Sustainability in practice: Every small step counts

Climate change is a growing global challenge with far-reaching impacts on health, environmental sustainability, and human wellbeing. Human activities such as burning fossil fuels, deforestation, and carbon emissions are some of the biggest health threats of the 21st century. This is driving unprecedented climate shifts, threatening the foundations of good health: clean air, safe water, nutritious food, and stable shelter. In this context, Australia is particularly vulnerable to climate-related events such as floods, bushfires, and heatwaves, which highlights the need for proactive measures.

Globally, the healthcare sector is a significant contributor to environmental change, accounting for 4.4% of global carbon emissions. In Australia, this number is even higher, producing approximately 7% of Australia’s greenhouse gas emissions. This impact stems from diverse sources, including energy consumption, waste, and the use of medical resources.

The United Nations and other international organisations, local governments, businesses and individuals are increasingly prioritising sustainability to address the impacts of climate change and its associated risks. For example, the International Society for Quality in Healthcare (ISQua), a global authority for health and care accreditation standards, has released a new principle to its 6th Edition Guidelines – Principle 6: Sustainable Care, in response to emerging challenges faced by health systems worldwide.

The RACGP Standards 6th Edition draft is now aligning with the new ISQua Standards, including a stronger focus on reducing the environmental impact of practice operations and promoting sustainable clinical care. This signals an exciting step forward, positioning general practices as active contributors to healthier communities and a healthier planet.

While the final version of the Standards is still being confirmed, early drafts suggest that practices may be asked to show how they are minimising their environmental footprint, through clear policies, simple sustainability initiatives, and systems to track progress over time.

Rather than introducing a completely new way of working, this inclusion acknowledges that many practices are already taking positive steps, like reducing waste, using telehealth, or switching to energy-efficient lighting. By recognising and building on these existing efforts, the 6th Edition offers a framework to support practices in embedding sustainability in a manageable, practical way.

Ultimately, this shift reflects a growing global movement towards climate-resilient, sustainable healthcare, one that Australian general practices are well-placed to lead.

All health service organisations, from general practices, large hospitals to specialist facilities and allied health teams, can play a key role in addressing these challenges through sustainable strategies. Implementing these initiatives will support in the reduction of environmental harm while also enhancing the resilience of services susceptible to climate-related disruptions.

Practical strategies to help make your practice more sustainable

While sustainability may seem complex, your practice can begin by implementing manageable steps. Your team is likely to be undertaking a number of proactive measures already (consciously or unconsciously) to reduce their environmental impact. To further support these efforts, the AGPAL team has compiled some practical strategies for minimising your environmental footprint.

1. Energy and water efficiency

• Conduct an energy audit: these can help you identify where most energy is being consumed and point to easy wins for saving energy. Some local governments even offer free grants and rebate options to help practices become more efficient. Similarly, tracking water usage and bills can help you identify leaks or abnormal water usage.
• Optimise lighting and controls: switching to LED lights can cut your energy use by up to 75%, also helping the practice save money. Likewise, adding monitor sensors, timers, and smart controls in staff rooms or toilets can also help save electricity.
• Water-saving fixtures: installing water-efficient fixtures, such as low-flow tap aerators can assist in reducing water use. Routinely check and fix any dripping taps, leaking toilets, or other plumbing issues as even small leaks can waste thousands of litres of water.

2. Waste reduction and recycling

• Conduct a waste audit: examining what type of waste your practice produces and in what quantities can help you understand what measures need to be put in place to improve recycling efforts.
• Set up separate bins: clearly labeled bins for paper and cardboard, cans and hard plastics, soft plastics and general waste can improve recycling rates. It’s best to place these bins in easy-to-access locations so that staff and patients are more likely to use them.
• Reduce single-use items where possible: identify areas where your practice uses single-use disposable items and assess if any reusable alternatives exist. For example, in kitchens or staff rooms, switch from disposable cups or plates to reusable kitchenware. If it’s safe, in clinical areas utilise fabric gowns instead of disposable ones. Even small changes like opting for reusable spray bottles for cleaning products can make a difference.
• Choose suppliers with take-back or recycling schemes: some medical suppliers offer programs to take back used products or packaging. Pharmacies often collect expired medicines for safe disposal, and as for e-waste (like computers or printers) it can be taken to e-recycling facilities or even donated to charities. All these alternatives make sure that these materials don’t contribute to landfill.
• Train and engage staff: educating your teams on how to properly dispose and recycle, providing guidelines and posters in key areas, can help raise awareness around the subject. Often, waste initiatives fail due to lack of awareness so make it part of practice culture to be mindful of waste disposal.

3. Sustainable procurement

• Buy local and sustainable products: if possible, source local products to reduce transportation emissions and support businesses in your area. You can also look for products with minimal packaging or sustainable or biodegradable product options. For example, you could switch to printing paper that is 100% recyclable or choose environmentally friendly cleaning products.
• Choose bulk orders to reduce packaging: be conscious of purchases and plan ahead to reduce the frequency of deliveries and packaging. Many items, such as disposable gloves or other non-perishables, can be bought in bulk. Find a balance and really analyse what works for your practice.
• Assess suppliers’ environmental credentials: when choosing any type of supplier, from medical equipment to cleaning services, review their environmental policies. Do they have any sustainability statement or certification? Or do they take back packaging for reuse? Choosing suppliers with strong environmental credentials encourages a greener supply chain.
• Avoid unnecessary materials: this can mean printing fewer brochures or promotional materials or digitising communications as much as possible. When appropriate, use electronic forms and secure email for patient communications rather than paper letters.

4. Low-carbon clinical care

• Optimise telehealth and virtual consultations: without compromising clinical care, offer telehealth appointments (phone or video consultations). This reduces travel-related emissions as well as saving patients’ time.
• Reduce unnecessary pathology and imaging requests: by adhering to evidence-based guidelines and avoiding redundant tests, GPs can prevent wasteful use of resources and carbon footprints tied to those services.
• Patient education and preventative care: GPs are in a unique position to advise patients and empower them, building patient activation. Investing time in preventative care or chronic disease management keeps patients healthier and can even reduce hospital admissions. In addition, promoting active and sustainable lifestyles can be encouraged at practice level by installing bike racks and encouraging people to walk to their appointments.
• Use greener inhalers: where clinically appropriate, using “greener inhalers” (such as dry powder inhalers) can help cut emissions. Of course, the clinical needs of the patient are the priority, but often there might be alternative options or devices that can be equally effective and safer for the environment.

Build a culture of sustainability at your practice

Taking the first steps toward a greener general practice may feel difficult, but it will become more manageable if you and your team embrace it as part of your practice’s culture. To begin, take small steps to help your team foster this commitment.

• Start a conversation with your team: make sustainability a team effort by discussing it in a meeting or informal brainstorming sessions with doctors, nurses, reception staff, and managers. Assess everyone’s interest and ideas as there might be people in your team already thinking about ways to reduce waste or save energy.
• Assess your current footprint: you can use sustainability checklists to evaluate your current performance. The goal is to find what you are already doing well, and which areas need improvement. For example, you might find that you already recycle paper but not plastics, or that you are leaving printers and computers on overnight, which could be switched off. These are easy wins on which you can act straight away.
• Choose priority actions: it’s not easy to tackle everything at once. Choose one or two priority areas to focus on initially. Coming up with clear, achievable goals for the following three to six months will make your environmental efforts more manageable. Another key step is to track your progress. Put your actions into practice and monitor them by keeping records. For example, if you have put new procedures in place (like turning off equipment in the evenings or separating recycling), use the data to review whether the changes are making a difference.
• Schedule a review: after a set period, review your initiatives to find out what has been achieved. It’s important to discuss these findings with your team to assess what needs changing. When relevant, celebrate your successes to acknowledge the group’s effort and the positive impact the practice has made. Once your initial goals are met, build on the momentum and select a couple of new priorities to work on.

Integrating sustainability into your general practice

Having already created resources on environmental sustainability within general practice, the  RACGP emphasises that sustainability should be embedded within health service delivery and governance rather than a stand-alone project. By integrating sustainability into clinical practice, teams can align with broader national objectives to help Australia meet its emissions reduction targets.

To further support and guide your team’s sustainability efforts, if you’re yet to do so, we suggest you take the time to read the RACGP‘s Environmental sustainability in general practice resource. This resource supports Australian GPs and their practice teams to reduce their environmental footprint. It provides information on key points like climate change and its impact on health, the roles of practice staff in addressing environmental sustainability, and clinical and non-clinical actions to minimise the practice’s carbon footprint.

Dedicating efforts to creating sustainable general practices can also support operational efficiencies and long-term benefits across various aspects of your business operations. For instance, reducing energy consumption and waste can lower operational costs, and patients are increasingly valuing environmental responsibility in healthcare providers. This can enhance the reputation and trust of your practice’s services.

Looking ahead: a sustainable future

Environmental sustainability in general practice is both an urgent responsibility and an exciting opportunity. Healthcare organisations and general practices play a unique role in supporting the health of both people and the planet. By adopting practical measures and leveraging resources such as the Environmental sustainability in general practice , your practice can make significant contributions to sustainability while also improving service delivery.

Starting small and focusing on continuous quality improvement can lead to long-term benefits for the environment, patients, and your organisation. Together, we can contribute to a healthier, more sustainable future for everyone.