How can I encourage my colleagues to be greener?

Be a role model

Samantha Holmes, former BMJ sustainability fellow, says, “Attempting to encourage your colleagues to ‘be more green’ can feel like a daunting task. As healthcare professionals, we work in busy clinical settings with plenty of demands on our time, energy, and brain power. Tackling sustainability in the workplace can feel like yet another task for your own list, let alone trying to convince your colleagues to do the same.

“You may wonder whether your green credentials will be up for scrutiny, or whether you’ll have enough authority to ask your colleagues to change something about the way they practise or deliver healthcare. You may feel concerned that you’ll be faced with a hostile or unreceptive audience. But there are ways of encouraging behaviour change that don’t require a direct approach, and, depending on your colleagues, may be more effective.

“The only thing we truly have any agency over is our own behaviour. With that in mind, one way to encourage your colleagues to be more green is by using Albert Bandura’s social learning theory1—be a role model for the behaviour, attitudes, and beliefs you’d like to see your colleagues imitate.

“This idea is supported by a recently published study which showed that role model stories activated healthcare professionals to participate in sustainability initiatives and climate advocacy.2

“How this looks in practice will depend on your professional circumstances and responsibilities. You could bring up sustainability considerations in a service planning meeting, offer to accompany someone on their first attempt at commuting to work by bike, or ask your Estates team for a recycling bin in the department. Let your green behaviour influence those around you.

“Lastly, keep in mind that people are more likely to imitate the behaviour of role models who are similar to themselves, therefore it’s important that all clinicians with an interest in sustainable healthcare take on this responsibility in order to provide a diversity of clinical leadership.”

Start with small, practical steps

Vasumathy Sivarajasingam, GP partner, Hillview Surgery, west London, says, “As doctors, we are on the frontline of health—both for patients and the planet. Climate change is not only an environmental matter but a public health crisis, with healthcare contributing significantly to environmental harm. Tackling this isn’t extra work—it’s part of our daily responsibility.

“Start small and make green the easy choice. Begin with simple actions like reducing paper use, printing double sided and only when necessary, and switching off unused equipment. Make sustainable options more accessible by providing bike storage, having recycling bins, and carpooling. These steps are cost effective and manageable without feeling overwhelming.

“Lead by example and incorporate green habits into your routine to inspire others. Use reusable water bottles, designate a meat free day each week, and offer virtual consultations when possible. Colleagues are more likely to follow when they see you embracing these habits.

“You can also encourage active travel by promoting cycling or walking to work to boost health and reduce emissions. Advocate for bike storage or cycle-to-work schemes. Even wearing comfortable shoes can encourage more movement during the day.

“Share practical tips and suggest simple, everyday actions like recycling, boiling only the water you need, and running dishwashers only when full. These are habits we already follow at home, making them easy to apply at work.

“You can build a sustainable culture by appointing green champions to lead initiatives and foster regular conversations about sustainability. Changing behaviour takes time, but collaboration and shared responsibility make it easier. Together, we can create a supportive, eco conscious culture in healthcare.

“By taking small, practical steps, we can reduce our carbon footprint, improve wellbeing, and enhance patient care. Let’s start today and make healthcare more sustainable for everyone.”

Leave the door open for others to join the fight

Laura-Jane Smith, consultant respiratory physician and lifestyle medicine physician, says, “Feeling that those around you are carrying on as normal while the world burns can be challenging. It’s easy to become a caricature of an angry activist, and just as easy to fall into despair.

“Neither of these paths lead to change. I’ve learnt that climate leadership requires patience, compassion, persistence, positivity, and self-care. There are many ways you can encourage your colleagues to be more green at work and at home.

“Start planting seeds by making sustainability, climate, and nature part of daily conversation. This may mean asking a question at a meeting or suggesting a colleague turn their QI project into SusQI. I like to share a fact of the day on our daily board rounds, and always choose a climate and nature based fact.

“Change is hard work and often people can’t see outside their current way of working. Starting small and demonstrating value, as well as showing what has been achieved elsewhere, can be good ways to bring colleagues on board.

“Often, sustainable care is good clinical care, so use this framing. When I assess inhaler technique, for example, many of my patients’ technique lends itself best to dry powder, which happens to be low carbon compared with metered dose inhalers that contain hydrofluorocarbons. When talking to managers, money talks—so present the cost savings from deprescribing, switching to reusable equipment, or virtual appointments.

“While many of us avoid conflict there is a place for challenge and we have a responsibility to challenge care that does not support a liveable future for us all. I save my energy for areas which require a lot of work such as food policy, which is a massive contributor to the climate and biodiversity crisis.

“Not everyone you meet will have the headspace or energy to act today. Remember that they may be your best ally tomorrow, next week, or next year, so always show patience and compassion and leave the door open for people to join the fight of our lives.”

Use the Green Impact for Health toolkit

Abigail Fry, GP and vice chair of Greener Practice’s national leads group, says, “As trite as it sounds, I chose to study medicine because I wanted to help people—and a key part of helping people is sustainability. I’d made changes in my home life to reduce my impact on the environment but hadn’t translated these into my workplace. I began to realise that my choices as a doctor were contributing to the climate crisis. Paradoxically, I was causing harm to the people I was trying to help.

“Most NHS colleagues I have spoken to are concerned about climate change and its link to health. I, for one, found it hard to know what to do. Looking for guidance I came across the Green Impact for Health toolkit. This free online resource lists simple, step-by-step action points we can take, with points and awards gained along the way. Seeing how easy it is to get a bronze award (believe me, every practice could do this) inspires practices to go further.

“One worry is the time it will take to implement changes. Creating a ‘green team’ across the practice or primary care network and dividing the toolkit actions into those relevant to different teams (admin, clinical, pharmacy, management, and so on) can help. Also, GP registrars and medical students can help with poster designs and quality improvement projects.

“Setting up a local league table between practices of toolkit points gained encourages friendly competition and regular meetings to share ideas and resources and helps with connections.

“Your colleagues will join you once they observe how simple actions can have profound effects across the practice: improving the health of patients and saving appointments and money while improving staff retention and the wellbeing of the whole team.”

Explore video consultations where safe and appropriate

Alexander Woywodt, consultant nephrologist, Preston, says, “Switching from face-to-face consultations to video has a very positive effect on the carbon footprint of a clinical service, especially where patients commute large distances to attend.

“Prior to the covid-19 pandemic, outpatient clinics in our department were exclusively face-to-face. As a regional renal centre, we serve a large geographical area and follow up appointments typically include a review of laboratory results and blood pressure readings with a change in medication, if appropriate. This is particularly true in transplant aftercare. Transplant patients also tend to be IT literate, and I know my patients well. This is an ideal scenario for video consultations.

“In my current practice, most routine transplant follow-up appointments are by video, and I only bring patients in for a reason. I provide telephone consultations where patients can’t do video, but I must admit I find it difficult to assess patients by telephone or to establish any form of rapport. Video consultations don’t suit all specialties or clinical settings but there is good evidence that they are safe and effective in this context. I also use video consultations for some consultations when patients are unwell.

“We’ve just published the effect on the carbon footprint of converting consultations to video, and we were surprised by the magnitude. In hindsight, asking stable transplant patients to spend a day on the road to see us in the clinic for a routine review seems wrong.

“The covid-19 pandemic served as a disruptor in a positive sense, enabling us to overcome barriers. Try and interest your colleagues in video consultations if clinically appropriate. A good starting point would be to identify outpatient clinics that feature continuity of care as well as a high percentage of stable and IT literate patients.”