New Productive General Practice Programme helps GPs get down to brass tacks to cut carbon

After being told you had a nasty cold (“it’s not the flu”) and declined a doctor’s appointment three months ago, you’re worried they’ve been so prompt in getting in touch this time. Imagine you’re about to have a 20-minute, online appointment with your doctor. You texted the practice last week to let them know you’ve had an unusual cough for five weeks that isn’t improving. They emailed straight back to set up an appointment, explaining your statistics put you at high risk of heart disease. The cough needs checking out.

Using a graph of the blood pressure readings you’ve been sending in, you and your doctor consider the decline in your health since your divorce two years ago and the relationship between your diet, stress at home and the health of your heart. You’re quietly horrified at the photos she uses to talk through the progression of heart disease, its treatment and the build-up of fatty deposits that cause high blood pressure. You don’t need any persuading to agree to a course of action to head-off heart disease. You’ll have an assessment at your community centre to confirm if you already have it and - along with your two teenage girls – you’ll see a wellness-coach to explore how best to reduce your lifestyle-associated risks.

This kind of consultation uses technology that’s available today; it offers low carbon access to services, reduces the need for carbon-intensive pharmaceuticals and equips both doctors and patients to make informed choices about care. Involving patients in monitoring their health encourages us to take responsibility and removes administrative tasks from the front desk. As patients with colds are politely turned away by a doctor at reception, those with multiple conditions can have longer appointments to discuss their wider health. Behind the scenes, responsiveness to patients’ text messages is possible by fine-tuning team time to avoid unnecessary repetition and reworking, and a more effective appointment system.

Forum for the Future has teamed up with the NHS Institute for Innovation and Improvement and The Centre for Sustainable Healthcare to weave sustainability through the about-to-launch Productive General Practice Programme. It will help general practices cut inefficiencies, free-up time to spend with patients and rethink the way services are designed to improve patients’ and staff experiences. What’s new about Productive General Practice is it’s the first fusion of sustainability thinking with Six Sigma methods – allowing practices to cut energy, water and waste to landfill at the same time they iron-out other process ‘wastes’.

Despite growing calls for leadership, GPs find ‘far off’ issues like climate change a distraction from clinical decisions when they’re sat in a room with someone facing disease or illness. In the Guardian article ‘Doctors urged to take climate leadership’, last week, UK military and medical experts call for the kind of action to cut C02 that we saw from GPs to cut smoking. But the life and death nature of general practice and its frenetic pace makes everything seem trivial: from popping out for lunch, to replacing the boiler, to turning the thermostat down, to leaving work on time. It’s one reason why GPs often say their work life balance is off kilter.

Productive General Practice is a fantastic answer to this call for less talk, more action from GPs on climate change – building on the Productive Series excellent record of helping frontline staff to improve hospital and community services. It offers an opportunity to get serious about the environment by making the links with patients visible and practical. It systematically channels cost savings achieved through better environmental performance, into better quality of care. And by using sustainability as a lever to reshape access and encourage shared decision-making with patients, it equips GPs to move the NHS a step closer to a national wellness service that supports us to lead healthy, active, fulfilled lives.

You can find out more about the launch of the programme in recent BBC programmes here. Contact Gemma Adams for more information on this project.