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This article was co-authored by Rose Gallagher, MBE, Professional Lead Sustainability at the Royal College of Nursing and Trustee UK Health Alliance on Climate Change.
We focus, in this third article of the series, on challenges faced by UK healthcare providers at present and in the immediate future, presented by the social pillar of sustainability – the “people” pillar. We also consider how healthcare providers, professionals, regulators and their insurers, through their cumulative experience and ongoing commitment to overcoming such challenges, have an opportunity to lead the way.
Social challenges
At its core, the social aspect of sustainability can be considered as "respect in the workplace". A fundamental understanding and appreciation of the unique identities, experiences, and contributions that each individual can bring to this global challenge. It is about recognising individual talent and value in addition to the power of collaborative effort.
While there is widespread agreement that diversity and inclusion are core to equitable futures for all, for these concepts to be truly meaningful, it is the everyday interactions that define success. It is about how staff, patients and communities listen and engage with one another in a way that fosters respect and inclusion.
A recent milestone in this area was the first meeting of the All-Party Parliamentary Group (APPG) for Healthcare Workers, held on 18 March 2025. Spearheaded by the Medical Defence Union (MDU), the APPG is focused on addressing key challenges such as the health and wellbeing of healthcare staff.
The MDU's research reveals a troubling statistic. Nearly 90% of healthcare workers reported feeling sleep-deprived at work, with 41% experiencing this issue on a weekly basis. The MDU has called on the UK Government and NHS employers to introduce measures that better support the health and wellbeing of healthcare professionals. Alongside this, the mental health challenges faced by health professionals is increasingly impacting on workforce availability. Cumulative trauma and workplace moral injury carry significant risks for retention of staff, stress and burnout – all of which ultimately impact on compassionate care delivery and the ability to motivate and create a culture of positive change.
Workplace wellbeing
This brings us back to workplace "culture" and its critical importance. Balancing financial goals, healthcare demand and ensuring safe staffing levels remains extremely challenging. The growing need and demand to integrate sustainability into providers’ activity and transparently consider and manage risk and demonstrate impact through good governance will become increasingly important. Healthcare providers must focus on concrete actions that prioritise workforce wellbeing, create safe avenues for risk assessment, whistleblowing and implement genuine inclusion initiatives that ensure fairness. Whilst doing is of course important, to be a truly ethical healthcare provider, the voice and lived experience of staff and service users must predominate bringing commitment to life, via meaningful actions.
More broadly, the increased potential for ‘climate litigation’ and the pursuit of climate justice is likely to grow, as civil society challenges action and rapid progression on global climate policy. Climate damage impacts people as well as the planet, bringing disorder to established routines and expectations, disease and property damage that may disrupt local communities and livelihoods, forcing some communities or individuals to migrate to new, unaffected or resilient jurisdictions. The opportunity to embed workplace wellbeing within organisation’s emerging adaptation strategies sits in a unique moment of time with multiple current and future co-benefits if embraced now.
Social opportunities
Healthcare providers, as anchor institutions, whether a district general hospital or specialist NHS Trust, can play a significant role in influencing the health and wellbeing of local communities. They play a pivotal role in their communities, not just as healthcare providers but as a constant presence offering significant economic and social benefits. Examples of the initiatives such institutions have led on, include:
People
The Rotherham NHS Foundation Trust has outlined its Integrated Equality, Diversity, and Inclusion (EDI) Plan for 2024 - 2027, setting a clear path toward fostering a more inclusive and supportive workplace. This plan is closely aligned with the Trust’s People and Culture Strategy, reinforcing its commitment to retaining and recruiting diverse talent, developing inclusive leadership and driving engagement and continuous improvement.
Key commitments within the plan include a firm stance on anti-racism, dedicated support for LGBTQ+ communities, initiatives to better assist healthcare professionals with disabilities and an overarching focus on enhancing the experiences of all staff.
The plan also acknowledges the importance of addressing barriers faced by individuals with protected characteristics, further to the Equality Act 2010. To ensure meaningful progress, the Trust is leveraging NHS Staff Surveys, published EDI data and Freedom to Speak Up arrangements, allowing for ongoing monitoring and timely responses to concerns.
At the heart of this initiative are staff networks, which the Trust views as essential in driving meaningful change and embedding inclusivity throughout the organisation.
Community
The Hampshire and Isle of Wight Healthcare NHS Foundation Trust has set out a clear vision to enhance health, reduce inequalities, and improve the overall experience of care by fostering strong partnerships with people and communities.
Recognising the immense value of lived experience, the Trust, which has a Community Engagement and Experience Team, actively promotes knowledge-sharing among team members and community partners. Their approach is rooted in building trusting relationships with diverse groups, ensuring that services are shaped by the needs and perspectives of the communities they serve. By engaging meaningfully with local people, they aim to enhance service accessibility and, in turn, drive better health outcomes for all.
A key aspect of their commitment to reducing health inequalities is the development of a structured approach to amplifying local community voices at every level, including representation at the Trust board. This is achieved through Neighbourhood and Place Groups, which bring together a diverse range of local representatives. Recognising that no single method can fully capture the needs of a community, the Trust employs a variety of engagement tools to foster meaningful dialogue.
These tools include surveys, focus groups, community events, outreach initiatives, and formal public consultations, ensuring a flexible and inclusive approach to collaboration. Insights gathered through these efforts are compiled into community involvement reports, which are shared with both the Integrated Care Board and local communities. These reports highlight case studies and real-world examples of how local services have evolved in response to community involvement, reinforcing the Trust’s commitment to co-creating better, more inclusive healthcare services.
Business
The recent announcement by NHS England to invest £100 million in solar panel installations and battery storage across 78 NHS sites offers opportunities to not just reduce costs and carbon emissions of building and its services but as anchor institutes to reduce fuel poverty in local communities. For example, a cross-sector initiative formed in 2016 in Staffordshire and Stoke-on-Trent (SSoT) invested in solar panel installations in collaboration with University Hospitals North Midlands (UHNM) which deliver savings into a community fund where patients at risk from the cold and exacerbated health conditions can access a local charity ‘Beat the Cold’.
Comment
As demonstrated by the three examples set out above, sustainable development requires both individual belief and a collective agreement to work to a common goal, in addition to dealing with the environmental challenges and health impacts of these. A workforce that is listened to and meaningfully engaged with, will be a happier and more valued team. The outcome being better engagement with the challenges faced, a more inclusive approach to the healthcare services being delivered, and a more resilient approach to the delivery of care.
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United Kingdom