The UK Hub for One Health Systems: Creating Sustainable Health and Social Care Pathways

Our vision is to establish a UK-wide hub facilitating the transition to an environmentally sustainable healthcare system by bringing together healthcare leaders, industry partners, and academics across various disciplines to address the challenge of decarbonising health and social care pathways (HSCPs). Through a deployable toolkit, we aim to develop and implement carbon and other pollutant reduction plans across different HSCPs, leading to measurable reductions both during and after the funding period of the grant. We define a "patient journey" as a specific segment of a health and social care pathway, focusing on areas with high potential for carbon reduction, such as community or primary care settings for mental health and secondary care settings for orthopaedic surgery. Our toolkit builds upon previous works on reducing carbon emissions and pharmaceutical pollution by co-applicants from the Getting It Right First Time (GIRFT) program, the Pharma Pollution Hub at the University of Exeter, and the One Health Breakthrough Partnership in Scotland. The toolkit involves mapping current carbon emissions and other pollutants, proposing emission reduction plans, and predicting their impact on environmental sustainability, financial aspects, patient health outcomes, efficiency, equity, and stakeholder acceptability. An iterative process involving stakeholders will refine and finalize the emissions reduction plans, followed by an implementation phase with regular monitoring and reporting. Our approach aligns with the "One Health" and "Planetary Health" concepts, considering the interconnectedness of human and natural systems to achieve health equity and environmental sustainability. By embedding environmental impact assessment into healthcare decision-making and research processes, our toolkit aims to foster a culture of environmental sustainability within the NHS. Structured into three complementary work programmes, our Hub focuses on (1) low-emission interventions in community and primary mental healthcare, (2) rapid assessment and implementation in clinical areas like urology and trauma & orthopaedics, and (3) incorporating environmental sustainability measures into clinical trials. Cross-cutting themes in (1) methods, (2) policy & geography, and (3) PPIE ensure coordination across work programmes, enhancing communication and transdisciplinary collaboration. Our team employs a diverse range of quantitative and qualitative methodologies to address the differential impacts on patients, NHS staff, and other stakeholders, promoting equality, diversity, and inclusion. The Hub's deliverables include frameworks for clinical and environmental impact assessments, rapid evidence acquisition, evaluation of environmental impact assessment data, development of delivery guidance, contextual factors to implementation, and national audit framework for ongoing monitoring of sustainability metrics. These outputs aim to support decarbonisation efforts across health and social care, improve population health, and minimize unintended consequences. Over the funding period, we aim to refine the toolkit, develop expertise, and establish a self-sustaining centre of excellence for environmentally sustainable healthcare innovation. Beyond the funding period, the Hub will support decarbonisation efforts, facilitate green clinical research, adapt frameworks for international health systems, and build capacity across health and social care. Our approach provides a comprehensive framework for analysing carbon emissions and other pollutants' impact on health and social care pathways, contributing to improved healthcare delivery, leaner services, increased industry engagement, streamlined care pathways, and adaptable findings for international healthcare systems.