Patient and visitor travel can be one of the most significant areas of the carbon footprint for primary healthcare organisations. While this area of your footprint isn't within your practice's direct control, there are opportunities for practices to influence visitor behaviour, and there are also significant potential positive overlaps with health outcomes.

Publicising your emerging carbon management plan to patients and asking them if they would like to be involved and how they might contribute is an excellent beginning.

Alternate forms of consultation

• Exploring opportunities to replace patient visits with telephone consultations, where appropriate, could be pursued. The NHS Information Centre indicates that 10% of all GP consultations are presently undertaken by phone, up from 3% a decade earlier. There may be further opportunities to use telephone consultation.

Changing modes and realising multiple benefits

• There will, of course, be many situations in which travel by private motor vehicle will be the only practical option for elderly, injured or infirm patients and visitors.

• In other cases however, travel by private motor vehicle may not be necessary, and private vehicles could be replaced with other modes of transport, including those which carry the added benefit of physical activity, such as cycling and walking. These opportunities could be promoted to patients within the surgery, with accompanying materials regarding cycling and walking routes and public transport options.

There are a wide range of ideas available through Sustrans for promoting walking and cycling, which provide clear links between the health and environmental benefits.

You could consider linking in with a local excercise group, much like this project in East Lindsay.