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Bevan Exemplar Cohort 5 Projects

Making connections to improve environmental sustainability at our hospital

Tom Downs, Lewis Roberts, Gwenllian Rhys and Yasmina Hamdaoui

Betsi Cadwaladr University Health Board


Climate change is the biggest global health threat of this century yet it is the greatest health opportunity. The healthcare sector, as well as being vital in dealing with the health impacts of climate change, also contributes to the problem. If the global healthcare sector was a country it would be the fifth biggest emitter of greenhouse gases.

As doctors, nurses and health professionals we have a duty to do no harm. Planetary health is the health of people within the natural systems on which our health depends. Within the contexts of planetary health, this means our duty is to do no harm to the environment. Each and every person in a hospital has the opportunity to take action that can help improve the health and well-being of our community, by leading by example with our own actions starting in our hospitals. Taking action on climate change is prudent now.

Project Aims:

In Wales, we are committed to achieve net zero carbon emissions from NHS Wales by 2030, this is a really important goal required to protect the well-being of future generations. To achieve this, taking action must be a shared endeavour for everyone working across each of our hospitals in Wales; starting today.

It can be difficult to know where to start taking action in our own lives but it can feel even more daunting to know where to start in your work place! That’s why when starting work at Ysbyty Gwynedd as an FY1 Doctor, I wanted to connect with the pockets of people already working on environmental sustainability, learn from their good practice, and bring them together creating a shared platform for transforming practice to be climate smart.

This shared platform became Ysbyty Gwynedd Green Group for us at Ysbyty Gwynedd.

Our shared principles for planetary health were inspired by the Bevan Commission’s Prudent Healthcare Principles:


  1. Time

The scale of the work to be done and the demands of our day jobs can be a challenge. This was overcome by sharing the work with others, galvanising action and sharing the responsibility. Allowing people to take time to rest and regenerate while others pick up the responsibility makes the work sustainable.

  1. The Coronavirus pandemic

Key members of our team and key people needed for engagement such as our Estates, Facilities and Procurement, were busy building capacity and procuring vital PPE. Engaging with these parts of the hospital made it a challenge to get quantitative measures of our impacts we agreed on at the beginning of this year. But we were able to continue meeting via zoom and keep something positive to focus on! We had well-being sessions by the Climate Psychology Alliance, and regular empathy circles, which helped us to continue work on climate action throughout the pandemic. Our positions as health workers in the pandemic allowed us to get involved in conversations about a transformational reset and an opportunity for a green and healthy recovery. And I was able reflect on these experiences and write a blog.

  1. Waste

Tackling waste has been even more challenging during the pandemic. We are now looking at the steps to be part of a re-usable facemask pilot, and have good engagement from infection control to overcome challenges going forward.

Key Outcomes:


We had over 85 people across our hospital engaged as Green Group members. Had a stall to engage staff in ideas of what the hospital can do to improve environmental sustainability.

We also were active in the local and national press. Our Communications and engagement lead Yasmina was on S4C and BBC Wales to talk about the importance of a healthy and green recovery from the coronavirus pandemic. See BBC Wales: Climate change “bigger threat” than Covid-19.

We acted as a case study for NHS England’s Greener NHS and were featured in the NHS sustainability impact report. We were also part of the healthy recovery campaign joining over 40 million health professionals worldwide. We were involved in helping to shape the build back better campaigns key messages. I wrote this opinion piece for the Bevan Commission on A Healthy Recovery for Wales. Clinical staff are now represented at our health boards environmental steering group and had meetings with the Carbon Trust about the overall health care decarbonisation strategy on how to get to net zero by 2030!


We hosted staff training and talks. Members presented in their own departments on carbon hotspots, greening anaesthesia and greener inhalers. We hosted a grand round on climate changes health and journal club on the Lancet Countdown. We also created a shared google calendar of Global climate and health events and webinars, that staff could keep track of and join as part of their professional development.


We created a shared project bank, that members can take on their own projects and update progress. Key areas identified by staff were, Waste, Energy, Transport, Food and Biodiversity. Sustainability was identified as an element of quality in individuals quality improvement projects.


We are the first hospital in Wales to take steps to partake in a re-usable mask pilot.


We now have a sustainable food group, working to help local growers apply for hospital procurement contracts.


We have a meadow plan to help improve biodiversity on-site, plans underway for a health walk. And have been donated 82 trees from NHS Forests to plant on site. Some members partook in guerrilla gardening during lockdown!

Next Steps:

1) Keep connecting, keep learning and keep transforming!

2) Planetary health integrated into the curricular in undergraduate and postgraduate training.

3) Identify Green Champions in each department.

4) Join health care without harm’s global network of 36,000 green and healthy hospitals and health centres.

5) Green Groups across each hospital in Wales as part of a Welsh Climate Smart Clinical Network.

6) Health Professionals across Wales pledge for planetary health.

7) Health warnings on point of sale of fossil fuel energy across Wales.

8) NHS Wales makes a statement declaring climate change a health emergency.

9) NHS Wales releases their net zero 2030 strategy.

10) Exploring the possibility of NHS Wales being a pilot country for operation zero, the global health care decarbonisation roadmap.

11) Welsh Health Care Professionals at COP26 in Glasgow.

12) Finally, no need for Green Groups as climate smart, sustainable and prudent health care is the norm for each of our hospitals across Wales, on our journey to be climate smart by 2030 and the wellbeing of future generations protected, achieving a healthier Wales.


Team Quotes:

“We have a responsibility to our future patients to practice sustainable medicine in order to safeguard the future health of our population.”


“What you do matters; every little action makes a difference”

“It made me aware of a problem I didn’t know existed before which is sustainability in health care”

“The Green Group has been a really inclusive environment, it has been great to connect with others I wouldn’t normally do so in my day job.”