Mapping Greener HealthcareMapping Greener Healthcare

The Scholarship Programme is run by the Severn Deanery School of Primary Care (SoPC), NHS Education – South West. The purpose of this programme is to offer high performing GPST3 trainees the opportunity to develop skills in sustainable healthcare within the context of the NHS.  Such skills will help equip them for future appointments within clinical commissioning groups and the NHS as a whole.  

Trainees on the programme have 20 days of study leave over 13 months, during which to learn about sustainable healthcare and to design and complete a relevant project, with educational support from the Centre for Sustainable Healthcare (CSH) and others.

Picture: Our second scholar with Dr Clare Gerada, the Chair of the RCGP, whom she interviewed for her article on cycling among GPs. Photo taken by Heather Whitney.

Educational Opportunities

1. Strategic educational input from the CSH  – possible attendance at an introductory workshop on sustainability in healthcare in Oxford. 
2. Educational support from the Sustainability Lead of NHS South West.
3. Local mentorship from the Royal College of General Practitioners’ Climate Change and Sustainable Healthcare Lead.
4. Regular guidance and support from national experts in the field of sustainable healthcare.
5. Project work as directed by sustainability mentor/ experts, for example in: Prevention; Patient-centred care and patient partnerships; Leaner care pathways; Low carbon treatment options.    
6. Network with other sustainability scholars and other ‘green’ organisations. 

The scholars are expected to write a final report and a briefer report to go on the SoPC website. They are encouraged to submit posters for conferences such as the RCGP Annual Conference and also to write articles for publication.

Skills and personal development

The project work is designed and supported to help meet educational goals set by the Scholar. Trainees develop specific experience in: Problem analysis, business planning, project management, critical review of success and failure, preparation of report, paper or presentation. 

Funding and practicalities

Appointees extend their period as a GPST in year 3 from 12 to 13 months, allowing them the opportunity for specific sustainable healthcare training and experience, while continuing on the GP training pathway. The additional month works out as 20 working days  (40 sessions) additional study leave which may be taken at any point across the year. Funding for this is provided by the Deanery.  In addition, educational supervision from CSH has been funded by Wiltshire PCT.

Selection

The selection process is competitive. Invitations to apply for the post are circulated to all ST2 doctors in the February prior to the start of the appointment in August of each year.  The application process is by CV, covering letter, and requires the written support of the doctor’s educational supervisor (trainer) and a member of their local patch educational team. 

Aims and Objectives of Recent Scholars

Sally’s aims:

Knowledge regarding:  

1. The relationship between climate change and health 
2. Sustainability – at home, in the community, at work/in the NHS 
3. The broader perspective of the role of doctors in society 
4. The balance between a doctor’s responsibilities to the individual and to society  
5. How to facilitate rather than dictate change

Skills in:

1. Project management: analysis of problem, evaluation/critical review, report writing            
2. Presentation             
3. Advocacy 

Sally’s main outcomes:

Sally spent the first month reading various books and journal articles on of climate change, sustainability and sustainable healthcare and met with Dr Maggie Rae, Corporate Joint Director of Public Health and Wellbeing NHS Wiltshire, and the team at CSH including Sir Muir Gray, Dr Frances Mortimer and Rachel Stancliffe.  She then devised her plan for a project. The formal outcomes are divided into a practice-based project – the production of a Sustainable Action Planning (SAP) “How-to Guide” and “SAP in Practice”, as well as a considerable amount of advocacy work.

Annie’s aims:

1. To promote cycling amongst GPs and GP registrars
2. To research the evidence base behind the benefits and risks of cycling to work
3. To learn about writing skills and improving my copyrighting
4. To get some work published 

Annie’s timeline and outcomes:

Over the initial months (August 2011– February 2012) Annie educated herself about Sustainable Healthcare through reading, browsing the key internet sites and networking via telephone and email.  She identified potential interview candidates and lined up interviews with them.  She emailed a list of questions to the interviewees prior to the meetings. Her outcomes included some publications – an 800 word article, "On Your Bike!" published in the Review section of the BJGP, and a 500-word article published in RCGP News.  She was also awarded the Green Practice Award by Dr Tim Ballard, after delivering a 5-minute presentation (an overview of her cycling work.)

Quotes from the scheme’s organisers and the first two scholars: 

“It was interesting to see how both scholars’ knowledge and plans for the scholarship developed along quite similar patterns over the course of the scholarship, both following almost a cycle.  They both started with a big wave of enthusiasm; they had lots of ideas and wanted to pursue them all, in many different directions.  We helped them to narrow these down towards something practical but also matching their interests.

“In both cases there was point when they experienced a dip, having thought a given plan was going to work really well and convinced themselves of how much sense it made.  When things didn’t go to plan – as happened in both cases – the scholars were disappointed and lost some of their confidence.  That was when they needed some more support and encouragement from us to help them get back on the bike, as it were, and keep going.  I think the whole process, including the low points, was really important in terms of their personal development.”

 Rachel Stancliffe, Director of the Centre for Sustainable Healthcare

“I have learned so much this last year about the relationship between climate change, health, and sustainability...  I have gained skills in project management, including analysis of problems, evaluation/critical review and report writing, as well as presentation and advocacy skills. I now have valuable experience in trying to make a change.”

 Sally Aston, Scholar and GP trainee

“The Scholarship was interesting and a challenge.  I learned a great deal and developed some useful skills.  ...  Things did not run smoothly, but I was able to identify the reasons for this and was pleased to be able to demonstrate change …  I hope that my advocacy work made people think, at least a little, about sustainability and that with time, this gains a greater role in future general practice.

 “I feel it has been a valuable year …I now have a much greater understanding of the importance of sustainable healthcare and hope that when I am a salaried GP/partner I will make the sustainable agenda an integral part of practice decision-making. …I hope that this year has been just the beginning of my role as an advocate for sustainable healthcare and intend that practising sustainably will be an intrinsic part of my career.” 

 Annie Elkins, Scholar and GP trainee

Acknowledgements

Thanks to CSH intern, Isobel Braithwaite, for her help in preparing this case study.