PRESTON NORTH & EAST PRIMARY CARE NETWORK
Our Green Plan for Practices
In response to the Greener NHS National Programme, Delivering a Net Zero National Health Service.
Healthier people on a healthier planet.
The eight practices who make up Preston North & East Primary Care Network recognise that general practice has a responsibility to respond to climate change. This plan sets out what we know and what we can do to support carbon reduction, both as practices and in collaboration with our patients and partners.
In October 2020, the NHS published Delivering a Net Zero National Health Service, setting ambitions to reach net zero for emissions controlled directly by the NHS by 2040, and for emissions influenced by the NHS by 2045.
To achieve our goals, the practices refer to guidance from the Royal College of General Practitioners, the Greener NHS programme, and the Green Impact for Health Toolkit. All eight practices aim to be signed up to the toolkit and to actively reduce their carbon footprint.
We are engaging with our staff and patients, and we welcome the contribution of our Patient Participation Groups. This strategy sets out our action plan and will be continually reviewed.
In October 2020, the NHS published Delivering a Net Zero National Health Service, setting ambitions to reach net zero for emissions controlled directly by the NHS by 2040, and for emissions influenced by the NHS by 2045.
We refer to guidance from the Royal College of General Practitioners, the Greener NHS programme, and the Green Impact for Health Toolkit. This living strategy will be continually reviewed with staff, patients and Patient Participation Groups.
OUR COMMITMENTS
From commitment to measurable change
Climate Declaration & Governance
- Nominate a named Green Lead in each practice to coordinate sustainability work.
- Create and publish a climate and nature crisis declaration on practice websites, in newsletters, and on social media.
- Keep the climate crisis as a standing agenda item at every practice meeting and PCN board meeting.
- Join and actively participate in the ICB Greener Practice group.
- Embed sustainability into practice culture, view all existing and new projects through the lens of environmental impact and choose environmentally friendly options wherever possible.
- Form a PCN-wide Green Team meeting quarterly, with representation from clinicians, admin staff, and PPG members.
- Include sustainability objectives in annual practice development plans.
- Review and update this Green Plan annually with progress against targets.
Progress:
Climate declaration completed and posted. Named Green Lead appointed. Signed up to Destination Net Zero.
Optimise Inhalers
- Use Greener Practice's High Quality and Low Carbon Asthma Care Toolkit for step-by-step QI projects aligned to IIF indicators.
- Review patients prescribed high-carbon inhalers (Flutiform MDI, Symbicort MDI, Ventolin Evohaler MDI) and consider lower-carbon alternatives where clinically appropriate.
- Consider environmental impact at each respiratory review, using the NICE patient decision aid.
- Encourage patients to return old or unwanted inhalers to pharmacies for environmentally safe disposal.
- Promote correct inhaler technique using placebo devices and the Rightbreathe app.
- Use Greener Practice educational videos as resources for both patients and staff.
Progress:
Clinical pharmacist leading on inhaler switching programme. Ongoing reviews across all eight practices.
Carbon Footprint Measurement & Reporting
- Complete the free SEE Sustainability GP carbon calculator for all eight practices to establish a baseline.
- Repeat the calculation annually to track progress and identify trends.
- Create a plan to target and reduce each hotspot identified.
- Monitor prescribing carbon footprint via OpenPrescribing data, especially inhaler metrics.
- Track energy consumption quarterly using utility bills and smart meter data.
- Set a PCN-wide carbon reduction target and report progress annually to staff, patients, and the ICB.
Progress:
Signed up to Destination Net Zero. Baseline carbon footprint calculations underway.
Energy & Water Efficiency
Reducing energy and water use saves money as well as reducing environmental impact.
Energy
- Promote energy-saving guidance for staff and patients, such as the Energy Saving Trust.
- Review practice EPC/DEC certificates for efficiency recommendations and projected payback periods.
- Improve insulation, including radiator backing and ceiling insulation.
- Replace all lighting with energy-efficient LEDs.
- Turn off monitors when not in use, automatically or on a timer.
- Install PIR sensors for corridors and outdoor lights.
- Turn off air conditioning, heaters, and non-essential equipment when not in use. Install heating timers.
- Consolidate to central shared printers rather than individual desk printers.
- Once electricity use has been reduced, explore solar panels or other renewable energy sources, consider as part of estates contract renewals.
Water
- Install automatic taps to reduce water usage.
- Label dual-flush toilets with the appropriate flush to use. For single-flush toilets, install Hippo Bags to save water with each flush.
- Maintain a robust system for reporting facilities problems such as leaky taps.
- Reduce kettle energy use by installing a boiling water tap, turned off outside working hours.
Progress:
All lightbulbs switched to LED at both sites. Stickers on light switches as reminders. Automatic taps installed at both Deepdale and Fulwood. Electricity usage reviewed and reduced during breaks.
Green Banking & Finance
- Review banking provider and switch to a green or ethical bank if necessary.
- Contact current banking provider to understand their environmental position.
- Consider ethical options for private pensions such as NEST, visit Make My Money Matter for guidance. (NHS Pensions is a defined benefit fund and is not invested.)
Progress:
Banking review completed.
Environmental Prescribing & Treatment
- Consider non-pharmaceutical interventions first, green social prescribing, physical activity, and lifestyle changes, bearing accessibility in mind.
- Engage with ICS prescribing incentive schemes for greener prescribing.
- Focus on preventative care wherever possible, such as treating pre-diabetes through lifestyle changes.
- Adopt a low-waste prescribing approach: avoid overprescribing, stop unnecessary third-party ordering, and encourage patient-led ordering using the NHS App.
- Raise awareness of recycling options, medicine blister packet recycling at pharmacies, inhaler returns for safe disposal.
- Reduce waste for care home residents: ensure appropriate prescription durations, check for medicine stockpiling during home visits.
- Encourage patients to check their bag at the pharmacy to reduce waste from incorrect dispensing.
- Continue remote consultations where clinically appropriate.
- Use disposable gloves only when clinically necessary.
Progress:
Inhaler optimisation programme ongoing. Low-waste prescribing approach under review. Remote consultations embedded across all practices.
Patient & Community Engagement
- Discuss the climate crisis with Patient Participation Groups and involve them in practice actions identified through discussion and carbon footprinting.
- Encourage PPGs to take an activist approach to green actions and to link with local climate or environment groups.
- Share the NHS series of 7 short videos on waiting room screens and social media to promote awareness of the link between planet and health.
- Engage with Social Prescribing Link Workers on green prescribing schemes and climate-health initiatives.
- Set up green care community and PCN meetings including social prescribers and ARRS staff.
- Promote and participate in local green community schemes, community gardens, tree planting, wildflower areas, through organisations like Let's Grow Preston.
- Include environmental rationale when prescribing increased exercise, linking with active travel.
- Promote self-care practices and education. For group sessions, consider combining with local walking routes.
Active Transport
- Sign up to a Bicycle Lease scheme for staff and provide secure bike storage and changing facilities.
- Encourage staff to walk or cycle to work where possible, and promote car-pooling.
- Display public transport information, including bus fare posters at Deepdale, to help patients travel to appointments sustainably.
- Encourage patients to attend appointments using active transport and explain the cardiovascular and respiratory benefits.
- Explore Electric Vehicle charging points for cars and bikes at practice sites.
- Sign up to the RCGP Active Practice Charter.
- Check and improve practice mapping on Google Maps, ensure pins are correct and cycle paths and pedestrian routes are shown.
- Apply for NHS Lancashire Green Plan grants for e-bike procurement to enable staff cycling.
- Host Bike Doctor visits at practices for patient and staff bicycle repairs.
Progress:
Bike racks installed at both Deepdale and Fulwood sites. Public transport posters displayed. E-bike grant application submitted, unsuccessful on first round, will reapply. Bike Doctor initiative application sent.
Reduce, Reuse, Recycle
A simple mindset to prevent waste: reduce the need to buy new, reuse or repurpose what you have, and recycle at end of life.
Reduce
- Use scrap paper and paper clips instead of sticky notes.
- Save blood forms electronically and only print when the patient requests a form or attends for their test.
- Opt for naturally wrapped snacks such as satsumas, or snacks with compostable or recyclable packaging.
Reuse
- Consider how existing or second-hand items can be repurposed — for example, using an old projector stand as a standing desk.
- Investigate reusable alternatives to disposable items such as blue curtains.
Recycle
- Sort recycling in-house or sign up to a company who can sort off-site. Waste contracts with majority recycling are often cheaper than destruction with heat recovery.
- Provide clearly labelled recycling bins for cardboard and plastic at both sites.
- Increase use of rechargeable batteries, including in ECG machines.
- Recycle hard-to-recycle items: lotion tubes and pumps (Boots and Superdrug schemes), medicine blister packets (Superdrug), and printer toners through schemes such as Brother recycling, Cartridges4Charity, and Zero Waste Recycling.
Progress:
Recycling bins for cardboard and plastic at both Deepdale (March 2025) and Fulwood (April 2025). Rechargeable batteries in use. Toner recycling programme completed. Following guidance from the L&SC Greener Practice group.
Green Impact for Health Toolkit
Developed by the RCGP using the SOS-UK Green Impact platform, the toolkit answers “What can I do in my practice?” with reasons for each action and tips on how to make the change.
- Register all eight practices on the free GIFH portal at toolkit.sos-uk.org.
- Nominate a Green Champion in each practice to coordinate toolkit progress.
- Complete a baseline self-assessment across the toolkit's 14 categories.
- Identify quick wins already achieved, many actions in this Green Plan count towards GIFH points.
- Target Bronze Award (75 points) for all practices, progressing to Silver (150 points) and beyond.
- Use the toolkit's action library to set quarterly focus themes across the PCN.
- Engage PPG members, students, or volunteers to help complete toolkit evidence and documentation.
- Report GIFH progress at PCN Green Team meetings and share successes via the ICB Greener Practice group.
Quick win:
Switch your default search engine on all practice computers to Ecosia, which uses ad profits to plant trees, an easy toolkit point that takes five minutes per machine.
Further commitments
Green Social Prescribing
- Work with PCN Social Prescribing Link Workers to build a directory of local green activities, community gardens, walking groups, conservation volunteering, parkruns, and allotments.
- Promote green prescribing as a first-line option for appropriate conditions such as mild-to-moderate depression, loneliness, pre-diabetes, and chronic pain.
- Link with Let's Grow Preston and local community gardening projects for patient referrals.
- Set up combined education and walking sessions using local routes listed on the Ramblers website.
- Track green social prescribing referrals and share patient success stories (with consent) to promote uptake.
Staff Training & Carbon Literacy
- Enrol Green Leads on free Carbon Literacy Training via SEE Sustainability or the Centre for Sustainable Healthcare.
- Include a sustainability induction module for all new starters, covering the PCN Green Plan.
- Hold lunchtime learning sessions (one to two per quarter) on topics such as low-carbon prescribing, active travel, and waste segregation.
- Encourage GP registrars and medical students to choose sustainability topics for their QI projects.
- Share the RCGP's e-learning module on sustainable development with all clinicians.
- Circulate short learning resources (videos, infographics) via practice communications monthly.
Building on existing work:
Lunchtime learning sessions on wellbeing topics are already running, sustainability can be added to the programme.
Sustainable Food & Drink
- Switch to Fairtrade tea and coffee in staff kitchens.
- Provide reusable cups, cutlery, and water bottles for staff; phase out single-use cups and plastics.
- Install a water refill station in patient waiting areas to reduce plastic bottle waste.
- Promote plant-based options when catering for practice events or meetings.
- Display patient-facing materials on sustainable diet and health, such as One Blue Dot resources from the British Dietetic Association.
- Support and promote breastfeeding in the practice.
Digital Sustainability & Communication
- Switch the default search engine on all practice computers to Ecosia.
- Continue and expand remote consultations (telephone and video) where clinically appropriate, to reduce patient travel.
- Reduce printing: save blood forms, fit notes, and referral letters electronically; print only on request. Default to double-sided, black-and-white printing.
- Ensure old IT equipment is recycled or donated through approved NHS disposal schemes rather than sent to landfill.
- Promote the NHS App for repeat prescriptions, appointment booking, and records access, reducing paper and phone call volume.
- Create a dedicated sustainability page on each practice website with the climate declaration, Green Plan summary, and progress updates.
- Feature a monthly green tip in practice newsletters and on social media.
- Display the NHS climate and health video series on waiting room screens.
- Celebrate milestones publicly, GIFH awards, carbon reductions, tree planting events.
Premises & Biodiversity Expanded
- Implement energy efficiency measures into planned refurbishments at both sites.
- Source quotes for solar panels to generate on-site renewable energy.
- Continue the NHS Forests commitment, up to 80 trees pledged at Fulwood, with planting extended to Deepdale.
- Create wildflower areas or planters in practice grounds to support pollinators.
- Install bird boxes or insect hotels on practice buildings.
- Set up a practice herb garden or planter that staff and patients can tend, linking to wellbeing and social prescribing.
- Work with Let's Grow Preston and Vinco Construction on grounds improvement and enhancement.
- Use only peat-free compost and avoid pesticides in grounds maintenance.
- Offer volunteering opportunities for tree planting and gardening to staff, patients, and community groups.
Progress:
10 fruit trees planted at Fulwood Health Centre in December 2024. Working with Vinco Construction on grounds improvement and enhancement. Solar panel quotes being sourced.
Vulnerable Groups & Health Equity
- Proactively identify patients most vulnerable to climate impacts, elderly patients, those with respiratory or cardiovascular conditions, and people in fuel poverty.
- Promote the Warm Home Discount, winter fuel payments, and local energy advice services to patients at risk of fuel poverty.
- Signpost patients to local food banks, community fridges, and cooking-on-a-budget programmes where appropriate.
- Ensure active travel and green prescribing recommendations account for disability, mobility limitations, and transport access.
- Consider air quality alerts for patients with asthma and COPD during high pollution episodes.
- Link with local authority and voluntary sector partners on heat-health plans for summer heatwaves.
Sustainable Quality Improvement
- Adopt the Centre for Sustainable Healthcare's SusQI framework for all QI projects.
- Complete at least one sustainability-focused QI project per practice per year, for example, reducing unnecessary blood test printing or optimising appointment DNA rates.
- Encourage GP registrars to choose a sustainability topic for their mandatory QI project.
- Present SusQI projects at PCN Green Team meetings to share learning across practices.
- Evaluate all new projects and pathway changes for environmental impact before implementation.
Progress & Action Plan
Tracking delivery against our commitments across all eight practices.
| Objective | Key Actions | Target | Lead | Status |
|---|---|---|---|---|
| Climate declaration & governance | Nominate Green Leads, post declaration, sign up to Destination Net Zero, adopt Green Impact Toolkit | Apr 2025 | BV | Completed |
| Energy & water efficiency | Carbon footprint calculation, LED lighting, monitor shutdown, staff awareness, automatic taps at both sites | Jul 2025 | BV | Completed |
| Green banking | Review banking provider and switch if necessary | Dec 2025 | — | Completed |
| Reduce, reuse, recycle | Recycling bins at both sites, rechargeable batteries including ECG machines, toner recycling, blue curtain alternatives | Jun 2025 | SR | Completed |
| Sustainable travel | Bike racks at both sites, public transport posters, e-bike grant application, Bike Doctor initiative, staff car-pooling | Oct 2024 | — | In progress |
| Sustainable procurement | Work with local organisations and suppliers on sustainable value-for-money supply chains | Ongoing | SR | In progress |
| Staff & patient wellbeing | Staff satisfaction surveys, lunchtime learning sessions, patient empowerment on climate action | Ongoing | — | In progress |
| Premises & biodiversity | Energy efficiency in refurbishments, NHS Forests (80 trees pledged), solar panel quotes, Vinco Construction grounds work | Jul 2025 | SR/BV | In progress |
| Prescribing & treatment | Inhaler optimisation, non-pharmaceutical interventions, low-waste prescribing, recycling awareness | Mar 2027 | CP | In progress |
| Green Impact for Health Toolkit | Register all 8 practices, baseline self-assessment, target Bronze Award (75 pts), quarterly focus themes | Mar 2026 | BV | Planned |
| Green social prescribing GIFH | Build green activity directory with Link Workers, referral pathway, combined walking/education sessions | Sep 2025 | — | Planned |
| Carbon literacy & training GIFH | Green Leads on Carbon Literacy Training, sustainability induction for new starters, lunchtime learning | Sep 2025 | — | Planned |
| Sustainable food & drink GIFH | Fairtrade tea/coffee, reusable cups, water refill stations, plant-based catering options | Dec 2025 | — | Planned |
| Digital sustainability GIFH | Ecosia default, reduce printing, promote NHS App, sustainability website pages, green newsletter | Jun 2025 | — | Planned |
| Vulnerable groups GIFH | Identify climate-vulnerable patients, fuel poverty support, accessible green prescribing, heat-health planning | Ongoing | — | Planned |
| Sustainable QI GIFH | Adopt SusQI framework, one sustainability QI project per practice per year, registrar projects | Mar 2026 | — | Planned |
FURTHER READING
Resources
Royal College of General Practitioners
Sustainable development, climate change and green issues
Green Impact for Health Toolkit
Free audit and awards for general practices (RCGP / SOS-UK)
Centre for Sustainable Healthcare
SusQI framework and resources
Greener Practice
Low-carbon asthma care toolkit and guides
SEE Sustainability
Free GP carbon calculator and Carbon Literacy Training
OpenPrescribing
Prescribing data and carbon footprint benchmarking
Energy Saving Trust
Workplace and home energy guidance
Make My Money Matter
Ethical pensions and green finance
Preston North & East Primary Care Network, Our Green Plan for Practices 2024–2027. This plan is a living document and will be reviewed annually. If you have suggestions or would like to get involved, please speak to your practice team or Patient Participation Group.
Aligned to the Green Impact for Health Toolkit and the Greener NHS National Programme.