Sustainable clinical leadership: How to move clinicians and managers from words to action (part 1)

In the first of a three-part series, Dr Dan Harwood writes about how hard it can be to champion clinical sustainability in a mental health Trust and gives some practical suggestions on how to move from talk to action.

People who actually do good things are regarded as a bit of a pain. They make the talkers, the virtue-signallers, the social media activists, and the policy writers feel a bit guilty. We even have a derogatory term for those irritating people who do things: do-gooders.

Yet if words and policies do not lead to actions, they are pointless. The talkers and writers and committee lovers are a big problem for those of us who want to do stuff, and an even bigger problem for people like me whose job as Trust Sustainability Lead is to get other people to do stuff. I led a workshop with our consultants about sustainability and how clinicians might get involved. Afterwards several doctors wrote telling me what I needed to do. When I politely emailed back asking if they'd like to help me find a solution to their problems, no answers were forthcoming.

What do I mean by 'doing'? I mean planting trees and flowers, I mean taking your patients for walks or playing frisbee with them outdoors, I mean changing care pathways so you do fewer tests and prescribe fewer drugs, I mean working with your team to support prevention in the community where your work, I mean reducing waste, of heat, medicines, plastic, disposable gloves, I mean helping nursing staff to improve their own health and improve the health of their patients. I do not mean sitting on a policy group, writing position statements, setting up committees, circulating a lovely document from the Health Foundation or the Kings Fund. These acts are not doing, they are prevarication. If we are to save the planet we need to do stuff. Read a green policy document, sure, but only if you are going to do what it says. Otherwise, don't bother.

This blog is about how, as a psychiatrist who cares about the environment, you can wake your fellow clinicians and managers from their torpor and get them to help you save the planet by doing things. Because I don't know about you, I am sick of the papers and policies and guidance documents and articles in Lancet Planetary Heath telling us what we need to do. I've read what I need to read. I know what to do, and I am doing it, or some of it at least. But I need some other people to do it too, not write more documents for me to read!

Let me start by saying that this is not easy. You will meet opposition as there are more talkers and writers in the world than do-ers. I have had a lot more failure than success, but I am learning, and I have some hints which help. Part 2 will explore them, coming next week!

Dr Dan Harwood