Introducing Environmental Sustainability to 3rd-year Physiotherapy students at University of Plymouth, UK

Introduction

As a result of the global industrialisation process, global temperatures are increasing. This is leading to increased extreme weather events including floods, fires, drought, heatwaves and hurricanes. Homes will be lost and displaced communities will migrate globally, vulnerable to ill health due to scarce water and food supplies, disease transmission, pollution and heat stress.

In the UK, healthcare is part of the problem. The National Health Service (NHS) accounts for 5% of total UK emissions and is the biggest public sector carbon emitter. On 1 July 2022, the NHS became the first health system to embed net zero into legislation via the Health and Care Act 2022. This placed new duties on NHS England, and all trusts, foundation trusts, and integrated care boards to contribute towards statutory emissions and environmental targets. Further to this, NHS strategy (2022) outlined plans to decarbonise the NHS and reduce the carbon emissions to net zero.

Within the NHS, Allied Health Professions (AHPs) are the third largest clinical workforce with huge potential to support the overarching NHS aims to obtain net zero. In 2022, the Chartered Society of Physiotherapy (CSP), our UK governing professional body declared that climate change is a health emergency and acknowledged that the state of the environment has an impact on the health of physiotherapists and patients. The CSP declared support for physiotherapists to take urgent action to reduce the environmental impact of healthcare.

As educators of the future UK Physiotherapy workforce, employed by a university with sustainability as a strategic ambition, it makes sense to begin to include environmental sustainability into our university curriculum. Whilst the HCPC are in the consultation phase and the CAHPO survey UK HEI, it feels important to start somewhere and international online meetings with the Environmental Physiotherapy Association provided inspiration to integrate planetary health into education in line with other established Physiotherapy programs across the world.

Danielle Munford (MSc)

Physiotherapy Lecturer, University of Plymouth

Danielle is Pathway Lead for the MSc Advanced Professional Practice in Neurological Physiotherapy at University of Plymouth. Danielle teaches on the BSc, MSc pre-reg and MSc Physiotherapy programmes striving to deliver a high standard of evidence-based education. Her main interests are neurological rehabilitation and environmental physiotherapy.

A pre-teaching online-survey for students

Prior to teaching commencing on this topic, I asked the 3rd year BSc Physiotherapy students (n=30) to complete an online survey to help inform my understanding of their pre-existing knowledge and their perceived importance of this topic. 77% of students rated climate change as 4 or 5 when asked ‘How important is climate change to you?’ (5 being most important). When asked what eco-actions they currently take the students replied with recycling, litter picking, beach cleans, active transport, electric vehicles, reducing meat intake and reusing containers. The students were able to identify links between planetary health and human health such as air pollution for respiratory health, crop failure for lack of food supplies, microplastics in water supplies etc. This shows that the students had some pre-existing understanding of climate change and thought it was an interesting topic.

Perhaps the most interesting answer to the short survey was that only 10% of the students had seen or heard a member of NHS staff consider climate change when selecting an intervention in the clinical setting. When probed about this during teaching, students reported that they had seen clinical educators choose to walk or cycle to community visits rather than drive and they had seen visors being washed and reused for environmental reasons. This means that 90% of students had not witnessed climate change impacting clinical decision-making during their NHS student placements, perhaps suggesting that this topic is not at the forefront of clinicians’ minds given the current pressures on the workforce.

This underlines the importance of including climate change in the undergraduate curriculum so that the future workforce is able to make informed decisions about the impact of healthcare on the environment. Through their clinical placements and beyond graduation, students can educate peers and drive innovation in NHS practice to ensure net zero is achieved.

From teaching to implementation

Following on from the key lecture, the students enjoyed 3 seminars which introduced the basics of carbon literacy, climate action and communicating climate change. Resources from the Sustainable Development Unit were helpful in the planning and delivery of these seminars and facilitated a clear understanding of how personal activities impact on the planet and then how a patient with COPD in a cycle of readmissions could soon accrue a large carbon footprint.

Throughout the seminars, students spoke passionately of their own values and experiences and some suggested ideas for how they could implement further eco-action as an individual and on a professional level. Some of the 3rd years suggested they donate their student Physiotherapy uniforms to the new 1st year cohort. In the UK student Physio uniform is plain white but the qualified uniform is white with navy blue so beyond 3rd year it is not usually worn again. The students suggested this would save approx. 5kg CO2e per polyester tunic as well as the financial saving for the 1st years receiving this free clothing. A donation rail was placed in a common area, signs made and the uniform exchange went ahead successfully.

The way forward

Plans to embed the topic of sustainable healthcare progress at University of Plymouth as we strive to motivate and equip future Physiotherapists to consider the impact of their professional decisions on our environment and to strive for a net zero NHS.

Greener AHP Hub: https://www.england.nhs.uk/ahp/greener-ahp-hub/

Centre for Sustainable Healthcare: https://sustainablehealthcare.org.uk/

Kommt gerne in Kontakt / Get in touch

🇬🇧 We would love to hear from you and continue the conversation about our teaching about the importance of movement in the forest. If you have any feedback, questions or ideas that you would like to share with us, please contact Danielle Munford via email or use the comment form below.