Planetary Health and Sustainability in WPBA

In response to the impact of climate change and the need to deliver a ‘Net Zero’ NHS, the RCGP felt it was vital that the GP curriculum should be updated to reflect the impact of these issues on the role of GPs and recognise the challenges GPs might face both clinically and professionally.

Healthcare services have a large impact on climate change and GPs play an important role in implementing measures that promote the health of both people and the planet and promoting the use of resources and services effectively and sustainably.

Healthcare is also affected by changes in the state of the planet. There is increasing awareness that air pollution, access to nature and global temperatures change the epidemiology of conditions seen in UK healthcare. Changes to reduce the impact of healthcare on the environment will improve both sustainability and the quality of healthcare.

Evidencing planetary health and environmental sustainability in WPBA

Environmental sustainability and planetary health can be demonstrated and evidenced across many elements of WPBA. The following list includes some examples. This list is not intended to be exhaustive; and environmental sustainability and planetary health can be evidenced across a wide range of areas in WPBA. We are continually improving the guidance and resources on these assessment pages, with a view to including specific guidance on how environmental sustainability and planetary health can be demonstrated.

Quality Improvement Project/Quality Improvement Activity

When undertaking a QIP, you should consider the project’s impact on sustainability as well as health outcomes for patients, communities and populations from an environmental, social and financial perspective.

More information on Quality Improvement Project

More information on Quality Improvement Activity

Leadership activity

Many Leadership Activities could be given a sustainability and planetary health focus. For example:

  • Reviewing prescribing (e.g. measuring ACB in high-risk patients)
  • Liaise with the practice’s social prescribing link workers to explore how the practice could more effectively work with them and then liaise with practice staff to make this happen (as meetings or in-house training for example)
  • doing an energy use audit of the practice or using a pre-existing energy audit to develop ways to reduce energy use;
  • Reviewing whether the right bins are being used (environmental and sustainability implications) and overall waste volumes are reduced
  • Developing and leading a wellbeing project (e.g. a regular team nature walk, adhering to ‘leave no trace’ principles)

More information on Leadership activity


COTs offer several opportunities for evidencing this area. For example:

  • Using appropriate psychological and social information to place the complaint(s) in context. E.g. Air pollution levels will affect the risk of developing many conditions and so understanding a patient’s air pollution exposure is therefore helpful to putting their risk of complaints into context. Similarly heat affects the epidemiology of vector borne illnesses, and stroke or heart disease.
  • Obtaining sufficient information to include or exclude likely relevant significant conditions. E.g. This might include obtaining sufficient information about the pattern of Pressurized metered-dose inhalers use.
  • The management plan (including any prescription) could include a discussion of how to safely dispose of unused medication or medicine packaging/inhalers.
  • The patient is given the opportunity to be involved in significant management decisions. There is evidence that when patients are genuinely involved in shared management planning, then resource use is reduced (reducing investigations, prescribing and procedures). In other words, ‘shared management planning’ is a sustainable practice.
  • Makes effective use of resources. As well as time as a resource it is appropriate to consider the financial, environmental and social resources that are part of the consultation and the accompanying management plan.

More information on COT


  • Addressing planetary health involves good communication with patients and ensuring that the information shared about medication or treatment options (for instance) is tailored to the individual’s needs. (Communication and Consultation Skills)
  • Clinical assessment and judgement will include ensuring that the history includes awareness of the patient’s context – e.g. understanding the specific, contextual impact that air pollution as an environmental risk factor for health issues has for the patient.
  • Discussing and understanding the sustainability implications of different medications as well as social prescribing. (Clinical Management)
  • Considering how appropriately resources are used - the way that care is managed can have a positive impact on sustainability. (Organisation/Efficiency)

More information on Mini-CEX

CAT and the Prescribing Assessment

Prescribing is a large component of the carbon footprint of GP care. A substantial theme in planetary health is improving the quality of prescribing.

The prescribing assessment follow-up CAT offers an opportunity to discuss and reflect on whether your prescribing is sustainable. It could also focus on looking at known areas of concern in prescribing like drug interactions, over prescribing, cascade prescribing and iatrogenic prescribing.

More information on CAT

More information on Prescribing Assessment

More information

The RCGP has many resources and links to external organisations that provide information on sustainability in GP, and in GP Training. Three good places to start are: