28 Aug 2019

The Environment & The Impact Of Care Products

As climate change and natural resource management move up the scientific and political agendas, the concept of sustainability has become a key issue. This article discusses how nurses and NHS organisations can engage with the concepts of sustainability and citizenship, to reduce the negative impact of healthcare provision on the global ecosystem and public health and wellbeing.

Sustainability and health

The relationships between humans and the global ecosystem are complex and still the subject of debate. Although individual human activity may seem insignificant, global human activity has an enormous impact and is generally agreed to be contributing to climate change. It is also using natural resources in quantities that are unsustainable in the long term and in ways that can have a negative impact on health and wellbeing. As Fig 1 shows, these effects are the combined result of a range of factors.

These are:

  • Individual factors such as age, sex and hereditary factors;
  • Lifestyle including work/life balance;
  • Community networks;
  • The local economy including markets and investments;
  • Activities;
  • The built environment;
  • The natural environment.

While the international community has yet to agree how to improve sustainability by reducing the impact of human activity, the UK has introduced a range of initiatives with the aim of doing so. The most generally significant of these is the Climate Change Act, which became law in November 2008. This gave the government the right to require public bodies to report on how they have assessed the risks of climate change to their work, and what they are doing to address these risks.

Within healthcare, the NHS Sustainable Development Unit ( was launched in 2008. Its mandate is to be a source of leadership, expertise and guidance concerning sustainable development to all NHS organisations in England. In 2008 the Climate and Health Council ( invited individuals and organisations to sign up to a declaration on the effects of climate change. This argues that climate change is having a critical impact on global health and the environment and calls for action at government, organisation and individual level.

The healthcare context:

As the third largest employer in the world and a major consumer of resources, the NHS has the potential to make a significant impact on the sustainability agenda. The NHS in England has an annual carbon footprint of 18 million tonnes of carbon dioxide, which consists of energy (22%), travel (18%) and procurement (60%). Although the service has seen an increase in efficiency, its carbon footprint has increased by 40% since 1990 (NHS Sustainable Development Unit, 2009). It is estimated that the NHS produces 600,000 tonnes of waste - over 1% of all domestic waste produced in the UK. It uses 50 billion litres of water and energy use produces 3.5 million tonnes of carbon dioxide per year (Royal College of Nursing, 2007).

As the largest employer in the UK, the NHS has a duty to engage with the agendas outlined in the Climate Change Act and to contribute to proposed government targets. Sustainability is, therefore, a huge political issue.

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