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A great place to start in terms of taking action is to engage with sustainability and decarbonisation in your practice.

Use the Green Impact for Health Toolkit

The Green Impact for Health Scheme is a useful tool to get started on the road to sustainable healthcare.

You receive a “working towards” certificate for having set your practice on a greener path with even one simple action, and collecting points leads to bronze, silver, gold and carbon awards. Actions include switching to low-carbon inhalers, social prescribing, referring patients in fuel poverty, reducing over-prescribing, reducing waste and renewable energy. You can find a summary of the actions here.

Government guidance on how to use All Our Health can be found here.

Greener Primary Care Wales

In 2022, Primary Care Division and Public Health Wales set up their version of the Greener Impact for Health toolkit, such that is abides by Welsh legislation. This Framework can help independent primary care contractors (general practices, community pharmacies, optometric practices and dental practices) improve their sustainability and environmental impact. You can find more information about it here.

Sustainable QuaIity Improvement (SusQI)

When you do a QI project, consider the environmental, social and financial impacts of the suggested QI (the Triple Bottom Line, created by the Centre for Sustainable Healthcare). See the Educational Resources section for more information on SusQI, as well as the asthma toolkit.

Carbon footprint your practice

A carbon footprint measures the total greenhouse gas emissions caused directly and indirectly by a person, organisation, event or product – in this case the carbon emissions associated with the running of a practice and providing healthcare to our patients. 

There is a free online non-clinical carbon footprint calculator for General Practices in the UK. The calculator measures and identifies the non-clinical greenhouse gas emission hotspots from running our practices and produces a carbon equivalent footprint. For more details, a watch the ‘How to’ video and Q&A from SEE sustainability. A carbon calculator is available at and a practice decarbonisation guide. See sustainability also runs carbon literacy training.

Healthy Environment Workshop

Public Health Wales’ Health and Sustainability Hub has produced this toolkit to support Public Bodies and their staff to consider and reduce their negative impacts on the environment, and increase those activities that have a positive impact.

The online workshop allows teams to discuss the big issues of climate change, zero waste and biodiversity and looks at the activities of the whole team as well as individuals within the team. It is suitable for every team in an organisation, not just those who focus on sustainability, as everyone can make a positive contribution.

The NHS Estate and Infrastructure can support biodiversity net-gain

NHS organisations in England occupy some 25 million m2 of land in acute care alone. And Primary Care estate is set within diverse settings, with potential to contribute to local nature and biodiversity action plans, especially in urban communities. This could be by contributing to nature corridors or supporting specific species (such as the Centre for sustainable healthcare’s bee friendly GP guide). Optimising nature and greening primary care premises can also improve population health through reducing air pollution, cooling grey infrastructure or reducing surface water flooding. The forthcoming Environment Bill will set legally binding targets to halt the decline in species abundance by 2030, putting the environment at the centre of all government policymaking. This will require all public bodies, including NHS England, to report publicly on their impact on key environmental outcomes. As an anchor institution, primary care has a key opportunity to contribute to a collaborative approach to improve biodiversity, nature and health. 

Disposal of medicines and devices

PenCycle aims to recycle/repurpose any Novo Nordisk disposable devices to avoid them potentially being sent to landfill.  It has previously been piloted in 3 areas across the UK and we are now rolling this out nationwide. 

The initiative covers any Novo Nordisk Flextouch or Flexpen disposable pens used in medications to treat diabetes, obesity or growth hormone treatments.  23 million of these pens are used annually each year in the UK and across the 3 areas during the pilot phase, 14,500 pens were returned to be recycled.  This equated to:

For further information, you can visit or contact Ben Skidmore at

Read all about endocrine disruptors here!