climate change and green issues can be found here.

You can change details about your practice and remove users from your practice team from your dashboard. Once logged into your Dashboard, go to the top right of your photo space, click on the up/down arrow icon to access ‘Manage Team’ and ‘Team settings’. On the team settings page you can amend all elements of your team’s profile.

Only SOS-UK administrators are able to delete practices, but we want to keep your team information up to date so we will automatically delete users who have not logged in for the past two years.

The scheme is completely free to use and there are no hidden costs. We do welcome your support and hope you will donate a minimum of £10 each year to SOS-UK (choose the Green Impact option) via our charity PayPal account here.

You can commit as few or as many hours as you like each year, there is no minimum requirement. The actions are designed to embed sustainability in what you are already doing, rather than creating new work.

To achieve one of the awards, you will need to do the following: 
Pioneer: Every practice that completes criteria (no matter how few) and submits for an award will receive a Green Impact for Health Pioneer certificate to demonstrate the commitment that has been made. 
Bronze: Your practice needs to achieve 75 points from the toolkit.  We recommend focusing on the Bronze level actions (100 points available).
Silver: You need to achieve 150 points from the toolkit. 
Gold: You need to achieve 225 points from the toolkit.

Platinum: You need to achieve 300 points from the toolkit. This was previously called the Gold plus award.
Diamond: You need to have gained a Platinum award and completed enough criteria on the Diamond theme to demonstrate that you have achieved NET ZERO carbon status in your general practice. This was previously called the Carbon award.

The points system is far from perfect but we do want to recognise both your achievement and effort so we reserve the right to have some discretion regarding deciding the appropriate awards for each practice each year.

You can submit at any time to claim the next level of award. There is a deadline for submissions. It is a high trust award but after submitting a practice might be asked to have an assessment by a student who has been trained to confirm which criteria have been achieved. You may be invited to an optional local RCGP Faculty annual Prize Giving where you will receive either a Pioneer, Bronze, Silver, Gold, Platinum or Diamond accreditation certificate for your practice. 

There is no right way to work through the toolkit. You might like to tackle it by starting with the Bronze criteria, or by the type of criteria (such as Food & Drinks, Waste & Recycling, Prescribing, Energy saving, Social Prescribing, News & Communication, Learning, Vulnerable Groups, Quality Improvement, Water, Travel & Exercise, Healthy Planet, and Zero carbon) or with whatever fits best with your practice’s needs, interests and priorities. You can get points and qualify for an award whichever way you choose to use toolkit.

If you really want a suggestion, try improving your Meter Dose inhaler (MDI) prescribing and score points to recognise your practices efforts by concentrating on the following:

Prescribing criteria

PRS003 – reviews your use of DPI v MDI inhalers (3 points)

PRS005 – liaise with ICB/Health Board re local prescribing of inhalers (3 points)

PRS009 – show evidence of low volume salbutamol MDIs rather than high volume MDIs and minimising MDI with the propellant HFA227ea (4 points)

PRS010 – show evidence of using DPI>MDI (6 points)

PRS011 – practice has implemented its plan to improve prescribing performance (5 points)

Quality Improvement criteria

QIP001 – practice encourage self-management with guidance for one condition (5 points)

QIP002 – Practice has planned a QI project to improve sustainability (6 points)

QIP003 – Show evidence of a self-management plan with guidance (5 points)

QIP005 – Evidence QI plan is in progress (6 points)

QIP007 – Practice has completed its QI plan (5 points)

In England you can find out what you need to know about inhaler prescribing via the Openprescribing website, In the UK you can use the GSK tool at https://value.gsk.com,

Completing all this interrelated work attracts 48 points in the toolkit. The Bronze reward requires 75 points.

There is no magic formula, just an allocation of the 100 points in each section based on an estimate of the likely difficulty and impact of each criterion. The points system is far from perfect but we do want to recognise both your achievement and effort so we reserve the right to have some discretion regarding deciding the appropriate awards for each practice each year.

The Bronze section is roughly about understanding/measuring/checking current practice and usage, Silver about reducing usage and improving practice, Gold about demonstrating the impact of actions and influencing more widely and Diamond is about achieving net zero carbon status. There are also Bonus Governance themes: These lists any extra criteria including existing regional competitions and awards administered by local RCGP faculties or other organisations. These can also earn achievement points. We want each RCGP faculty and devolved nation to consider setting up local awards. 

General Practice is under extreme pressure, and practices may feel unable to take on more than is absolutely necessary. However Green Impact for Health was developed by General Practice for General Practice to make the process as easy as possible. When we audited the use of the toolkit after its first year in 2014, we found that practices that completed only two simple actions from the toolkit could each save around £1,000/year. 

If you require any technical support, please contact the SOS-UK Project Manager via giforhealth@sos-uk.org.

For general programme enquiries please contact Terry Kemple via greenimpactforhealth@gmail.com.

If you are a trainee, the GP curriculum includes a guide on ‘Population and Planetary Health’. The toolkit can provide quality evidence for your e-portfolio. You can use the toolkit to do a SusQI project. It also helps you learn more about management of General Practice. 

You can do your own planetary health impact assessments to evaluate how your activity may cause environmental changes that affect natural systems and long-term health and decide how we can make meaningful restorations and reparations. 
To do your own assessment follow the steps below 
Check your personal carbon footprint using the WWF calculator or this calculator from carbon footprint.com.

To check your practice’s (non-clinical) carbon footprint, there is a free GP non carbon footprint calculator online here with FAQ and video walkthrough available at See Sustainability.

Sustainable Healthcare is the concept of providing healthcare in a way that is beneficial to patients without harming the planet. “Sustainability” in the health care system is providing high quality care and improved public health without exhausting natural resources or causing severe ecological damage.

Planetary Health links the disruptions of the Earth’s natural systems caused by humans with the resulting impacts on public health and then develops and evaluates evidence-based solutions to secure a world that is healthy and sustainable for everyone. Good planetary health will come by seeing the threats and reacting fast enough by switching to better ways of living. 

Green issues relate to or are concerned with the protection of the environment.

“Global warming” or “Global Heating” is the long-term temperature change of the planet. Since 1880 and the start of the industrial age the average surface temperature has risen about 1°C. This warming is caused mainly by burning fossil fuels and releasing heat-trapping ‘greenhouse gases’ into the atmosphere.

“Climate change” is the broader range of changes that are happening to our planet. These include global warming, rising sea levels, shrinking glaciers, accelerating polar ice melt, and shifts in plant blooming times.

Mitigation refers to efforts to reduce or prevent emission of greenhouse gases. This aims to avoid the unmanageable.

Adaptation refers to efforts to reduce our vulnerabilities and build resilience to the impacts of climate change. This aims to manage the unavoidable.

Greener Practice are the main network hub for those working in general practice to raise awareness of the health benefits of climate action and to support practical action. Their website acts as a one-stop shop for general practices wishing to become greener, with links to information, resources and practical tools. They are also local groups and they run webinars which are available as CPD resources. Links can be found on their website here and they can be found on Twitter @greenerpractice. 

The UK Health Alliance for Climate Change (UKHACC). The RCGP is a founding member of the UKHACC. It brings together over a million doctors, nurses and other health professionals to advocate for responses to climate change that protect and promote public health. The Alliance coordinates action, provides leadership, and helps amplify the voices of doctors, nurses and other healthcare professionals across the UK.

BMA/GPC England and the Climate Emergency published its policy document in June 2020, available online here.  

Greener NHS works on behalf of the health and care system in England and aims to make the NHS net zero carbon by 2040 and 2045. It supports the NHS to embed and promote the three elements of sustainable development – environmental, social and financial.

Centre for Sustainable Healthcare (CSH) is a charity based in Oxford working on sustainable healthcare in research and practice. It provides strategic input and consultancy to national and local programmes. There is a network for Primary Care here with lots of resources as well as a forum for discussion.

World Organization of Family Doctors (WONCA) has a Working Party on the Environment that fosters the role of family doctors in protecting the health of their patients and communities from the impacts of environmental hazards and environmental degradation, and to promote healthy and sustainable societies at the local and global level. Family Doctors from every region of the world are engaging in planetary health within their local and global communities. The Working Party always welcomes new members.

Planetary Health Alliance is a consortium of over 240 dedicated universities, NGOs, government entities, research institutes, and other partners around the world committed to advancing planetary health.

Lancet Countdown: Tracks Progress on Health and Climate Change and is an international research collaboration, that tracks the world’s response to climate change, and the health benefits that emerge from this transition.

Carbon Brief Daily News: Every weekday morning, Carbon Brief sends out a free email digest of the past 24 hours of media coverage related to climate change and energy, as well as their pick of the key studies published in the peer-reviewed journals.

SEE Sustainability: SEE is an environmental sustainability consultancy experienced working with general practice. It provides a range of services to small and medium sized businesses to improve their sustainability of people (Social) and planet (Environmental) while improving their profit. (Economic). It also provides on-line carbon literacy training for practices.