Mareeni Raymond is a GP in London
In 2024, City and Hackney general practices made a big push to bring sustainability into everyday primary care by linking the Green Impact for Health (GiFH) Toolkit1-4 to the Local Enhanced Service (LES). It worked: thirty practices signed up and many earned awards for their efforts.5
But in 2025, the LES requirement was removed. Would practices keep going without this financial incentive, or would sustainability slip down the priority list?
A year later, the picture is mixed.6
Only seven practices chose to continue using the GiFH Toolkit without being prompted by the LES. Three achieved Gold awards, one achieved Silver and three achieved Pioneer status.6
Others didn’t submit toolkits. That’s a shame, because it means we don’t know whether they carried on with the progress they made in 2024 or whether the work paused under the pressure of other general practice demands.
Perhaps this was the key to the achievement – sharing the workload and spreading the green leadership ethos.
However, for some teams, sustainability didn’t just continue—it grew. They built on the foundations laid during the LES year and pushed themselves further. Achieving a gold award requires much investment in the ethos and management of every aspect of practice operations. While no practices achieved Gold in 2024, we now have three.
Our Hackney-based practice was one of the few that achieved Gold this year, progressing from Silver last year. Last year I was a funded clinical lead working one session a week for NHS North East London. As a GP I committed to spreading the ethos of greener practice across Hackney – starting with my own practice. This year, however, I took a step back and handed over leadership of the toolkit to our PCN pharmacist and our Operations manager. Perhaps this was the key to the achievement – sharing the workload and spreading the green leadership ethos. Perhaps those practices who did not submit toolkits could not maintain momentum without the incentive, and perhaps sharing the load, delegating to other team members so it became business as usual, might have helped, but I can only reflect on our experience. From anecdotal experience, I know those practices with internal champions achieved greater awards.
The past year shows that environmental sustainability can survive beyond contractual requirements, but it doesn’t happen automatically. Some practices continued to thrive, while others may have struggled to keep the momentum going. As ICBs are forced to reduce and remove dedicated funding for clinical leadership session times, there may be a decline in primary care being able to contribute to the NHS net zero targets.
The challenge now is finding ways to support all practices, whether through leadership, time, shared learning, or simple encouragement—so that sustainability becomes a steady part of primary care, not something that rises and falls with each contract cycle.
Deputy editor’s note – some other practical wins for GPs and practices see: https://bjgplife.com/how-to-be-a-triple-bottom-line-tbl-general-practice-working-for-profit-the-people-and-the-planet/ and https://bjgplife.com/net-zero-on-a-budget-how-to-decarbonise-with-zero-capital/ and https://bjgplife.com/turning-the-tide-on-healthy-eating/
References
- https://toolkit.sos-uk.org/greenimpact/giforhealth/login [accessed 19/6/25]
- https://primarycare.northeastlondon.icb.nhs.uk/home/green-primary-care/ [accessed 19/6/25]
- https://northeastlondon.icb.nhs.uk/publication/green-plan/ [accessed 19/6/25]
- https://greenimpact.nus.org.uk/green-impact-for-health/ [accessed 19/6/25]
- Raymond M. Embedding sustainability in primary care practice: reflections on the Green Impact for Health toolkit in City and Hackney. Br J Gen Pract. 2025 Aug 28;75(758):414-415. doi: 10.3399/bjgp25X743217. PMID: 40877133; PMCID: PMC12723497.
- https://greenimpact.nus.org.uk/wp-content/uploads/2026/01/Green-Impact-for-Health-2025.pdf [accessed 25/2/26]
Featured Photo by micheile dot com on Unsplash
