CSH Publications


Bee HealthyBee Healthy Project Guide. Centre for Sustainable Healthcare (2020) 



Space to breathe Space to Breathe. Valuing green space at NHS sites for staff wellbeing. Centre for Sustainable Healthcare (2020)



green walking guideGreen Walking in mental health recovery: A Guide. Centre for Sustainable Healthcare (2020)



CSH 10 year impact

10 year Impact Review. Centre for Sustainable Healthcare (2018)



Carbon modelling within dentistry: towards a sustainable future. Public Health England and Centre for Sustainable Healthcare (2018)



Triple Bottom Line Analysis of Eye Motility Services at Moorfields Eye Hospital and its Satellite Clinics. Centre for Sustainable Healthcare (2018)



Guidance for Commissioners of Financially, Environmentally and Socially Sustainable Mental Health Services (future proofing services). Joint Commissioning Panel for Mental Health &  Centre for Sustainable Healthcare (2015)


CSH report 2014Centre for Sustainable Healthcare Report (2014)



Promoting Value, Protecting Resources - a doctor's guide to cutting waste in clinical careProtecting Resources, Promoting Value: a doctor's guide to cutting waste in clinical care. Maughan, D. & Ansell, J.  Academy of Medical Royal Colleges (2014)



Facing the future: Sustainability for the Medical Royal Colleges. Maughan D & Gibbs R, Academy of Medical Royal Colleges (2014).



Sustainable System-Wide Commissioning - Guide for CCGs. Written and researched by Forum for the Future, Centre for Sustainable Healthcare, NHS Institute for Innovation and Improvement. NHS Institute for Innovation and Improvement, March 2013.


Sustainability in Psychiatry, Royal College of Psychiatry Occasional Paper 97 (2015). Maughan, D.



Unhealthy Investments Fossil fuel investment and the UK Health Community. Published jointly by the Centre for Sustainable Healthcare, MedAct, Healthy Planet UK, Medsin and the Climate and Health Council (2015) 


The carbon impact of health services: Using data to inform service design through service-line footprinting. Royal College of Psychiatrists Occasional paper OP89 (2013).



Carbon impact of mental health services: case study: A service line analysis of Nottinghamshire Healthcare's Carbon Footprint. Stancliffe R, Centre for Sustainable Healthcare (2012).



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Sustainability in quality improvement: redefining value. Mortimer F, Isherwood J, Wilkinson A, Vaux E. Future Healthcare Journal, 2018 Vol.5(2):88-93
Sustainability in quality improvement: measuring impact. Mortimer F, Isherwood J, Pearce M, Kenward C, Vaux E. Future Healthcare Journal, 2018 Vol.5(2):94-97

The Sustainable PhysicianMortimer, F. Clinical Medicine (2010), Vol 10, No 2: 110-11

Should doctors lead on Sustainability? Stancliffe, R. Bhutta, M., BMJ Opinion (2013) July 1st 2013 blog

We can rebuild it? Developing sustainable healthcare for our future. Burnham, A. Howe, A. Stancliffe, R. Roundtable report: New Statesman and Pfizer policy forum (2013)

The adult health and social care crisis – green infrastructure as part of the solution, Williams, B., Town and Country Planning Association, (2017), Vol 86 (10)

Healthcare’s response to the climate emergency: what would Greta say?, Szymankiewicz J, BMJ Opinion (2020) March 2nd 2020 blog

Kidney care

Case studies:

Heat exchangers in HD machines achieve significant environmental and cost savings. Campbell F, Milne S, Connor A, Stevens P. Presented in abstract form at the Renal Association May 2010.

Toward Green Dialysis: A Case Study to Illustrate and Encourage the Salvage of Reject WaterConnor A. Milne S. Owen A. Boyle G. Mortimer F. Stevens PE. Journal of Renal Care 2010;36(2),68-72. 

Teledialysis: new service technologyTara Collidge, Bruce Honeyman, Susan Stewart, Anne Allan, Rob Brown, David Heaney, Robert Peel.Journal of Renal Nursing, Vol. 3, Iss. 3, 20 May 2011, pp 150 – 151

Saving Carbon and Time. The Follow Up of Renal Transplant Recipients by Telephone Consultation: Three Years Experience from a Single UK Renal Unit.  Connor AMortimer F, Higgins R. Clinical Medicine 2011 Jun;11(3):242-6.

Green Waste Management for Renal Medicine Units. Connor A, Thomson M, Mortimer FBritish Journal of Renal Medicine 2010;15(2):7-11.

Cutting the carbon cost of dialysis: efficient delivery of acid concentrate. Mortimer, F., Dixon, J., Gilmour, F., Stoves, J., Owen, A., Connor, A., Campbell, F. British Journal of Renal Medicine 2014; Vol 19 No 2:21-23.

Research outputs:

The Carbon Footprints of Home and In-centre Maintenance Haemodialysis in the UKConnor A, Lillywhite R, Cooke MW. Hemodialysis International 2011 15 (1), 39 - 51. doi: 10.1111/j.1542-4758.2010.00523.x.

The Carbon Footprint of a Renal Service in the United Kingdom. Connor A, Lillywhite R, Cooke MW. Quarterly Journal of Medicine 2010 103 965 - 975.

The Green Nephrology Survey of Sustainability in Renal Units in England, Scotland and Wales.  Connor, A. and Mortimer, F. (2010). Journal of Renal Care, 36: 153–160.

Cumulative Savings from Green Nephrology Innovations. Mortimer F, Stott I, Connor A. Poster presented at Renal Association – British Transplantation Society Congress, March 2013.


NHS could save £1bn by adopting green strategies used in kidney units. Limb M. British Medical Journal 2013;346:f588 doi: 10.1136/bmj.f588

Green Nephrology: Reducing kidney care’s carbon footprint.  Connor ABritish Journal of Renal Medicine 2010;15(1).

Clinical Transformation – the Key to Green NephrologyConnor AMortimer F, Tomson C. Nephron Clinical Practice 2010;116(3):201-206. 

Sustainability: The seventh dimension of quality in health careConnor, A. and O'Donoghue, D. (2012), Hemodialysis International, 16: 2–5. doi: 10.1111/j.1542-4758.2011.00652.x

Renal medicine can take the lead in greener healthcare. Connor A, Tomson C, Mortimer FBritish Journal of Renal Medicine2009/10;14(4):19-22.


Why should psychiatrists care about sustainability? Maughan, D., Davison, P. (2015), The Lancet Psychiatry. Vol2, 675-7

BMJ BlogsWhat has climate change got to do with mental health? Blogs.Bmj.com. (2013). Maughan, D. L. (n.d.). 

A sustainable futureMental Health Practice, 17(4), 13–13. doi:10.7748/mhp2013. Maughan, D. (2013).

What psychiatrists should know about environmental sustainability and what they should be doing about it. International Psychiatry, 1–4. Maughan, D., Berry, H., & Davison, P. (2014).

Sustainable psychiatry in the UK. Psychiatric Bulletin, pb. bp. 113.045054. Yarlagadda, S., Maughan, D., Lingwood, S., Davison, P.

Clinical practice: key to meeting the NHS's energy targets. Health Services Journal. Retrieved July 4, 2014 Maughan, D., Wallace, S., & Lillywhite, R. (2014).

Responding to financial, climate and social change. OT News May Edition Maughan, DWhittaker, B., (2014).

Reducing non-attendance rates in community psychiatry: a case for sustainable development? Daniel L. Maughan and Michael Pearce BJPSYCH INTERNATIONAL VOLUME 12 NUMBER 2 MAY 2015

Cost and carbon burden of long-acting injections: economic evaluationDaniel L. Maughan, Rob Lillywhite, Matthew Cooke

Sustainability in Psychiatry, Royal College of Psychiatry Occasional Paper 97 (2015), authored by Daniel L. Maughan.

Primary-care-based social prescribing for mental health: an analysis of financial and environmental sustainability Daniel L Maughan, Alisha Patel, Tahmina Parveen, Isobel Braithwaite, Jonathan Cook, Rob Lillywhite and Matthew Cooke. Primary Health Care Research & Development, page1 of 8 doi:10.1017/S1463423615000328.

Economic and environmental costs of social prescribing for mental health in primary care. Maughan, D., Patel, A., Parveen, T., Braithewaite, I., Cook, J., Lillywhite, R., Cooke, M. Primary Health Care Research and Development

The economic cost and carbon burden of long acting injections. Maughan, D., Lillywhite, R., Cooke, M., The Psychiatric Bulletin 39 (4). ISSN 2056 - 4694.

Choosing Wisely in the UK: the Academy of Medical Royal Colleges' initiative to reduce the harms of too much medicine. Malhotra, A., Maughan, D., Ansell, J., Lehman, R., Henderson, A., Gray, M., et al. (2015), BMJ (Clinical Research Ed.), 350(may12 7), h2308–h2308.doi:10.1136/bmj.h2308

Mind games: standing by while the world ignores climate change. Maughan, D. L., & Berry, H. L. (2015), BJPsych International, 12(2), 29–30.

Social networking sites: a clinical dilemma? Maughan, D. L., &Economou, A. (2015), Journal of Medical Ethics, 41(2), 203–205. doi:10.1136/medethics-2013-101341

A systematic review of the effect of community treatment orders on service use. Maughan, D., Molodynski, A., Rugkåsa, J., & Burns, T. (2014), Social Psychiatry and Psychiatric Epidemiology, 49(4), 651–663.

Clinical practice: key to meeting the NHS's energy targets. Maughan, D., Wallace, S., &Lillywhite, R. (2014, July 2), Health Services Journal.

BMJ Blogs: What has climate change got to do withmental health? Blogs.Bmj.com. Maughan, D. L. (2014, October 27).

A sustainable future. Maughan, D. (2013), Mental Health Practice, 17(4), 13-13.doi:10.7748/mhp2013.


Evaluation of a collaborative project to develop sustainable healthcare education in eight UK medical schools. Walpole, SC, Mortimer, F. Public Health 2017. Vol 150: 134-148

Exploring emerging learning needs: a UK-wide consultation on environmental sustainability learning objectives for medical education. Sarah C. Walpole, Frances Mortimer, Alice Inman, Isobel Braithwaite and Trevor Thompson Int J Med Educ. 2015; 6:191-200; doi: 10.5116/ijme.5643.62cd

Learning objectives for sustainable health care. Thompson, T., Walpole, S. Braithwaite, I. Inman, A., Barna, S., Mortimer, F. Lancet 2014 Nov 29;384(9958):1924-5. doi: 10.1016/S0140-6736(14)62274-1.

Climate change and health: the basics of climate science and the impacts of climate change. John Somner, Frances MortimerAndrew Connor, Mark Thompson BMJ Learning, published online November 2010. Available at: http://learning.bmj.com/learning/search-result.html?&moduleId=10017629

Low-Carb NHS: Training and CPD for a Sustainable Health System. Barna S, McKenzie J, Mortimer FNational Health Executive; 2011;May/June

The health effects of climate change: What does a nurse need to know? Barna S, Goodman B, Mortimer FNurse Education Today 2012; 22(7):765-771 doi: 10.1016/j.nedt.2012.05.012

Climate change and the duty of a doctor. Barna, S. and Mortimer, FChemical Hazards and Poisons Report. October 2010 

The social role of doctors. Maughan, D. & Bajorek, T. RCPsych trainees online (e-learning platform). Published November 2014. Available at: http://tron.rcpsych.ac.uk/default.aspx?page=21026.

Embedding sustainability into clinical medecine and medical education. Farrow, E. Health Mangagement (2017), Vol 17 (5)

Evaluation of a collaborative project to develop sustainable healthcare education in eight UK medical schools, Walpole, S. Mortimer, F. (2017), Public Health,150, 134-148


Whittaker B (2012) Sustainable Global Wellbeing: a proposed expansion of the occupational therapy paradigmBritish Journal of Occupational Therapy, 75(9) 436-439.

World Federation of Occupational Therapists (2012) Position statement on environmental sustainability, sustainable practice within occupational therapy. Forrestfield: WFOT. (Ben Whittaker was project leader on this paper).


Eyes, economics and the environment - should green issues drive changes in ophthalmic care? Yes. Somner JEA, Connor A, Benjamin L. Eye(Lond). 2010 May 21. [Epub ahead of print].

The Carbon Footprint of Cataract Surgery. D S Morris, T Wright, J E A Somner and A Connor. Eye 27, 495-501 (April 2013) | doi:10.1038/eye.2013.9.


An estimated carbon footprint of NHS primary dental care within England. How can dentistry be more environmentally sustainable? Duane, B. , Stancliffe. R, Steinbach, I. , Berners Lee, M. White, S.  (2017), BDJ 223, 589–593 (27 October 2017): doi:10.1038/sj.bdj.2017.839


Inhaled drugs and global warming: time to shift to dry powder inhalers. Hillman T, Mortimer F, Hopkinson NS. BMJ 2013;346:f3359.

Responsible Prescribing and Dispensing: I. Sustainable COPD Inhalers. Starr M, Centre for Sustainable Healthcare (2012).