Why is global sustainability important to healthcare?
Give 4 examples of how global changes affect healthcare.
- Material inequality:
- The world’s wealthy are getting richer while at least half the world’s population live on less than £1.30/day
- Population and consumption:
- The world population is growing
- More people mean the need for more space, energy, food, and water
- This is made worse by the fact that people in the developing world aspire to what the developed has by the way of material goods and food
- Resource depletion:
- It was estimated in 2005 that we had consumed half of the earth’s extractable reserves of oil and gas and that they are likely to be completely depleted by the end of the 21st century
- We will be more dependent on alternative sources of energy in the future e.g. nuclear power, shale oil, fracking
- Climate change:
- The greenhouse effect has been caused by a change in gas concentrations
- This impacts on food production due to regional floods and droughts, changes in the environment with regards to incidence of infectious disease e.g. risk of malaria
- Deaths from heat waves and droughts leads to changes in human migration from affected areas
- Climate change will affect all countries, but will have the greatest impact on those who have the least access to the world’s resources and who have contributed least to carbon emissions
- Loss of biodiversity:
- Increased rate of animal extinction due to habitat destruction and poaching
- Crisis in healthcare:
- Crisis in chronic health problems with an increasingly ageing population
- There are increases in chronic diseases such as diabetes due to rising obesity
- There is a crisis in the cost of healthcare
List some ways in which global warming has affected health care.
How has changing weather affected healthcare?
Give 3 impacts of rising temperatures.
- The number of reported weather-related natural disasters has tripled since the 1960s
- In the last 150 years, the 12 hottest years on record have occurred in the last 13 years recorded:
- This leads to heatwaves which can cause excessive deaths
- This leads to droughts leading to severe food shortages
- High temperatures also raise the levels of ozone and other pollutants in the air that can exacerbate cardiovascular and respiratory disease
- 25% of all fossil fuel greenhouse gas emissions can be accounted for by transport. Switching to electrically powered transportation methods will significantly reduce CO2 production - the effect of this will be greatest in India and lowest in Europe
- Agriculture and food production account for 10-12% of greenhouse gas emissions. 80% of this is from livestock farming. There is an increased demand for animal sourced foods. A reduction in the consumption of animal sourced foods could have benefits for cardiovascular health
- Rising sea levels
How will rising sea levels affect healthcare?
- 13 of the world’s 20 largest cities are located on the coast
- 1/3 of the world’s population live within 60 miles of the coast
- Rising sea levels would result in mass migration
List 3 simple actions that could be taken to counter these effects
REAP:
- Increased use of renewable energy resource
- Education of carbon literacy and numeracy
- Activity modification - modifying human behaviour - being more active
- Promotion of a plant-based diet
What document is used to promote sustainability in the NHS?
Realistic Medicine
List 4 actions that can be taken to promote low carbon clinical care and NHS sustainability.
- Prioritise environmental health
- Substitute harmful chemicals with safer alternatives
- Reduce and safely dispose of waste
- Use energy efficiently and switch to renewable energy where possible
- Reduce water consumption
- Improve travel strategies
- Purchase and serve sustainably grown foods
- Safely manage and dispose of pharmaceuticals
- The greatest part of carbon emission from NHS England is from purchasing of goods and services - 22% is from the purchase of pharmaceuticals
What is the NHS carbon reduction strategy?
What piece of legislation is the strategy based upon?
- Based on national targets set by the Climate Change Act 2008
- Commits the health service to more than an 80% reduction in emissions over the next 30 years
Give 2 benefits to patients that will come from low carbon clinical care
- Better prevention of conditions
- Greater responsibility to patients in managing their health
- Leaner in service design and delivery
- Use the lowest carbon technologies
When was the NHS-social care integration bill passed/initiated?
Passed in 2014
Came into place on the 1st April 2016
What 2 aims has the BMA stated following the new 2018 GP contract?
BMA will aim to reduce the workload and improve recruitment
What is the Cambridge dictionary definition of resilience/sustainability?
Resilience - the ability to “quickly return to a previous good condition”
Sustainability - the ability to be “able to continue over a period of time”
List 4 positive factors and 4 challenges facing resilience and sustainability in your career as a doctor and in your personal life
- Positive factors:
- Job security
- Financial security
- Stable terms and conditions
- Respect for professionalism and knowledge
- Appreciation for being in the role of a doctor
- Working with a team
- Ability to develop knowledge and interests
- Ability to fit work around interests and lifestyle choices
- Challenges:
- Considerable and rapid workload
- Time management
- Increasingly complex care over time
- Relentless arrival of mail and blood results, and having enough time to action them diligently
- Care verse cure for long term conditions
- Running a business
- Working in a team
What is the fit note and what is it’s purpose?
This replaced the sick note in April 2010.
- To facilitate earlier discussion regarding rehabilitation and returning to work
Who can write a fit note?
Only a doctor
What information does the note contain for the employer?
List 4 things the doctor can recommend to the employer regarding the promotion of return to work.
- Things to consider which will promote return to work:
- Phased return
- Adjusted hours
- Adjusted duties
- Adaptations to the work place
Does the fit note affect statutory sick pay?
It does not affect statutory sick pay (off government?) but the employer is under no obligation to pay the employee (?)
List 7 roles of Occupational Health
- To ensure the health and well-being of the working population by preventing work-related ill health and providing specialist rehabilitation advice
- To provide independent, impartial advice to employers and employees on the effects of work on health and the effects of health on work
- They advise on fitness for work, workplace safety, the prevention of occupational injuries and disease while recommending appropriate adjustments in the workplace to help people stay in work
- They provide rehabilitation to help people return to work and give advice on alternative suitable work for people with health problems
- They recommend and implement appropriate policies to maintain a safe and healthy workplace
- They conduct research into work related health issues
- Ensure compliance with health and safety regulations including minimising and eliminating workplace hazards
What other healthcare professionals may occupational health services work alongside?
- Nurses
- Ergonomists
- Hygienists
- Occupational health advisors
- Physiotherapists
- Psychiatrists
- Therapists
List 3 positive benefits of work on health
- Adequate finances which are essential for material well-being and full participation in today’s society
- Meets psychosocial needs where employment is the norm
- Central to individual identity, social roles, and social status
- Employment and socio-economic status are the main drivers of social gradients in physical and mental health and mortality
List 4 negative effects of unemployment on health
- Poorer general health
- Long-standing illness
- Poorer mental health
- Psychological distress
- Higher medical consultation rates
- Increased medication consumption
- Increased hospital admission rates
List 3 benefits of re-employment
- Improved self-esteem
- Improved general and mental health
- Reduced psychological distress
