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Graphic of paper dolls used to represent sustainability

From literacy to leadership: communicating effectively for change

Climate-literate respiratory professionals are better equipped to make informed decisions that take environmental impact into account. They can contribute to more sustainable care by incorporating these principles into day-to-day practice, team discussions, quality improvement and policy.

Turning knowledge into impact requires additional skills in communication, negotiation and diplomacy. 

Key actions

  • Use the fact that healthcare workers are among the most trusted professionals globally to be a trusted messenger on the realities of climate change
  • Frame the climate crisis as a health crisis to make it relatable to people’s lives
  • Adapt the way you communicate and your focus, depending on your audience 
  • Use every opportunity to bring a sustainable healthcare lens to your work 
  • Be an advocate for patients and the planet by influencing practice and policy 

Communicating effectively and leading change

Knowledge Skills Attitudes
Understand the links between climate change, air pollution, and health Educate patients and colleagues about the climate crisis, the wide-ranging impact of air pollution on health View sustainability as a core component of high-quality care and patient safety
Recognise how healthcare contributes to environmental degradation Make low-carbon clinical decisions (e.g. inhaler choices, avoiding unnecessary interventions), implement lean care pathways, prioritise disease prevention Feel confident advocating for change within teams, organisations, and systems  
Know the principes of sustainable healthcare and define the triple bottom line Incorporate a SusQI approach to quality improvement projects.   Bring a sustainability lens to all improvement projects and programmes
Be familiar with the “Delivering a ‘Net Zero’ National Health Service” document and local Trusts’ Green Plan Complete simple carbon footprinting eg through completion of the carbon literacy for healthcare eLfH module or via Carbon literacy project   Demonstrate a drive to share best practice through sustainability communities of practice 
Understand that collaboration across broad disciplines is needed for effective action  Communicate about climate with, and maybe bring together disparate individuals from primary and secondary care, estates and facilities, transport, local and district councils, politicians, charitable organisations and, most importantly, patients  Values everyone’s perspective

Health professionals are trusted communicators and important advocates in issues of public health.

At a time when the public has lost faith in politicians and the media, the voices of nurses, doctors, pharmacists, and other health professionals are essential to accelerate a society-wide transition to a healthy, sustainable, and equitable world. 

Framing the climate crisis as a health crisis can help people see global warming not as a distant abstract concept but as something relevant to their lives and the lives of their families.

We have an opportunity to develop a paradigm of care for the 21st century, one which is better for patients and better for the environment. Healthcare has a responsibility not to follow but to lead on carbon reduction; respiratory medicine should be at the forefront.
Dr Robert Winter OBE
National Clinical Director for Respiratory Disease

Health professionals are in a powerful position to influence policymakers, businesses, hospital leadership, patients and the general public to implement actions aligned with climate commitments. Consider speaking at events, writing articles or letters, engaging with media and politicians, joining advocacy and campaigning groups, collaborating with charities, local council or transport groups and local government.

You don’t need to be an expert or have all the answers to start engaging others. Focus on what matters to your colleagues, start small, and build from there.

The most effective sustainability projects are often those that start with a conversation and grow through collaboration.

Emphasise co-benefits, prioritise prevention, make a pitch for hope!


Learn more

Read:  “Defining Roles and Responsibilities of the Health Workforce to Respond to the Climate Crisis”.  

Watch: Lancet Countdown 2024 report video 

Listen: The Ecomedics Podcast, Real Zero Podcast 
  • Frame environmental sustainability as an integral part of high quality care—not an add-on.
  • Align with organisational values and strategy and highlight responsibilities and mandatory reporting under the NHS Net Zero commitments.
  • Underline the ways in which sustainable care, particularly prevention and admission avoidance, can tackle health inequalities and the NHS England Core20plus5 aspirations.
  • Highlight opportunities where carbon savings can also deliver cost savings and clinical co-benefits.
  • Think long term: sustainability in practice is not a one-off event; it requires a shift in mindset and sustained engagement for lasting impact. You cannot reduce plastic waste in your department alone. You need your colleagues to work with you to achieve a collective change in practice. If you leave or move department, the project will not be sustained unless it is embedded in local pathways.
  • Engage all interested parties to build support and develop resilient pathways. This will also bring in diverse perspectives, access to critical resources and co-development with those who will either be directly involved in the process or be affected by it. Whether you’re trying to reduce emissions from inhaler prescribing or improve clinic travel options, involving everyone affected will foster collaboration, trust and accountability–key factors for long term success.

Learn more

Here are some of the elements a sustainable respiratory department could have:

  • Teamwork – multiprofessional action
  • Digitally enabled - online communication via email/hospital app re appointments, video appointments as well as face to face
  • Patients bring own inhalers for technique coaching
  • Bins for inhaler recycling
  • Posters on the walls on walking/singing groups, air pollution info, healthy eating, low carbon inhalers
  • General recycling bins
  • Prevention forms a key part of consultation eg support to stop smoking
  • Lung function tests the same day as the main appointment to reduce travel
  • Integrating/promoting sustainable prescribing practice in local guidelines
  • Staff walk to work or commute by bike

 

Sustainability should be built into the way organisations deliver care, not added on afterwards. Respiratory teams can influence change by linking projects to Green Plans, patient care, and cost savings.

Change diagram

 

Governance and Strategy

  • Make sure your Trust or ICB has a Net Zero lead, board group and Green Plan in line with NHS guidance.
  • Push for sustainability to be part of business cases and service changes (triple bottom line: clinical, financial, environmental).
  • Link respiratory work with Core20PLUS5 priorities to address inequality.

Procurement and Prescribing

  • Work with procurement teams on supplier standards (e.g. Evergreen assessment).
  • Ensure formularies support low-carbon inhalers and devices where clinically appropriate.
  • Review use of consumables and equipment — avoid single-use where safe alternatives exist.

Services and Estates

  • Ask if your organisation has a climate adaptation plan (heatwaves, extreme weather, medicine storage).
  • Strengthen digital/remote services to cut unnecessary travel while keeping care accessible.
  • Check facilities support active travel and provide green spaces and healthy food.

Culture and Communication

  • Join existing sustainability groups or QI teams — build on what’s already happening.
  • Share progress through short updates and celebrate small wins.
  • Link with external networks to spread ideas and gain support.
If you want to go fast, go alone. If you want to go far, go together.

Before starting from scratch, see if you can build on existing work.

Check if your organisation or ICB already has:

  • A Green Plan or sustainability strategy
  • A sustainability lead or committee (if yes, consider joining!)
  • Ongoing QI work you could contribute to (e.g. see the QI section for examples eg inhaler recycling or telehealth expansion)

Share your progress and impact once you get started

  • Use short updates to share what’s happening (emails, posters, newsletters, update slides at meetings)
  • Celebrate small wins—even basic changes like switching to digital patient info leaflets or adding air pollution advice to asthma action plans
  • Use your results to get further support or expand your work
  • Measure impact in as many useful ways as possible 

Connect to broader networks for support

  • You’re not alone! Joining a professional network can help you find ideas, collaborators, and encouragement.

If you’re embarking on a new project your first action should be to map out who you will need to speak to and include.

Depending on the scale and scope of the project these may include:

Internal External
  • Colleagues in your department
  • Clinical leads
  • Other departments (eg adult/Paeds, ED) 
  • Pharmacy
  • Nursing teams
  • Estates and facilities staff
  • Lung function physiologists 
  • Sustainability officers
  • Procurement team 
  • Admin and management teams 
  • Finance teams 
  • Communications team
  • Council officers
  • Public health teams
  • Smoking cessation services
  • Regional networks
  • Community organisations
  • Patient representatives/groups
  • Integrated Care Board staff

 

It can be useful to think in advance about barriers you may face, so that you don’t hit a wall early on, and you are ready with a constructive response to any challenges. 

Resources

BMC Research article: The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review

Find system-level levers, such as changing formularies to prioritise lower carbon inhalers, work with procurement or waste teams to reduce waste or recycle more, work with ICS to develop green plans.

  • Emphasize near-term health benefits of climate-change mitigation measures.
    • “Everyone will breathe cleaner, healthier air as we transition away from fossil fuels”
    • “Well insulated and ventilated homes use less energy and are the foundation for health”
  • Be solutions-focused and practical
  • Align messages with local and national priorities
    • Admission prevention is high quality care, cost saving and low carbon
    • Investing in prevention through smoking cessation services saves lives, reduces inequality and reduces resource use
    • The digital transition provides opportunities to better meet patient needs and reduce travel
    • Use short impactful evidence summaries or template letters eg from Medact 


If you would like to raise your voice about the impact of pollution and climate change on health, contacting your MP is a powerful way to be heard. You can write about your personal experience, ask for cleaner air initiatives, or support local green policies.

Learn more

Clinical trials can be a major source of greenhouse gas emissions, but this is often not considered in clinical trial design. The nature of clinical trials often makes them carbon intensive. Some fundamental aspects of trial design could make them more cost-effective and carbon-efficient. For example, the adaptive trial designs implemented during the COVID-19 pandemic allowed multiple medications to be investigated within the same trial. The limitations on travel and requirements for virtual consultations during the pandemic could also provide an example of how trials can be run whilst minimising greenhouse gas emissions. 
More research into the carbon cost of interventions could be hugely valuable in guiding future steps in sustainable respiratory care. Recent examples include efforts to calculate the carbon footprint of asthma management in the UK, and post-hoc analyses of clinical trials using inhalers to quantify the carbon footprint of each arm. Reporting of carbon footprint analyses of clinical trials should be encouraged. For further discussions on greener clinical trials this viewpoint paper is recommended. 
Example – Finnish national Allergy Program (2008-2018)
Finland’s national Allergy Programme (2008–2018) successfully reduced asthma and allergy prevalence and treatment costs through a comprehensive, collaborative strategy.

Key elements included:

  • Holistic Prevention: Shifting focus from medical treatment to promoting immunological tolerance, healthier lifestyles, and reducing unnecessary medicalisation of mild symptoms.
  • Nature Engagement: Encouraging regular contact with natural environments to support immune health, known as the “Nature Step.”
  • Early Intervention: Using early steroid treatments and improved diagnostics to manage asthma effectively, lowering hospital admissions and severe outcomes.
  • Environmental Improvements: Reducing air pollution and promoting physical activity as integral components of the programme.
  • Community Collaboration: Involving healthcare professionals, educators, and the public in a coordinated effort to improve outcomes.


Impact:

  • Asthma and allergy rates plateaued, with fewer severe cases and hospitalisations.
  • Direct and indirect costs associated with allergic diseases and asthma decreased by roughly 30% over the programme period.
  • Large-scale educational initiatives reached thousands of healthcare professionals, enhancing knowledge and practice nationwide.
  • The programme demonstrates how a comprehensive, multi-level approach integrating medical, environmental, and societal factors can achieve sustainable improvements in respiratory health.

 

Summary

Communicating about climate change is part of our duty to protect and promote health. Respiratory professionals are uniquely placed to connect the dots between climate and lungs, policy and practice, knowledge and action.

Visit our Examples and inspiration section to find out more

Access useful information in our resources section