The National Health Service (NHS) contributes 5% to the UK’s total emissions and is the biggest public sector carbon emitter in the UK (CSH, 2021). The Centre for Sustainable Healthcare (CSH) (2021) has also identified that there is a gap in the knowledge and skills of the healthcare professionals in relation to how their practice impacts on the climate emergency. In 2019, Newcastle Hospitals declared a climate emergency which featured in national media and news publications.

•In August 2021 the Faculty of Health and Life Sciences at Northumbria University were invited by the Centre for Sustainable Healthcare to take part in the Sustainable Quality Improvement Education project. This pilot project enabled integration of the sustainable quality improvement (SusQI) framework into the nursing and allied health care curricula

In order to be able to deliver comprehensive evidence-based materials to the students, academic staff from across the healthcare faculty needed to develop their own understanding of how NHS and climate change were intertwined. As part of the CSH pilot workshops were provided for faculty to attend, supported by educational materials for the delivery of taught content across the curricula. Once module leads had attended the workshops, they shared the teaching materials and supporting information with their module teams to inform seminar delivery.

Initially SusQI teaching was introduced into the BSc (Hons) Nursing curricula as part of the third-year dissertation module, across al four fields of nursing- adult, child, mental health and learning disabilities and included the apprenticeship route. Students are directed to pre-seminar preparation which includes watching videos that highlight the global impacts of climate change, as well as the Shine video which is a production by the Sustainable healthcare team in Newcastle to provide local context. The students are required to complete a final project which can be either a research project proposal or a service improvement proposal and they are encouraged to consider sustainability within their project plans.

Impact in Practice

To achieve impact in practice, students need to consider implementation of their proposals. To support this the competition provides links with clinicians and future employers so proposals can be shared with potential sponsors. Students are also encouraged to consider how their proposals can support them during employment interviews, which again allows employers the opportunity to support these initiatives in practice. In addition, the abstracts of the competition submissions are published in the nursing newsletter which is shared across faculty

Comments from students

Learning about sustainable ways to work within the nhs is invaluable.  Embedding this way of thinking in a body of students that are full of ideas, passion, and desire can only result in economic, financial, environmental and/or social elements featuring in considerations permanently.
Having a knock-on effect; positive effective change agents, transforming care transforming systems transforming organisations.
Knowing about SusQi sooner rather than later better equips people  it definitely changed my way if thinking when considering changes to practice big or small
It was great to receive training on the Advanced Clinical Practitioners Masters' course on the benefit from SusQI which can be incorporated into many aspects of practice to help the environment

Competition
The final year nursing students were invited to enter a competition which is judged by members of the regional NHS trusts and helps to create a link between student innovation and the workplace. A dedicated prize is awarded for the most sustainable project examples of the prize winners includes a project on the repurposing of food waste, which highlighted that in 2018-2019 NHS food wastage cost £230 million, amounting to 39% of the total food budget. a bus that is equipped with basic medical equipment is set up in the centre of Preston and the food waste from lunch time is repurposed to allow staff to offer a nutritious, hot meal alongside examinations, vaccinations, observations, wound checks.

Conclusions

The initial challenge experienced was integrating the SusQI materials and tools into the existing curricula in a way that ensured they had the maximum impact on the student experience and illustrated the importance of SusQi on future professional practice. We overcame the challenges of introducing the new content by working collaboratively as a result were able to successfully embed SusQi into the curricula. In addition, the sustainability content fits well within quality improvement, and allows students to understand how simple steps, can have a large impact on carbon dioxide emissions. Thus, the importance and compatibility of the content has also supported integration. We  continue to review where further integration can occur, and to facilitate further incorporation into programmes.

Acknowledgements

On completion of the pilot study we achieved SusQI Established Beacon site Status with the support from the Centre for Sustainable Health care. This means Northumbria University is one of two nursing faculties to achieve this status in the UK, and the only site in the North of England. Established Beacon site status demonstrates that we have met the CSH criteria for integrating sustainability into the quality improvement teaching component of our core nursing curricula. Special thanks to everyone who have supported us on our journey.

References

Centre for Sustainable Healthcare. Educational examples. 2021. https://www.susqi.org/ (accessed 13 June 2023)

Lemaitre S; Centre for Sustainable Healthcare. Food waste action week. How health professionals can take action.Blog. 2022. https://tinyurl.com/mrxh648r (accessed 13 une 20