From saving energy and reducing waste, to boosting physical activity and contact with nature, Greener Practice’s Quality Improvement Projects (QIPs) are enabling primary care to become more sustainable across the UK. More than 50 QIPs are available to our NetworkPLUS members, giving them clear, step-by-step guides that deliver proven benefits for patients, practices and the planet. As this approach gathers momentum, the potential to deliver positive change at scale is exciting.
Now, thanks to the Royal College of General Practitioners (RCGP), GP registrars can join Greener Practice free of charge* to access these ready-made resources, which support their training. QIPs also make excellent medical student projects, attracting the interest of medical schools including Exeter, which funds Greener Practice membership for their students.
Every QIP includes an end-of-project certificate for self-completion. This provides a written record of the outcomes, including savings in carbon emissions (where they can be calculated), cost savings and improvements for patient health. The certificate is a vital part of the QIP process, as well as providing ready-made evidence for e-portfolios, appraisal, revalidation, and CQC.
As Greener Practice Director, Dr Katrina Davis, explains, ‘Certification is about more than recognising achievements. It provides valuable evidence towards meeting CQC requirements and enables Greener Practice to demonstrate our impact. We need the data to enable us to secure funding, increase our reach and deliver on our mission of environmentally sustainable healthcare. If anyone needs help completing their certificate, please get in touch with us at contact@greenerpractice.com.’
Mile Oak Medical Centre in Brighton, Sussex is one example of how QIPs can deliver lasting, more sustainable ways of working. Two years ago, they examined asthma control among their 8,600 patients. Costs of poorly controlled asthma are estimated at 52% higher than well-controlled asthma, which in turn has a third of the carbon footprint of poorly-controlled asthma. Lucy Dowd, a 4th year medical student on placement at Mile Oak, took up the issue and followed the Identifying Poor Asthma Control QIP for her Independent Research Project. She discovered 39 patients had requested 12 or more SABA inhalers over the previous 12 months. Re-auditing 12 months later, after running the QIP, she found this had been reduced to 5 patients.
Lucy did an amazing job. We are delighted with the outcome of this QIP, which has changed the way we work with patients to control their asthma. We have reduced the risk of asthma attacks for patients and improved their quality of life, whilst also saving more than 10 tonnes of CO2e annually in my practice and over £1,000 in NHS costs. The results from all the QIPs we have undertaken are documented by certificates – they are an invaluable record.
-Dr Abigail Fry, GP partner at Mile Oak and Director of Greener Practice
A popular QIPs is Iron, Appropriate Prescribing. GPs traditionally prescribed 2 or 3 times daily iron tablets for patients, but it has been found that taking them more than once per day blocks the iron receptors in the bowel. This means the body cannot absorb more than one a day – and taking more iron causes more side effects (which can lead to patients abandoning treatment and therefore wasted tablets). By checking that patients are not being over-prescribed, practices are saving on average over £1,000 a year.
Dr Fry comments, ’There are over 6,000 GP surgeries in England alone. If every one of them undertook this simple measure, it would save the NHS at least £6 million pounds a year whilst reducing the carbon footprint of medicine waste. The Iron, Appropriate Prescribing QIP guides you through the process of making this change. This is just one of 52 QIPs, and it illustrates the huge potential they contain to transform primary care, making it more resilient for the future.’
In Sheffield, medical student Abdullah Aziz recently completed the Vitamin D Testing QIP during his placement at Birley Health Centre. Vitamin D testing in primary care has increased tenfold since 2001, despite national guidance recommending targeted testing rather than routine screening. Testing for non-specific symptoms leads to unnecessary costs and increased carbon emissions. Abdullah’s assessment of testing carried out over one month at the practice showed that 76% were inappropriate according to NICE guidelines. By raising awareness among clinicians, Birley Health Centre is able to save each year an estimated £7,380 and nearly 5 tonnes of carbon emissions, the equivalent of driving a standard petrol car 19,000 kilometres.
Abdullah’s work is a clear demonstration of the carbon and cost savings that can be achieved through straightforward measures such as reducing inappropriate prescribing. Our QIPs can make excellent projects for medical students on placement. Introducing changes to more sustainable ways of working has multiple benefits, including saving time long-term. Even so, we know busy GPs worry about their capacity to get started. Medical students are a brilliant additional resource to help kick-start the process of change and show what’s possible in quite a short period of time.
-Dr Honey Smith, medical student supervisor and Director of Greener Practice
Curious? Explore our library of QIPs to discover the full range of projects available to Greener Practice NetworkPLUS members. Find out more about membership here.
*Registrars can find the link to sign up to Greener Practice in the RCGP June Learning Bulletin email. Offer runs until 17 May 2027.