Hi,

This is my second blog to let you know what has been happening in Leicester so far.

1) PHEMS - we have been having some trouble with this as the lady in charge was stuck in turkey but we are now on track. We have a contact for a clinical leader for our module who we will get in touch with. We need to decide whther our SSM will be phase one or phase two - probably phase one as it is less clinically orientated but the exam must be very stribgent for it. We need to meet up to discuss this porperly

2) We are setting up our own leicester google mail address so we can give it to people

3) Managerial - we have written and sent our letter to our contact for a managerial project to target in a hospital in leicester. We need to meet really before the meeting to discuss our "tactic"

4) Clinical project - I have now got a clinical contact who is interested but doesn't know how we will go about it in terms of method. I will be phoning him to brainstorm more in depth.

Targets: 1)Meet with Mo and Rida to discuss PHEMS properly and also managerial meeting
2)Set up managerial meeting!
3) Talk to mustafa about how my method can be conducted before I ring my contact.

P.s. if anyone has any tips on the clinical projects I.e. methodology that would be great!

Lucy

Newcastle: Blog number two

Hope it’s all going well for everyone!

So this is what I have been up to over the last couple of weeks:

1. Some reading on national and local resources-still ploughing through Stern’s “Blueprint for a safer planet.”
2. David Pencheon kindly identified some key contacts in the North East Region.
3. I wrote a letter to the Strategic Estates Adviser to NHS North East at the Strategic Health Authority. We arranged a meeting at the Strategic Health Authority, situated just outside Newcastle in Newburn (not quite sure why I’m setting the scene in quite such detail).

Meeting Outcomes:

1. I certainly learnt a lot! The Strategic Estates Adviser (SEA) had a wealth of experience and expertise in sustainability within the NHS. We went through the BREEAM (Building Research Establishment Environmental Assessment Method): Healthcare standard. We focussed on the chapter on transport- as this is the area in which I had expressed an interest.

2. FOCUS: The SEA advised that I focus on one aspect. I had been tentative about having a fixed agenda as I had been hoping that there would be an existing project/ network that I could join up with. I am still hoping to link up with others working on existing projects…But in the meantime I am going to look at transport across the strategic health authority.

3. BACKGROUND READING: SEA will send BREEAM: Healthcare standards documents- the chapter on transport will be particularly useful. I was given a copy of the Sustainable Development Unit’s procurement carbon reduction workbook to read.

4. KEY CONTACTS: SEA will send a contact list for the Sustainable Development Leads for the North East Strategic Health Authority.

5. REPORT ON TRAVEL: I will contact each of the Sustainable Development Leads asking for a copy of each trust’s “Green Travel Plan” (something that each trust is supposed to have). The SEA felt it would be useful for the Strategic Health Authority to combine the information into one document as they do not have this information. Within the report, I will compare NHS trusts to one another as well as to a model travel plan as set out by BREEAMS/ the Sustainable Development Unit. I will feed the document back to the Sustainable Development Leads as the information may enable trusts to learn from those that have performed slightly better. Throughout this process I will be in contact with Mustafa/ David Pencheon/ and the SEA seeking advice about how best to present the data and what to do with it.

TROUBLESHOOTING

• The SEA warned me that some of the Sustainable Development Leads may not respond as they are not officially appointed positions. If this happens I will contact the Trust exec. and go from there.
• If I receive an overwhelming amount of data I will try to find one or two other medical students to help put the report together.

I am pleased by the positive response from the SEA, and excited about having a focus and a potential project to get stuck into. Woop!

Much love xxxx

The latest in Sheffield...

Hey all,

So things are looking up here in the steel city :) Heres the latest:

GP progress...
I've had a really positive response from a practice in Sheff who has already made substantial progress to becoming 'green'. They've given me the contacts for some other practices who they know are also interested in doing a similar thing but haven't quite got around to doing it yet...cue the 'donkey workers' (BCMCCP members!) I'm hoping to get in touch with them ASAP: ideally I'd like to calculate their current carbon footprint, then implement some carbon reduction measures, and finally assess their progress over the coming 7 months and use this as a case study for sustainable development within a primary care setting. Very exciting news is the GP 10:10 checklist is almost finished - based it on some past correspondence that Frances had had and asked the Sheff GP for their feedback. Elly is now going to get her GP practice in Brighton to feedback as well and then hopefully we can get that up and running on the 10:10 and Campaign for Greener Healthcare websites.

Food fun ...
I'm yet to contact the man in charge of this at Sheff NHS Trust - the reason being I tried to contact John Hughes first - has done some really amazing work with Nottingham NHS trust in terms of food and catering, if you have a minute you can see a summary of what he acheived here: http://www.corporatecitizen.nhs.uk/casestudies.php/14/nottingham-university-hospitals-nhs-trust-sustainable-food-service/2
to see if he could give me any advice before heading into it feeling completely blind...But unfortunately I didn't get any response. Anyway, I've done a bit of reading around it though still much more needed but I'm going to hopefully write to the Sheff man in charge and see what response I get and take it from there. Has anyone got any draft/final letters they've sent to chief execs and have had positive responses from? Did we get any further with designing a draft template letter? Theres something veeeeeery exciting going on in Sheffield soon which I think could help get some results with the trust....

...Sheffield Food Festival and Food Plan!
Stumbled across this during some internet roaming and looks like it could be the perfect motivations for Sheff NHS trust to get themsleves into gear with more sustainable food procurement policy. Its the brainwave of a group of people called The Public Health Improvement Team in Sheffield who work to 'address the wider determinants of health and well being' and work with NHS Sheffield amongst others. The Food Plan is a work in progress which aims to : "draw together some of the key issues affecting food in Sheffield. Part of this will focus on healthy eating and people’s access and ability to cook safe, nutritious and affordable food. As well as this, issues such as the environmental impact of the food we eat, the local food economy and our food security will be addressed." Amazing!! So...emailed to find out what the plan is regarding Sheff NHS and awaiting a response. No reply as yet so I think I'm going to go in person next week as their office is easily accessible and in the town hall-always works better having a face to a name as well! The Food festival is planned sometime in June and is there to support the key themes of the Food Plan as well as to celebrate 'Sheffield's culture of food' (theres gonna be alot of pie and Hendersons relish! (check out sheff's own version of Lee&Perrins you can even get a tshirt: http://www.hendersonsrelish.com) . I thought if we could get it sorted it would be a brilliant opportunity to have our own BCMCCP stall and offer the Carbon Addict screening??!! What do people think??

Finding other students...
I've been in touch with two other students at Sheffield who have been involved with trying to set up a Healthy Planet and are really keen to get involved with BCMCCP stuff. Unfortunatey both of them have had/still have exams so we haven't got much further than swopping contact details and sending round a few emails. Up till now I've held off sending round mass emails to med school/environmental societies as I wasn't entirely sure of what exactly was planned for the next few months. However, now that there is a better idea I think it'll really help having a few more people on board (especially with the Food Festival and the donkey work thats going to be needed with the GP case study!) so that'll be something to think of soon...

The next few weeks:

• Finish GP 10:10 agreement - get it up on the websites so it can be downloaded if needed
• Get in touch with the interested Sheff GP practices and see what we can plan to acheive in the next 7 months
• Go down in person to the office of the Public Health Improvement Team and get involved with the Food Plan and the Food Festival - ask about the possiblity of a BCMCCP stall!
  
• Write a letter to the Sheff NHS food man in charge - ask about Food Plan - are they involved? What progress is being made...if any..!
• Update the other students at Sheff - discuss getting more people involved and what roles they could have
• Get on with the SDL!!! Haven't done as much as I would have liked by now so I'm going to really try and set aside some time each week specifically for this.
  

Wowza! That was a mammoth update - I'll try and update more regularly to avoid the mass essays in future....!

Hope alls well with everyone else? After falling out with my computer (no more virus but now apparently just need more RAM (or 'memory' for technophobes like me)) I'm hopefully going to be all Skyped-up and ready to roll in the next 1/2 weeks so hopefully be speaking to you all very soon....

Phil xx

Done so far - Coming up next

What I did :

- Help from above :
unfortunately there is no one occupied with climate change and health on a national level in Belgium. So far for help from above…
In the last national report on climate change there is one full page about climate change and health, where heatstrokes and malaria are mentioned. So one new aim is to get at least 5 pages in the next report, written by a newly formed student group!
I did find people at the university to help me, they are working in the field of environment and health (mostly doing biomarker measuring but interested in climate change too). They will help me for the practical part (case-study), but the problem remains for the educational part: there is no one with expertise.. (or he/she is hiding pretty well)

- Help from peers:
that is going very well, there are plenty of students interested in Ghent University and yesterday IFMSA Belgium was formed and I was there to talk about the program to get the other universities involved. Everyone was incredibly enthusiastic, so next thing is setting up Healthy Planet Belgium. I wrote an outline of the program (what, why, how, …) to send to everyone that should be involved.
Oh and I also have contact with some engineers for the case-study (dialysis)

- Global Health and CC in the curriculum: we don’t have SSC’s or PHEMS, we don’t have global health in our curriculum BUT we will have it soon (even sooner than I’d expected!). I got a crucial professor (head of the curriculum committee) exited and other students to help me. We will have a meeting (end of June) to make a proposal for a 3-4 days course on global health, this proposal will be presented by myself at the committee in November. I invited some important professors to the meeting (most are in the committee, so they have to decide on their own proposal -> higher chance it will work) to help us with the program ((one of them is Marleen Temmerman, who just won the british lifetime achievement award)).

- Case study:
I choose the dialysis unit for several reasons (expertise from the green nephrology program, it’s simple, and I have an idea (which will remain secret until the next blog)). I went there last week to see if they were interested, and they were (a lot, almost too much). Thursday I have a meeting with the policy-person of sustainability in the hospital to talk about the program and see what can be done in the dialysis unit. When I have the basic info on the carbon footprint of our dialysis unit I’ll contact Frances to see which interventions are most interesting.

What I’m going to do:

- May-june:
get the case-study going, delegate it to other students because I’m away in the summer
preparing proposal for global health and CC in the curriculum
set up Healthy Planet Belgium under BeMSA (Belgian medical students association)
communicating with the most interested students in the other universities, so there is someone
responsible for every university.
keep on looking for someone with expertise in the field on a national level..

- July-august-september:
I’ll be away, so mostly preparing for the next year, where the project will start in other universities. And probably a lot of mails with the dialysis unit to see how everything is going. And self-directed learning.

- Beginning next academic year:
presenting case-study + project in all the universities. Organize workshop/weekend/or what we find appropriate to help everyone get started. Lectures about CC and health so that at least everyone knows there is a link.. (this is all still quite vague, but it will get clear along the way
I will start with broader policy issues because that is what interests me (the case-study now is more to show the other students what kind of things they can do and to get to know everyone in the hospital that is involved in sustainability).

It has been a lot of fun so far, because everyone I talked to is extremely enthusiastic. It’s like they were all just waiting for someone to propose them to do something. Just what I need to keep doing this when I actually have to study for my exams J

Step 1: Finding Interested People and Helping Hands

Since the training weekend I have been in exam mode, so while not as much has been done as I'd like I've done about as much as expected.

The big thing that's got me excited is that after sending out an email to Hull York med students (a pretty vague one basically saying 'who's interested in climate change and might possibly be interested in helping me out with a project I'm doing?') 30 people (i.e. 3-4% of the student body), some from every year, have replied. Which is great. So now there is a list of interested people who have offered to help me with things should I need it, but also I now know that a lot of students want to help. If I can get that across to local management then hopefully we can get more done- numbers matter and all that.

With the help of Frances I've found out that one of our lecturers is looking into the PHEMS thing. He's really enthusiastic about getting an SSC up and running for September and has offered me his support in it. So that's exciting. There is already a general environment-based SSC at HYMS so the plan is to get the leader of that one involved and Frances also put me in touch with a foundation year doctor in York who is interested.

SDL is on hold but I'm itching to get stuck in. Once I finish for summer in 4 weeks my first priorities will be getting some background and policy reading done and also arranging some meetings (via David) with local NHS bods to find out what can be done practically, and run some ideas by them.

So yes, still enthusiastic. Plodding along. Doing OK I think.

All the best,

Jess

First blog

Hi this is Lucy from Leicester attempting her first blog. So far I have been doing some reading about climate change but can't say I'm feeling particularly knowledgeable just yet! I have read up on pain management programmes in comparison to analgesics and they seem superior in quality in as far addressing the psychological and physical manifestations of pain. From there I contacted David and Frances further to find out if I was heading along the right track and they will hopefully point me to a good clinical contact in the field. I have also drafted a letter to the contact from David regarding our managerial option which will be sent on shortly (after being looked at by Rida and Mo!). I have also contact someone about PHEMS but have not heard anything just yet so I really need to chase that up about the deadline submission. I am also trying to reduce my carbon footprint and have done some dry runs on my bike!

Lucy

Bristol's blog 2

Within the last 2 weeks I have been reading up on climate change and global health and starting to understand everything a lot better. I feel as though i still need some more time to continue self directed learning before i am confident enough to address the NHS. I have been looking into current sustainable programmes and schemes already set up in Bristol and thinking about how we can interlink these programmes with the BCMCCP.

I am waiting on a reply from Frances related to specific contacts within the Bristol NHS and ideas on which clinical pathways I should follow.
After making contact with Assiya, the other programme director in Bristol, we are planning to meet up and discuss how was can work together can combine our variety of knowledge and skills.

I was shocked after looking into my own personal carbon footprint and am making small changes (mostly involving walking and using public transport) in an attempt to reduce my own carbon emissions. Also to the annoyance of my housemates and course-mates I have been encouraging them to leave their cars at home and buy more locally sourced and in season foods (one day they will listen).

For the next two weeks I will be continuing my self-directed learning, creating a joint plan with Assiya for the next few months, formulating a letter to send to contacts within the NHS and getting in contact with local sustainable groups and programmes to see what progress they have made and how the BCMCCP can assist them. I would also like to get in contact with other programme directors and see how their first few weeks have been.

Bristol's blog 1

My name is Alice Seymour; I am at the University of Bristol studying medicine in third year. I have just started my clinical years on the wards, finally talking to patients, and feel that as students we are the key change in the NHS. Although I do not know much about global health and climate change at the moment I am very keen to learn and hope that I will be able to assist the Bristol NHS in taking steps towards a more sustainable future, when my peers and I will be working within the NHS.

From the training weekend I have learnt:
· About the wide range of opportunities available for us as programme directors to get involved with. I am now aware of both the managerial route of action and the clinical route and how best to put my skills and interests to use throughout this programme.
· The effectiveness of long and hard ‘grunt work’ over shouting at a problem and that sometimes for a little benefit a lot of behind the scenes action takes place. We should learn to ‘change with the system rather than shout at the system’.
· The importance of reframing issues, by putting them into context, so as to create the largest impact on your chosen audience. Bring solutions and advantages to people not problems.
· A lot more about climate change and global health in general, in particular the health co-benefits and the significant proportion of the NHS carbon footprint created by procurement.
· Lastly i have become aware of all the current organisations and groups currently acting to educate others about climate change and encourage people and industries to become sustainable and reduce carbon emissions.

Over the next 8 months i am looking forward to:
· Developing my knowledge on climate change, global health and the NHS through self directed learning and talking to other programme directors, Mustafa, David and Frances.
· Working with other programme directors and finding like-minded individuals in Bristol.
· Creating international links.
· Getting stuck in to helping the NHS become more sustainable.

Motivation
· I am interested in setting up a network, of students at the University of Bristol and the University of West of England and staff within various hospitals within the Bristol NHS trust, to make people aware of the issues and provide education on how to tackle climate change at a local level. I also hope that through the network there will be the possibility of continuing the programme after the 8 months.
· Self directed learning and education is important to me. I would like to understand climate change and global health in greater detail so I can confidently talk to; others within the field, people who wish to learn more about sustainability and cynics who do not think we can make a valuable difference. I also hope to learn how to be sustainable at home and within a hospital ward.
· I want to create a tangible case study of the whole 8 months in the hope that it can be used and adapted by other NHS trusts across the country. They will be able to see what works and what does not work at Bristol and compare this to their own trusts.
· I am interested in creating an international link with Kenya. I visited Kisumu, western Kenya in Aug 09, and saw firsthand the health services available and the problems faced in particular by orphans and vulnerable children. I would like to contact a medical student through KOP (the Kenyan Orphan Project) whom i am a volunteer for and see if anyone is interested in learning more about climate change and global health or setting up a similar programme in the future. If i am not able to find anyone in Kenya i would be interested in looking at another country for an international link.

Specific involvement
I want to get involved with the clinical pathway Dr Frances showed us. I am particularly interested in either mental health (my placement for summer term) or oncology. I would like to see if there are any similar 10:10 programmes in action and either monitor the progress, assist in the initiation or assess the outcomes of these programmes. The reason i would like to focus on mental health or oncology is that they are two areas in which i am considering specialising in the future although I am happy to focus on another speciality if needed.
I plan to look into travel or waste management auditing and the possibility to assess or create a GP carbon footprint tool (i am aware that one GP surgery in Bristol has signed up to the 10:10 pledge).

Plan so far
Within the next week I hope to contact David and Frances and see their thoughts on how I should begin my 8 months and my overall aims for the programme. Complete self directed learning and look into creating a network of students and NHS staff.
Over the next 14 days I will create a letter to send to the clinical and medical director of the Bristol NHS trust and within the next month I will attempt to create an international link and interview someone within the Bristol NHS trust. I will continue to develop my own education on climate change and global health and communicate with the other programme directors to discuss the methods which have worked and ideas which have not worked so well.

The first blog...of many

My name is Philippa and I'm currently a third year medical student at Sheffield University. I intercalated last year at Leeds University in an International Health Bsc.

I chose to apply for this programme for a number of reasons. Firstly, I feel a social responsibility to my own and future generations to work towards a more sustainable way of living. Furthermore, as a future employee of the NHS I would like their evidence-based ideals to encompass the proven effects of climate change on health, and the need for carbon reduction and sustainable development. Another major factor that motivates me is the opportunity to greatly expand my knowledge and understanding of the ecological, political and economic aspects of climate change.

I learnt a great deal from the training weekend. I realised that our programmes are going to be hugely diverse, depending upon the trust's response as well as our own personal interests. A crucial point I will take home with me is the need to stress that carbon reduction strategies within the NHS do not mean compromising on patient care but rather aim to further improve the quality of the service. The evident enthusiasm for change, held by everyone there, was great to witness and be part of, and I am really looking forward to the future contact we have together.

As a medical student I feel that I am more fitted to working within the clinical aspects of this programme because of past practical experience within the clinical setting. Programme transformations such as the nephrology example given by Frances, have great power to motivate others, and to be used as positive examples of successful carbon reduction strategies in terms of both financial and quality of service benefits. I am also interested in engaging health professionals into the 10:10 agreements. However, I am equally aware of the importance of 'top-down' changes in policy if we are to achieve long-term and significant carbon reduction restructuring.

I am still undecided as to which particular approach will be my focus, or whether I could effectively use aspects of both policy and clinical practice approaches. Within the clinical setting I am interested in the development of a G.P. 10:10 tool and engaging G.P.s with this. For the next 7 weeks I am on a G.P. Placement and so can use this to gage their interest and current progress in the matter. If a transformation programme appears to be a viable option within Sheffield, I would be interested in its application to mental health. Regarding the managerial and policy approach, I am particularly interested to look into the food and catering aspect of the trust's procurement carbon footprint and see whether this could be, or is planned to be part of the trust's own carbon reduction strategy.

So my plan for the next 2 weeks is:
· Contact David Pencheon about the meeting he is holding with the Sheffield G.P.s in the near future and hopefully attend this. Also ask if he knows who is responsible for food procurement in Sheffield NHS.
· Contact Francis to let her know I'm interested in preparing and piloting a GP 10:10 tool
· Get in touch with other interested students in Sheffield to form a working team

Climate Change plans in Brighton

Hi I'm Elly - a 4th year student, studying Medicine at Brighton and Sussex Medical School, but currently taking a few years out to do a BSc in Pharmacology at the University of Brighton and work with Medsin-UK and Healthy Planet.

I have always had a desire to get involved with projects that allow me to play a small part in fighting injustice, which brought me to getting involved with the local student StopAIDS campaign. It was through working with StopAIDS I discovered Medsin, and was on the first local Medsin committee in Brighton. This lead to me being on the National Committee, and although I have enjoyed being on a governing body of a student Global Health network, and learnt so much, I have a real desire to be on the front lines now.

I understand the need for the layers in leadership, and bureaucracy, but while working within these areas it is easy to lose touch about why you are doing it.

I applied for this programme because selfishly I have a desire to learn more about Global Health, but I also want to be active in combating the inequalities.

As “climate change is the biggest threat to health in the 21st century”, it seems the most logical area to work in. As I am training to be a healthcare professional, it would be inefficient to be learning about disease pathology, if it is CC that will be the greatest cause of ill health. I know that as a clinician it is impossible to combat everything that ill affects health, but it would be immoral to not even consider combating climate change as our duty.

I have an active interest in Climate Change, and how we are going to combat, and prevent it. In particular I am interested in how the international arena has reacted to the notion of Climate Change; the economics, the politics and the policies.
I have wanted to be involved with a project that would allow me to really get involved with making an impact on the UK’s carbon output.

My personal interests lie within campaigning and policy, so it will be very interesting to use a different approach. In particular I wish to investigate the method of a top down approach; by working with management to establish methods of change, and implementing them. I believe that yes it is necessary to educate our peers, but that real change can only happen if it is implemented first by management.

Taking into account the co-benefits that sustainable development will have on the NHS, it is logical that management implement such changes, and with the government putting pressure on the trusts and mandating them to create SD plans, it appears that a top down approach would be most effective.

I am also interested in the clinical side as well, but because of my degree in pharmacology and my job in a local GP’s clinic, I felt that it made sense to work in these areas. As I work in the surgery a couple of days a week, and I understand the structure of the surgery well, I would like to create a 10 point plan to reduce the carbon footprint of the surgery. Similar to the one designed for Nephrology. I hope to create it early on in the programme, and then use it at the surgery, creating a case study that I may then be able to present to the RCGP’s conference. And if successful be used as an example for the all GP surgeries.

So my plan for the next few weeks:

• Contact local environmental groups, including our local Healthy Planet.
• Form a local group that I can work with
• Establish any work that has been done so far.

I am also really keen on education and PHEMS, and so have contacted my med school on how to set up an SSC and am looking into developing a proposal for that.

Well this is my first blog, so hopefully they will become a little bit more action packed as time goes on!!

Elly

Hannah: Blog number one

My name is Hannah and I am in my third year studying medicine at Newcastle University. I spent last year at Leeds University studying for the intercalated BSc in International Health.

My main motivation for attending the BCMCCP was to learn how to help the NHS within my region reduce its carbon emissions. I saw the programme as an opportunity assist in making tangible change, whilst gaining knowledge and meeting like-minded people. In short, I did not want to complain about a situation that I was doing nothing to improve.

I learnt a lot at the training weekend in London and really enjoyed meeting others on the programme.

The main points I took from the weekend were:

• A better idea of the programme, including its conception, purpose and my role
• An understanding of the range of areas in which I could get involved
• An insight into how best to approach different actors within the NHS- I am particularly thinking about David’s talk which included: reframing, storytelling, letter writing and the power of league tables.
• Frances’ talk highlighted quite how complex it is to make the NHS more sustainable. There are so many actors, variables and vested interests, which also means there are many opportunities…
  

I am really excited about getting stuck-in. I anticipate that the next 8 months will be busy and at times frustrating. But I am sure that the programme will be rewarding and I am looking forward to working closely with everyone else in the team.

Areas I am keen to get involved in:

• I am most interested in health policy and effecting change from the top down. This is because I (possibly naively) believe that policy change is likely to have a wider impact. I would be happy to look at the clinical side later on, but would prefer to focus on one area in the beginning. I anticipate that my area of focus is likely to depend heavily on individual actors and the responses I receive.
• I want to increase my knowledge about how the NHS functions and read local and national policies and documents on sustainability
• I hope to join and/or create a network of people working on sustainability within the Newcastle trust. I will find working as part of a team more enjoyable and know it will be more effective than acting alone.

Welcome to the BCMCCP Director Blog!

Hello everybody!

So here is our wonderful blog, I hope it works. I'm sure it will.

This blog is the very best way we can have a group-wide awareness of what's going on. I'll be posting interesting things every so often, but this is really for you all to use.

So! Let's get the blogs up every two weeks.

Over and out!

Mustafa