Sustainability Fellowship and Scholarship Programme
An independent charity, CSH has been leading efforts to incorporate the values of environmental sustainability into the health sector since its establishment in 2008. It has a particular focus on engaging those in the front line of patient care and promoting the concept of “sustainable clinical practice” and has developed a “SusQI” framework for integrating sustainability into Quality Improvement methodology.
CSH is respected nationally for a specialty-led approach combining research with support for local change, underpinned by wider engagement with patients, and relevant industry and clinical bodies. As part of this programme, CSH has partnered with NHS bodies and specialty organisations to create Sustainable Specialty Fellowships, and has managed Fellows and Scholars in a range of specialties.
"The Centre for Sustainable Healthcare supports clinicians to take a leading role in galvanising co-ordinated, systematic and evidence based action for sustainable healthcare. Their sustainable specialties programmes and their work in medical education are excellent examples of what clinicians need to help them take exemplary action for tomorrow whilst continuing to deliver high quality care for today."
Dr David Pencheon, Previous Director, NHS Sustainable Development Unit
What is a Sustainability Fellow or Scholar?
A CSH Sustainability Fellow is a health professional who is seconded or employed to work half- to full-time on sustainable healthcare for 1-3 years, before returning to clinical practice. Fellowships have a strategic role in accelerating transformation towards sustainable healthcare and often include a research element supported by a university partner; they may focus on a clinical specialty or on a cross-cutting theme such as education, quality improvement or a specific topic (e.g. single use plastics).
A CSH Sustainability Scholar typically has 1-2 allocated days per week to work on a sustainability project over the course of a year and is based in a host organisation – often an NHS Trust.
Fellows and Scholars are supported by a range of in-house resources including training courses and materials, web-based networking tools, online case libraries, and a sustainability in quality improvement (SusQI) toolkit.
CSH Sustainable Specialty programmes
Clinical specialties are uniquely placed to address the sustainability of services – from the design of the clinical pathway to the organisation and delivery of care. CSH’s Sustainable Specialty programmes combine research with support for local change, underpinned by wider engagement with patients, and relevant industry and clinical bodies.
Programme objectives for a CSH Sustainable Specialty Fellowship
- Increase knowledge about resource use and opportunities to improve value within specialty care pathways
- Support the transmission of good practice through a network of local representatives within clinical departments
- Accelerate progress in the specialty via policy development, commissioning and education
- Professional development of the fellow as an ambassador for sustainable healthcare
- Research publication(s) quantifying the baseline environmental impact of relevant clinical pathways and identifying opportunities for improvement
- Development of sustainability criteria for service commissioning
- Active specialty sustainability network with annual meetings/awards
- Case library of sustainable quality improvement projects
Why set up a Sustainability Fellowship or Scholarship programme?
In order to meet public expectations of compassionate, effective, patient-centred care, while also keeping within existing financial constraints, health services need to do more with less. However, it is increasingly well recognised that financial costs are not the only resource constraint. The NHS recognises the climate crisis will have detrimental effects to human health and has set a target for net-zero carbon emissions by 2040. Meanwhile many Royal Colleges including the Royal College of Emergency Medicine, Royal College of General Practice, Royal College of Physicians, Royal College of Psychiatrists, Royal College of Paediatrics and Child Health and the Royal College of Nursing have “declared climate emergencies”, acknowledging the climate crisis and the catastrophic effect on human health of not acting decisively and urgently on climate change.
Benefits of a Fellowship
Fellows gain the opportunity to learn about a dimension of healthcare, develop skills in leadership and research, and contribute to strategic initiatives at national and local level to promote sustainable resource use.
Patients benefit from service changes designed to increase value from resources by preventing illness and promoting individual and community resilience, empowering patients to manage their health, reducing wasteful activity, and making use of low carbon alternatives.
Health services benefit from service changes as above, and from staff engagement in service improvement and resource stewardship. Many sustainable innovations save money - e.g. it has been estimated that the average dialysis unit could save £150-200,000 each year by implementing documented sustainable innovations.
The Health Professions benefit from the development of Fellows as ambassadors for sustainable healthcare, and from their work to further understanding the environmental, social and financial burdens of services, while promoting a culture of innovation and resource stewardship.
Who can be a Sustainability Fellow or Scholar?
Fellows and Scholars can come from any professional background in any field of healthcare. To date CSH has helped to establish fellowships in the following disciplines:
- Nephrology · Dentistry
- Psychiatry · Ophthalmology
- Surgery · Psychiatry
- Anaesthesia · General Practice
CSH seeks to maximise the impact of Fellows and Scholars through:
- Development of Fellows and Scholars as future leaders for sustainability, providing a unique opportunity to learn about healthcare systems from a different perspective, while developing skills in leadership, healthcare improvement, academic writing and public speaking.
- Supporting Fellows and Scholars to contribute to a specialty-wide discourse on sustainability, through regional and national presentations, publications, events and online networking – e.g. via CSH Networks, the Health Foundation Q community, BMJ blogs and other collaborations.
- Development and sharing of case studies demonstrating sustainability in practice.
CSH support for Sustainability Scholars
Scholars typically have 1-2 allocated days per week to work on a sustainability project over the course of a year and are based in a host organisation – often an NHS Trust.
In its Scholarship programme, CSH provides three online training courses, each of which comprises 4-6 hours of interactive self-study followed by a half-day workshop facilitated by expert instructors +/- an optional work-in-progress presentation a few months later. Current courses include Introduction to Sustainable Healthcare, Carbon Footprinting in Healthcare, Sustainability in Quality Improvement, Public Health Leadership for Sustainability, Sustainable Dentistry, Sustainable Primary Care, and Green Space and Health. Further courses are under construction.
In addition, CSH provides supervision and project guidance, access to in-house training resources and input to written outputs of the Scholarship. CSH uses its extensive networks to connect Scholars to people in other NHS Trusts, specialties and countries who are undertaking related work, and assist them in disseminating their work through its websites, e-newsletter and on social media.
Cost breakdown for CSH training and supervision for a single Scholar
If the money is paid as a grant, there is no VAT applicable.
CSH support for a group of Scholars
At the request of specialty organisations, CSH has developed a model for group support of a cohort of sustainability Scholars. We recommend a base of support around structured CSH courses plus some group and individual sessions to give extra project support and peer learning.
CSH will provide an induction and training programme with a combination of access to introductory courses in sustainable healthcare and a (newly-developed) tailored course for the specialty or discipline, drawing on relevant case studies, knowledge and skills.
In addition, CSH will provide supervision and project guidance via quarterly group supervision meetings, as well as two individual one-hour mentoring sessions per Scholar over the year. Scholars will be invited to submit progress reports and raise questions in advance of the meetings, so that CSH staff can ensure that sessions are as useful as possible.
As with individual Scholars, CSH will use its extensive networks to connect Scholars to people in other NHS Trusts, specialties and countries who are undertaking related work, and will assist in disseminating their work through our websites, e-newsletter and on social media.
It is important that the Scholars’ work is informed by and feeds into strategic priorities of the relevant partner/specialty organisation(s). This will be facilitiated by quarterly catch-ups calls between CSH and the project lead for the partner organisation. CSH will provide a briefing paragraph about progress of the Scholarships for relevant internal meetings.
Cost breakdown for CSH training and group supervision for ten Scholars
If the money is paid as a grant, there is no VAT applicable.
CSH support for Sustainability Fellows
A Fellow works half- to full-time on sustainable healthcare over 1-3 years, taking a strategic role in accelerating adoption of sustainable practice within their area.
Model 1: CSH In-house Fellowship
In a CSH in-house Fellowship, CSH works with partner organisations, taking the lead in programme set-up and design as well as hosting and managing the Fellow.
Formal training in sustainable healthcare is provided through CSH online training courses (described above) and Fellows are assigned to a supervisor within the team, with whom they meet weekly or fortnightly throughout the post. Fellows have an active role in selecting and designing projects to achieve the programme objectives as well as their own professional development goals, while benefiting from CSH’s experience, resources and networks.
CSH Fellowship programmes include an inaugural Summit to engage senior stakeholders and gather perspectives and expertise from across the specialty. Ongoing strategic guidance and collaboration is provided through an Advisory Group, including representation from professional bodies, health service providers and comissioners, patients and industry.
Fellowships generally include a research element, undertaken through partnership between CSH and an academic partner institution. Fellows may register for and complete a research degree (MSc, MD or PhD) as part of the programme.
Cost breakdown for CSH Fellowship, per year
If the money is paid as a grant, there is no VAT applicable.
Model 2: CSH support provided to external fellowship
In this model, CSH is commissioned to provide training, mentoring and project guidance to a Fellow hosted by another organisation. The support provided is similar to that described above for Scholars, although additional project support may be commissioned if needed; for example, help with carbon footprinting, creating a learning resource, running an awards scheme or hosting an event.
How to set up a Sustainability Fellowship
As well as CSH, partner organisations in setting up a Fellowship might include one or more of:
- Specialty organisation/professional body
- NHS Trust
- Academic partner, e.g. a university, Academic Health Sciences Network
- Other education provider/commissioner, e.g. Health Education England
When approaching partner organisations, consider what they will gain from the Fellowship, e.g meeting the needs of their members/patients/staff/students, reputational gains, etc.
- Potential funding sources include:
- Royal Colleges / Specialty associations
- Charitable foundations
- Education funders, e.g. Health Education England
- NHS Charities
- Industry sponsorship
Fellow/Scholar salary costs may sometimes be covered by NHS Trusts or through an existing fellowship scheme in medical education, quality improvement, innovation or leadership.
Each organisation will have its own funding priorities, so consider how the Fellowship will fit with these and make sure that is clear. Many organisations will have their own templates for funding applications, otherwise CSH has model proposals which can be adapted.
Please get in touch if we can help: email@example.com.
An Example of a previous Sustainability Fellowship
The Royal College of Psychiatrists (RCPsych) Research Fellowship in Sustainability 2013-15
Trainee psychiatrist, Dr Daniel Maughan, took up the RCPsych Fellowship in August 2013 and worked full-time with CSH over two years to improve the sustainability of mental health services.
The primary goal was to advance the awareness and understanding of sustainable approaches in mental healthcare. Working with the College and other influential partners, Daniel authored a number of landmark reports, including the Academy of Medical Royal Colleges’ report, Protecting Resources, Promoting Value (which identified £2 billion waste in the system and reached the front page of the Guardian in 2014) and Guidance for Commissioners of Financially, Environmentally and Socially Sustainable Mental Health Services, 2015. He obtained an MD at Warwick University and completed research into carbon footprinting methodologies in healthcare.
A network for sustainability in psychiatry was created, which continues to enable sharing of resources between its >400 members, and two national summits brought network members together with senior policy leads.