Change Ideas

Change ideas shared by participants

This section includes change ideas shared by participants during the webinar.

Health board owned buildings
- Buildings should be properly insulated
- Use heat pumps to reclaim heat whilst ventilating the building
- New builds should meet Pasivhaus standards
- High standard controllable heating with thermostats – set to 19C as default
- Lights on sensors
- Door closers to prevent heat loss
- Double glazing and triple glazing
- Dry Storage for wet clothes, showers for people walking, running and cycling to work
- Ensure hot water is not too hot
- Reduce light pollution – do we need security lighting in very remote locations? Could they be on motion sensors?
Catering
- Reduce disposable plastic - paper straws, paper sandwich containers
- Promote microwave cooking over other cooking methods
- Encourage staff to bring packed lunches with reusable packaging - storage space
- Promote plant-based diets, more vegan and vegetarian choices, improved range and quality of plant-based foods.
Consumables
- Support primary care with sterilising equipment for minor surgery to avoid using single-use equipment
- Good guidance on best use of PPE, overzealous application = waste
- Rechargeable batteries
- Avoid battery use by wiring otoscopes and ophthalmoscopes to mains electricity.
Durability
- False economy in buying stuff that is not fit for purpose, and which then breaks and requires replacement, factor this in to options appraisals for purchases.
Energy
- Explore having the electricity supply from a green energy company
- Wind turbines
- Solar panels
- Ground source heat pumps.
Food
- To reduce the carbon footprint of your food, focus on what you eat, not whether your food is local
- ‘Eat local’ is a common recommendation to reduce the carbon footprint of your diet. But transport tends to account for a small share of greenhouse gas emissions. How does the impact of what you eat
- Worst plant protein better than best animal protein for environmental impact.
Landscape
- And a shelter belt in development, trees planted each year
- Our community hospital has a saturday gardening club forstaff. We look after the courtyards
- Our social prescriber had a group of patients tending to our gardens in Links Health Centre, they managed to source free plants from the council that were being thrown out
- Look at forming or joining a green prescribing group or climate and sustainability programme board in your Health Board
- Encourage tree planting around all health board premises.
  Enable the installation of surgery polycrubs.
  Reduce the number of cuts per year and the amount of grass cut – wild flowers support more bees etc
- Other green infrastructure options include SUDs ponds, rain gardens, green walls etc. Also improve the resilience of infrastructure to current and future climate change, as well as providing green/ blue spaces for users. Energy generation including PV panels and low impact lighting are also quick wins.
Office Waste
- Posters at printers and photocopiers to discourage unnecessary printing and copying
- Black and white, double-sided
- Use recycled paper
- Recycling bins for waste paper.
Patient Information
- Patient information poster at clinics to educate patients round issues related to recycling
- Have a poster highlight importance and using more 6 SABA seeking further guidance.
Patient pathways when accessing healthcare
- Realistic medicine – don’t send patients for procedures that do not have a realistic chance of improving the quality of a patient’s life, reduce unnecessary referrals and investigations and treatments
- Spinal rather than inhaled anesthesia
- Use virtual consulting for follow-up wherever possible
- Reduce unnecessary follow-up; use patient-initiated returns.
Prescribing and dispensing medications
- Practice pharmacist can made huge difference in relation to prescribing
- Low-impact breath-activated dry powder inhalers first line on the formulary
- Improve quality of asthma and COPD management
- Support used inhaler return schemes
- Support empty pill strip return schemes
- Ensure best use of compliance aids, reduce unnecessary blister pack use.
- Polypharmacy reviews
- Another campaign to reduce medicines wastage and safe disposal
- List of medicines not suitable for prescribing e.g. cough mixtures
- Develop green prescribing data tool
- Electronic prescribing unfortunately I think is years off - serial prescribing is a step in the right direction
- Finding patients on STU makes this easier (ask practice pharmacist if needing help how to find them)
- Community Pharmacies are duty bound to take used inhalers back once finished as they are for other medicines/tablets etc 'for safe disposal’ as don't recycle. Safe disposal of medicines including inhalers is part of the community pharmacy contract
- Participate in meetings to explore a national inhaler recycling service
- Worth highlighting to the HB Director of pharmacy or community pharmacy champion - they are required to safely dispose of medicines as part of the contract, and incineration is currently the safest way to destroy the HFCs in cannisters. It may be confusion of recycling (not currently available) vs disposal.
Purchase Locally
- Avoid transporting items long-distance; when can local suppliers and service providers be used?
Social Prescribing
- Social prescribing instead of medication
- Better population health reduces reliance on health care resources
- Promote and support activities such as park run, move more, daily mile
- Effective link worker – campaign for an effective link worker program in your Health Boards
- Dedicated to the advancement of social prescribing through promotion, collaboration and innovation We Work to create partnerships, across the arts, health, sports, leisure, and the natural environment.
Staff engagement
- Staff can help – for example switching off monitors and printers, not printing stuff that can be seen on screen, supporting staff to cycle or walk to work, harnessing their ideas
- Green teams in workplaces – how can this be promoted?
- Green cluster project
- Green leadership within clinical teams, the work force can lead community change
- Climate change challenge – competition for best idea, implementation etc.
- Mini climate change conference.
Sustainability champion
- There should be a sustainability champion in each HB - ours is a non-exec director and that would be the route to alert them to building/transport initiatives that would have environmental impact.
Technology
- Encourage remote consultations with good IT Wi-Fi networks, mobile phone networks, community hub network support
- Easy to use video linking, support for video linking with good hardware, speakers etc.
- Effective IT support for remote working.
Transport
- We've set up a cycle to work scheme, and have approval from Health Board to install bike racks at the surgery. Next step is to get a charge point at the surgery
- Deprived areas would have the most to gain from safe active travel infrastructure
- Think about taking out insurance - theft a massive issue
- Charge points for electric vehicles
- Safe storage bicycle racks
- Promote cycle scheme sign-up, including primary care
- Bus routes to include health care premises, bus stops at health care premises
- Encourage staff to use public transport by supporting travel card schemes
- Reduce patient travel - better to move one consultant than a clinic full of patients
- Foldable bikes fit neatly in corridors indoors - less likely to be stolen
- Find a patient group or local bike shop to take over servicing your e-Bike
- There are courses available for adults (similar to bike-ability in schools) to build confidence using bikes on the roads. These can be accessed via Cycling Scotland or local councils
- Sometimes the health centre can become the local hub for NC500 bike repairs.
Waste management
- Avoid putting unnecessary waste into the incineration waste stream
- Provision of adequate bins for sorting for recycling, give hotel services teams accountability for ensuring these are used appropriately
- Better access to battery recycling.

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