In recent years there has been a realisation that we need to talk about wellbeing instead of health. While we have made great strides in overcoming disease, it has not decreased the burden on health services. Even though we are all getting richer and living longer it has not resulted in happier populations.
On top of this the climate crisis threatens to worsen global health and wellbeing. Deaths related to air and water pollution will increase while extreme weather patterns such as floods, droughts, hurricanes and heatwaves will increase the number of preventable deaths and increase the burden of mental health problems.
The NHS is often referred to as one of the leading systems of care in the world ensuring equitable treatment for everyone regardless of their financial capacity. Yet it is buckling under the pressure of the ever-increasing burden of mental health and an ageing population with a complex array of chronic diseases. The pressure placed on NHS staff has resulted in large-scale recruitment drives from overseas which risks draining the medical talent and expertise of less developed nations such as India and the African sub-continent.
It has been estimated that 80% of chronic disease is preventable yet huge proportions of both government and corporate pharmaceutical funding are spent on the treatment of symptoms. A greater understanding of the interventions needed to promote wellness is required so health systems can shift the spend of their resources from treatment to prevention – a more sustainable model.
To try and develop a good practice model of dealing with musco-skeletal diseases at work the charity decided to focus on its own employees and involved them in designing their employer policies. This resulted in better flexible working to enable people to work and travel at times that met their needs, more technology to enable working from home, better designed office space and furniture including a dedicated wellbeing space that supports physical and mental health. Personalised health assessment and coaching programme, promotion of movement in office spaces including stretching sessions, education with staff on the impact of stress and the need for fresh air and regular breaks.
Every individual has a role in understanding what contributes to their own wellness. Actions to prevent ill-health should be prioritised. This means achieving better quality sleep, resolving and releasing stress (via meditation or exercise), eating a balanced diet and socialising with friends and family. Reducing dependence on chemical drugs should also be a key aim as the complex interaction of multiple, different medications are still largely unknown by the medical profession.
Incorporating ‘wellness’ actions into daily routines and timetables could be a key place to start this process.
Reducing presenteeism, or staff being at work when they are ill, is one of the biggest ways businesses could help prevent further ill-health. Unhealthy working cultures such as long hours and high levels of stress are more likely to lead to mental health problems and burnout among staff. Set good examples at the top and among managers and this will trickle down to all staff. Businesses also have a key role in providing systems of preventative health interventions such as counselling at work, healthy food offered in canteens, processes to allow staff to flag their stress levels and how managers can respond when staff are struggling. Most HR research shows such actions to ‘care’ for staff means higher staff retention, loyalty and improved productivity.
Globally, healthcare’s climate footprint accounts for 4.4% of the world’s net C02 emissions. If healthcare were a country it would be the fifth largest emitter on the planet. The NHS produces higher emissions than the global average and the equivalent to 11 coal-fired power stations. To be fair, the NHS does have a carbon reduction policy and has reduced its emissions by 18% over the past 10 years, despite an increase in clinical activity.
In addition the climate crisis will prompt an increase in the health burden across the world. For example, a study into the health impact of the flooding in Lewes in the UK in 2000 found quadrupled community levels of psychological distress – and that those psychological problems were still identifiable four years after a flood.
More health organisations need to declare a climate emergency and move more swiftly to decarbonising their own footprint. So far, only two NHS bodies have declared a climate emergency: Newcastle upon Tyne hospitals NHS foundation trust and the Greater Manchester health and social care partnership. In contrast, more than 100 local authorities have declared a climate emergency.
There also needs some practical responses to preparing the health system for climate changing including increasing awareness of the associated mental health effects.
Newcastle upon Tyne was the first healthcare organisation in the world to declare a climate emergency and pledge to become carbon neutral by 2040. Newcastle has been in the vanguard of sustainability for decades with all electricity bought from 100% renewable sources, zero waste sent to landfill since 2011 and it recycles more than 40% of non-clinical waste (the average in the NHS is 23%). All procurement contracts include sustainability criteria, while hospital cafes and restaurants provide compostable cutlery and plates. The trust has commissioned new staff, patient and visitor electric bus services for 2020 and already has electric catering and estates vehicles and is one of the first in the world to ‘green’ dialysis treatment using less pollution anaesthetics and heat recovery technology within dialysis machines.
REAL is a community interest company that aims to support citizens and organisational leaders to transition to carbon zero and sustainability, founded by Safia Minney & friends.