Sustainability, Resilience and Occupational Health Flashcards

Question

What does re-employment lead to?

Answer 1

There is evidence that re-employment leads to improved self-esteem, improved general and mental health, and reduced psychological distress and minor psychiatric morbidity. The magnitude of this improvement is more or less comparable to the adverse effects of job loss.

Answer 2

The Cambridge Dictionary defines sustainability the ability to be; “Able to continue over a period of time”

Answer 3

It could be looked at in relation to low carbon clinical care and the environment. It could be looked at in relation to the ability of the NHS to “Continue over time” In Scotland we have a National Policy Document “Realistic Medicine” that in part relates to this.

Answer 4

Prioritise Environmental Health Substitute harmful chemicals with safer alternatives Reduce and safely dispose of waste Use energy efficiently and switch to renewable energy Reduce water consumption Improve travel strategies Purchase and serve sustainably grown food Safely manage and dispose of pharmaceuticals Adopt greener building design and construction Purchase safer more sustainable products

Answer 5

NHS Sustainability Development Unit’s Strategy Document (NHS England)

Answer 6

The SDU has shown that short term reduction of 40% in emissions is technically feasible without compromising standards of care.

Answer 7

The NHS carbon reduction strategy, based on national targets set by the Climate Change Act 2008, commits the health service to more than 80% reduction in emissions over the next 30 years. So the health sector will be forced to reduce its carbon emissions.

Answer 8

The greatest part of carbon emission from NHS England is from purchasing of goods and services, 22% is from purchase of pharmaceuticals. Sustainability is not just about more efficient use of energy in buildings but also of equipment and consumables.

Answer 9

``` It will – Be better at preventing conditions Give greater responsibility to patients in managing their health. Be leaner in service design and delivery Use the lowest carbon technologies ``` It will be better at preventing conditions. - On World Health Day 2008, the director of WHO, Margaret Chan, forecast an increase in deaths worldwide from malnutrition, diarrhoea and infectious disease attributable to climate change. - Specialities should aim to tackle underlying causes of disease; the social, economic and environmental determinants of health. - Make effective contraception more widely and easily available worldwide to help reduce the financial, social and environmental effects of unwanted pregnancies. - Increasing access to clean water, proper sanitation and education on hygiene techniques such as hand washing. Give greater responsibility to patients in managing their health. - Many patients could be empowered to take on greater role in the management of their health and healthcare. - For example the use of information prescriptions instead of medication prescription by an East London GP practice. Be leaner in service design and delivery - e.g. combine clinics for diabetes, cardiovascular and stroke, use ‘lean’ principles to eliminate duplication and poorly targeted investigations. - Reduce the number of steps in patient pathway of referral to treatment by channelling patients from the clinic direct to pre assessment, reducing their journey time. - Greater use of online records, email and telephone can reduce travel emissions by moving information in place of patients, staff and lab samples. - More effective prescribing remembering pharmaceuticals comprise a fifth of carbon emissions from NHS England. - Disposing of the unused drugs has a marked environmental impact considering some reported figures of almost 50% non compliance Use the lowest carbon technologies. - Inclusion of sustainability measures in the evaluation of medical technologies will allow service planners, clinicians and patients to choose clinically effective treatments with the best environmental profile and will encourage further development eg green nephrology project provides a model of sustainability. It has looked at dialysis water recycling, heat exchangers, reduction in packaging and virtual clinics

Answer 10

Transport accounts for almost 25% of all fossil fuel greenhouse gas emissions Cutting emissions through walking and cycling and less vehicle use brings large health benefits e.g. reduction in diabetes, CV disease and depressio

Answer 11

Reduce the need to travel: -teleconferencing, video conferencing for follow-up appointments where clinical examination not needed. - One stop clinics where consultation, diagnostic testing and management plan all done on the same day in the same facility. - Multiple clinics on the same day – coordinating care between different specialities for the same patient Better ways to travel: - car pooling, car sharing, fuel efficient vehicles (hybrid or electric) , health service transport e.g. buses to transport patients to and from clinics and hospital Institutional plans - e.g. providing facilities for people to cycle to work, utilise bus services. - Incentivise active travel – reduce car parking spaces, cycle to work schemes to provide for the purchase and use of bikes, encourage walking to work or incentivise use of public transport.

Answer 12

“Figures show extent of NHS reliance on foreign nationals” How much of the NHS workforce has potentially migrated to the UK? - 11% of all staff and 26% of doctors are non-British Where do they tend to come from? - India, the Philippines, Ireland, Poland, Nigeria, Zimbabwe, Portugal, Pakistan, Spain and Germany. What are the potential risks to the UK and also to their country of origin? What changes in the UK or their country of origin might change this? Is this sustainable long term?

Answer 13

In Scotland the SNP 2015 manifesto committed to “Meet the funding challenge” laid down by the chief executive of the English NHS in the Stevens Report by voting for a £24 billion increase in health spending, £9.5 billion more inflation. This will lead to the Scottish NHS budget increasing by £2 billion.” “They will vote to stop the supposed privatisation of the English NHS.” There has been legislation passed in Scotland in 2014, that came in to place on April 1st 2016 relating to the Integration of Health and Social Care. This brought together NHS and local council care services under one partnership arrangement for each area. This will necessitate a closer working relationship between NHS workers such as GPs and Social Care providers such as Care Managers and Social Work. They share funding of around £8 billion of Health and Social Care Funding.

Answer 14

There is an increasingly elderly and comorbid population, which continues to place greater strains on the NHS. There is currently much debate in England in respect of the commissioning of NHS services by any qualified provider, which could be perceived as gradual privatisation of services. In addition on the 21st April 2016, the UK government announced an annual investment in the General Practice sector of the NHS of 2.4bn by 2020-21. This included funding for a £500m sustainability and transformation package that includes £56m for a practice resilience programmes. There are therefore different approaches currently between Scotland and England in terms of the ongoing nature and provision of NHS services in the context of rising need for NHS services

Answer 15

In 2018, a majority of General Practitioners in Scotland voted for a changed national GP contract. The BMA in Scotland stated it will reduce workload and improve recruitment. Additional members will become part of the practice team and allow GP’s to fulfil their role as expert medical generalists. There are a number of changes in staffing and funding designed to promote sustainability of General Practice. The effect of the changes will be to reduce risk to practices and to promote sustainability.

Answer 16

It is now been suggested we should remodel the WHO definition of ‘what is health’ proposed in 1946 from: ‘a complete state of physical, mental and social wellbeing and not merely the absence of disease’ to ‘resilience, adaptation and self-management in the face of physical, social and emotional challenges’