Sustainability has enhanced the way care is delivered, making us more resilient, future-ready, and better aligned with both staff values and patient needs.
March 2026
Cheshire and Merseyside Integrated Care Board (ICB) have reported impressive results from 10 pilot projects towards delivery of their Green Plan. The programme has delivered significant benefits for patients, staff, budgets and the planet – all for a total upfront investment of £20,000. Ten GP practices across Cheshire and Merseyside were involved, each piloting a different project. Three larger projects were given £2,500 funding, while seven smaller initiatives received £1,000 each.
The projects have led to lasting change which will deliver ongoing improvements to patient health and well-being, cost and time savings, carbon footprint reductions and nature gains. One participating GP practice said, ‘sustainability has enhanced the way care is delivered, making us more resilient, future-ready, and better aligned with both staff values and patient needs.’
The projects, and some of the highlights, are:
- Low Carbohydrate Lifestyle Support Group for patients with Type 2 diabetes, Liverpool. Positive health outcomes for patients included average improvements in their HbA1c by 14 mmol/mol, lowering the risk of complications. De-prescribing was possible, with participants taking 1,103 fewer tablets overall. Patients lost weight and enjoyed improved well-being, such as better sleep and concentration, while staff reported greater job satisfaction. The carbon saving during the six month-long project at this one practice was 169.18kg CO2e, roughly equivalent to driving a petrol car for 500 miles, e.g. a round-trip from Liverpool to Southampton!
- Improving Period Dignity and Optimising Sustainable Choices, Warrington. A practice in an area of high social deprivation ran this project. During appointments, 100 female patients aged 16-25 were invited to try re-usable period wear and consider sustainable contraceptive choices. This raised patient awareness of options and how they could save money by choosing sustainable period wear. Following the success of the four-month long project, the initiative continues at the practice and is being considered for roll-out across the Primary Care Network.
- Blooming Health, Liverpool. A therapeutic garden has been created in the practice grounds to address mental health and loneliness, while promoting a greener space. Building a sense of community with patients, volunteers and staff, the GP partner-led project initially ran for 8 months with twelve participants and is still ongoing. Over time, the therapeutic garden is delivering improved well-being for patients, environmental gains and cost savings through deprescribing and reduced need for medical interventions.
- Proud to be Going Greener, Liverpool. The entire practice team worked together to introduce small, practical measures with a meaningful impact. Steps included an energy audit, optimising asthma care to reduce inhaler waste while improving patient health, and installing a drinking water filter system for staff and patient use. Results include lower energy bills, fewer patient asthma attacks through training in Salbutamol use, a 50% cost saving on couch-roll and the total elimination of bottled water on site.
- Greener Plant Project, Liverpool. Indoor plants were introduced, creating a calmer, more welcoming waiting room. The team recognised that indoor greenery has been shown to reduce stress, anxiety and blood pressure, whilst also improving indoor air quality. Posters explain to patients ‘why we have plants here’ and how ‘caring for our planet is caring for our patients’. Staff organised free events for families to promote this approach, with colouring competitions, sunflower growing and opportunities to talk to the Health & Wellbeing Team.
- Great Sutton Goes Green, Ellesmere Port. This practice focussed on increasing physical activity with on-going benefits for the environment. A gardening group planted 15 trees, whilst a walking group of 55 participants improved their physical activity by 100%, covering 15 miles over 7 walks. After the pilot project ended, 35 individuals were still walking regularly. Walking compared to vehicular travel enabled participants to save combined carbon emissions of 232.34 Kg CO2e.
- Inhaler Disposal in Primary Care, West Kirby. By reviewing prescribing habits and raising awareness of safe inhaler disposal, this practice has improved asthma control for patients and is reducing waste. Posters explain why proper inhaler disposal matters, with messages including: ‘inhalers contain powerful greenhouse gases. Even empty inhalers can harm the environment’. In partnership with local pharmacies, patients are signposted to safe disposal points.
- Asthma Project, Liverpool. Recognising that an indicator of poor asthma control is the overuse of SABA medication, and that inhalers account for 4% of the NHS carbon footprint, the practice team came together to agree care standards and update their asthma management knowledge. In the process, staff morale improved. Wins include a 36% reduction in SABA prescriptions, plus cost and carbon footprint savings. Ongoing benefits include fewer hospital admissions and GP appointments, and better quality of life for patients.
- Streamlining Routine Chronic Disease Blood Tests, Winsford. A one-page protocol was designed and implemented for blood tests for patients with two or more chronic disease diagnoses. This avoids test duplication, such as cholesterol testing for both diabetes and coronary heart disease. Benefits include more efficient use of administrative and clinical time, reduced costs to both primary and secondary care services, and less patient travel, reducing carbon emissions. Early results are very promising.
- Embedding Green Impact into the Culture, Cheshire. Steps were taken to streamline blood tests, increase inhaler recycling, reduce iron prescribing and introduce in-house recycling schemes. Results include a 23% reduction in LTC blood test appointments, and a 57% reduction in iron prescribing (by switching to the new iron prescribing guidelines). Inhaler recycling has increased significantly, while food waste and printer consumables are now routinely recycled. The practice was shortlisted for the RCGP General Practice Awards 2025 (Sustainability award section) and received a commendation.
Dr Nadja van Ginneken, who oversaw the whole programme, said, ‘We are delighted with the success we have achieved with these initial projects, which is a tribute to the wonderful commitment of everyone involved. They achieved not only a triple win of improved patient care/wellbeing, reduced carbon impact, and cost savings unanimously, but also achieved improved staff morale in 80% of projects which was unexpected – it is therefore a quadruple win. This breaks down the myth that GP practices should not do sustainability work due to already having too much to do, because this type of project creates a sense of community and common purpose among staff and patients alike. We have identified a further 8 potential projects this year and are looking at how to scale up the new ways of working trialled by these projects, for roll out across our region.’
The full report is available for Greener Practice Members here
written by Sara Rowell