Mapping the movement for climate change and health in England: a descriptive review and theory of change analysis

Abstract

Aims: There are a growing number of organisations working to address the connections between climate change and health. This article introduces the concept of ‘theories of change’ – the methodology by which organisations or movements hope to bring about social change – and applies it to the current climate change and health movement in England. Through movement mapping, the article describes and offers reflections on the climate change and health ecosystems in England. Methods: Organisations working on climate change and health in England were identified and publicly available information was collated to map movement characteristics, target stakeholders and methodologies deployed, using an inductive, iterative approach. Results: A total of 98 organisations working on health and climate change (and/or sustainability) were initially identified, of which 70 met the inclusion criteria. Most organisations target two or more stakeholders, with healthcare workers, management structures, and government being most commonly cited. Methodological approaches identified include Formal education programmes; Awareness-raising; Purchasing-procurement power; Advocacy; Financial; Media-messaging; Networking; Knowledge generation; and Policy making, of which education, awareness-raising, and advocacy are most commonly used. Conclusion: There is a tendency for climate change and health organisations in England to focus on individual level and sectoral change over system change. More could be made of the potential for the healthcare professions’ voice and messaging for the wider climate movement. Given the rapid boom of climate change and health organisations in recent years, a mind-set shift that recognises different players as part of a cohesive ecosystem with better coordination and collaboration may reduce unnecessary work, and facilitate more cohesive outcomes.

Sustainability is critical for future proofing the NHS

“…Executive and board level leadership teams could be supported by developing networks of learning and communities of practice that enable staff and wider stakeholders to learn from each other and provide opportunities to improve environmental sustainability and clinical care 79. Healthcare workers, who are recognised to have a trusted voice and impactful messaging when talking about the climate crisis, are increasingly motivated to speak out as part of their professional responsibility to try and prevent a worsening of the climate crisis, and they should be supported in this 748081. Rotational training—wasteful in terms of travel and resources, disruptive to trainees’ lives and of arguable educational benefit—might be an area for reconsideration 82…”

“…Responsibilities and interventions are required to achieve this aim, delivered through purposeful and considered leadership, reinforced and supported by governance mechanisms, policies and standards, and proactive government investment. Staff should be empowered to engage with sustainability and net zero actions, encouraged to challenge and be proactive in suggesting service improvements, and supported to take wider climate action 80. Opportunities should be given to patients and communities to actively shape and demand health promoting environments and services.…”