Net Zero consultancy service
The climate crisis is a health emergency
To deliver better health now and for future generations we must tackle climate change at source, and we all need to play our part.
Contributing around 4% of England’s emissions, the NHS is both a part of the problem and the solution. Which is why in 2020 the NHS became the world’s first health service to commit to reaching net zero emissions. All areas of the healthcare system can make a difference, and many are already on the way.
As outlined in the Delivering a Net Zero NHS publication, NHS England have set two targets:
- To be net zero by 2040 for directly controlled emissions.
- To be net zero by 2045 for emissions that the NHS influences.
How can the RCGP help general practice achieve net zero?
The College has developed a service to provide PCNs and practices guidance and support to:
Work towards the NHS target to become net zero by 2040
The RCGP Net Zero service provides practices with a roadmap - specifically a carbon reduction plan with realistic, measurable actions to put in place to work towards meeting the NHS targets; and to keep them on track to achieve this.
Take steps to address climate change
The RCGP Net Zero service will help practices demonstrate to patients and the public their commitment to supporting climate change, positively impacting the practice’s corporate and social responsibilities.
Become more efficient
The RCGP Net Zero service will aid cohesion within practices by providing a common goal that everyone is working towards: whilst delivering high quality low carbon care and saving money.
What is the RCGP Net Zero offer?
The RCGP’s Net Zero service matches a practice with a trained adviser who will work closely with the team to develop a decarbonisation plan. The plan will include a baseline assessment of the practice’s current carbon use and emissions; agreed reduction targets, and a prioritised list of actions the practice can take as they work towards reducing their impact on the environment.
The development of the plan will take place across a six-week period and include the following stages:
- Initial online consultation. This is a scoping call to help the adviser understand the practice’s aims and expectations. The adviser will discuss how to find the information needed to calculate the practice's carbon footprint, how to complete the calculations, and prepare for the in-person visit. The practice will receive a Net Zero Handbook and a data collection tool.
- In-person practice visit. This is an opportunity for the adviser to meet the team and to better understand the practice needs, behaviours and challenges. The visit will involve a practice walk-around to assess how and where improvements can be made, and engagement with the wider team to understand how the practice operates.
- A virtual meeting. This touch-point is focussed on establishing a plan (taking into consideration the observations from the practice visit), agreeing the action points, working out the deliverables, how the practice can achieve these, and next steps. The practice representative can use this opportunity to further strengthen team and leadership buy-in to the proposal plan, and sense-check it is realistic, achievable and will bring about the intended impact.
- A check-in. This is an opportunity to monitor progress against the agreed action plan and measure impact, ideally this will take place three to six months after development of the plan.
How much does it cost?
As a not-for-profit organisation in the healthcare sector, we understand your needs and challenges. Our costs are set at the lowest sustainable level whilst not compromising on standards or deliverability.
The first ten practices to register will receive the pilot rate - £2,495 + VAT. Pricing for subsequent practices will be finalised following the pilot.
Prices are available on request for an Integrated Care System (ICS) or Primary Care Network (PCN) commissioning several practices at once.
Why work with the RCGP?
As strong supporters of NHS initiatives, delivering a net zero NHS by 2040 is part of the College's multifaceted approach to sustainability and climate change.
We are experienced
Our Primary Care Development programme has been supporting practices for almost ten years. We have worked with over 400 practices and helped over 90% improve their CQC rating.
We are quality assured
Our team comprises more than 40 advisers, all of whom are from general practice. This means we understand the environment – the challenges and pressures faced by practices - and ensure action plans are achievable, realistic and sustainable.
We are committed
The RCGP is committed to climate change: we believe that high-quality general practice can be delivered with a low environmental impact. As a not-for-profit and leading professional body for general practice, we are best placed to address the needs of the profession and lead the workforce.
Join the move to net zero healthcare: let's decarbonise primary care together
There are no obligations. The journey to reaching net zero needn't be daunting. We're keen to further understand your needs.
We've helped over 90% of the practices we've worked with to improve their CQC rating. Don't just take our word for it.
You will find a series of 30-minute eLearning modules and a decarbonisation guide with practical solutions to get started.
In September 2019, the RCGP formally acknowledged the climate crisis and the catastrophic effect on human health of not acting decisively and urgently on climate change.
Case studies and testimonials
Over the past ten years, the RCGP has worked with over 400 practices. This support has ranged in scale from CCG / system level all the way through to working with individual practices. Read our case studies to learn more about the type of services we offer.
The RCGP was commissioned by a Clinical Commissioning Group (CCG) in a deprived area of London to support seven practices as a part of a wider quality improvement programme. This involved working alongside several other organisations. The practices were identified by the CCG as requiring the most hands-on; support due to the depth of the issues they were encountering.
The practices were taken through a diagnostic review to determine the support they needed - these covered areas such as:
- Improving operational efficiency
- Mentorship and management change
- Specialist advice and guidance
- Partnership challenges
- Succession planning
- Recruitment difficulty
The RCGP and CCG held regular meetings to monitor and report on progress with the support and engagement from the practices. These meetings and close contact allowed for the programme to be agile in tailoring the service to the changing needs of the practices and provided a mutual system of support for all parties.
The results of the programme were extremely positive for both the CCG and the practices involved.
From the CCG:
"The RCGP worked closely with each individual practice and provided bespoke and varied support after their scoping visits. Support delivered to practices who were struggling with their long-standing issues that were not necessarily quick fixes was very successful, for example, dealing with partnership issues, succession planning or helping a practice address its issues with a local care home are difficult to quantify yet highly valuable. Furthermore, the RCGP supported practices with impending CQC visits. The feedback from practices to the CCG has been consistently positive".
From the practices:
"This is the best thing the CCG has ever done".
"Having something like this is such a breath of fresh air, it can only lead to improvement and change really, so it’s good."
"One word: Magnificent. We didn’t actually expect an outcome like this, and it was so supportive and friendly. Absolutely fantastic, we recommend to everybody".
The RCGP was commissioned by a large, at-scale practice that had previously been rated 'good' by the Care Quality Commission but was placed in special measures following an inspection. This led to regulatory actions and included a significant incident raised by the Clinical Commissioning Group.
This gave a short time frame to explore the issues from all perspectives of a large team (formed from several practices) who were shocked and upset and needed both sensitive interview and constructive support to move forward.
The RCGP multidisciplinary support team undertook a diagnostic visit and conducted a root cause analysis with the senior management team. The analysis followed a similar pattern seen in smaller practices:
- Weak corporate governance, where, despite a detailed management structure, there was a lack of definition of boundaries and accountability.
- A strategic focus on expansion rather than ensuring the safe day-to-day running of the organisation.
- Weak operational delivery systems based on historical working patterns with individual practices behaving autonomously, with little central reporting or oversight, and an inequitable distribution of staff and resources.
- An unhelpful culture. Although nominally one organisation, individual practices remained wedded to their original teams and sites.
A diagnostic report and action plan were produced based on these findings, along with the significant incident report and action plan required by the CCG.
The RCGP team worked with the senior management team to develop a clear shared vision, robust central governance and a plan to 'win hearts and minds'. Specific regulatory actions requested by the CCQ, and the CCG were also addressed.
In addition, the College team provided diagnostic and targeted support for individual practices to address specific safety concerns and develop practice teams. As a result of these actions, the organisation was stabilised. Corporate governance was strengthened, and the senior management team undertook an extensive programme of quality improvement which has satisfactorily addressed the most pressing CQC and CCG concerns but is moving far beyond that needed to get out of Special Measures.
In turn, communication improved across the organisation, staff and resources are more equitably spread, allowing more effective operational delivery and a new single organisational culture was developed.
The RCGP was brought in to support a practice based in a deprived area of a coastal town. The practice was the result of the merger of two practices and had a patient list of approximately 16,000. The practice had been recently placed in Special Measures after receiving a rating of 'Inadequate' across all but one area of its most recent Care and Quality Commission (CQC) inspection.
Along with the inspection results the practice was also having trouble retaining GPs, served a large care home population and had taken on additional services (for example, walk-in centre and special allocations) due to its isolated location.
The RCGP assigned a multi-disciplinary team to the practice covering GPs, practice management and nursing to provide an initial scoping exercise followed by intensive support. The scoping revealed that there was uncertainty among key staff members with a senior GP thinking of leaving the practice, and the practice managers feeling unsettled. There was also no leadership of the large nursing staff and limited governance in place.
The advisory team used various delivery methods to maximise delivery impact and minimise costs by making use of face-to-face meetings along with online calls and email correspondence. Once the reinspection date was announced support focused on CQC preparedness.
The practice came out of Special Measures as a result of the inspection, however the lasting impact on the practice reached far beyond the inspection grading. The practice team reported that they felt motivated and empowered, and retention rates had improved because of the support they received.
The RCGP was contacted for assistance to prepare a practice for their CQC reinspection. This practice was placed into special measures - it was rated as 'Inadequate' by the Care and Quality Commission (CQC) specifically in the areas of 'Safety' and in being 'Well-Led'.
According to the CQC, the leadership challenges faced by the practice included not communicating their leadership vision with staff, no regular performance reviews, no documentation around internal investigations, a lack of training and not meeting cleanliness standards.
The RCGP assigned a team of three advisors: a GP, Practice Manager and Practice Nurse who each worked within their relevant area of the practice to bring the leadership back on track. The team found that the practice had recently gone through a merger which had not gone well, and at the same time had changed their computer system. As a result, the practice’s leadership had neglected to notice issues that had arisen regarding support for their nursing staff, and their Practice Manager was overwhelmed and not coping well.
A detailed action plan was drawn up for the practice and advisors to have a common document to work with and to measure progress. The action plan covered:
- Implementing a staff appraisal process
- Reviewing their processes and risk assessment procedures
- Putting infection control and cleanliness processes in place
- Improving communication with staff through updated policies
- Ensuring minutes from regular staff meetings were available to all staff.
In addition to the development of a practical action plan, the RCGP advisory team provided personal, peer to peer support to encourage and guide the individuals of the practice through the challenges they were facing and bring them back to be a high performing team.
As a result of this work the practice was rated overall as 'Good' in four out of five areas by the CQC at their reinspection.