WP2: General Practices

General practice analysis of institutional, organisational, and professional factors that influence the implementation and sustainability of decarbonisation actions.

This is comprised of two elements: an online survey for general practice teams, and longitudinal case studies with a sub-sample of 12 practices. The research shall be conducted in three ICB areas: Coventry and Warwickshire ICB, Birmingham and Solihull ICB, and South Yorkshire ICB.

WP2.1: General practice survey

A brief, 5-minute online survey was distributed to general practice staff in the three selected ICB areas.

This survey aimed to:

Establish current levels of interest in decarbonisation in general practice.
Understand the type and extent of specific decarbonisation actions that are being undertaken.
Gauge the awareness of decarbonisation resources currently available to general practice.
Understand the intentions, actions, and plans surrounding decarbonisation currently present in practices.

The GPNET-0 Study general practice survey has now closed. The study team would like to thank anyone who took part.

In the first instance, survey results were used to identify 12 diverse practices, which were then selected as case study sites to participate in a 12-month longitudinal study.

A publication for the general practice survey has been developed and is under review in BMJ Open.

WP2.2: 12-month longitudinal study

This work package is a longitudinal investigation of general practice teams' experience of, engagement with, and implementation of decarbonisation activities.

Through the general practice survey, we have selected 12 diverse practices from our study area. Case study practices vary according to practice size, deprivation index, ethnic diversity, location, practices' current engagement levels with decarbonisation activities, and varied geographical areas.

Participating practices receive £2500 to cover study-related expenses: £1000 after setup, £500 at 6 months, and £1000 post-follow-up workshop.

Data collection:

The below image summarises data collection.

A baseline workshop was held with multidisciplinary practice teams to support the development of a Green Action Plan (GAP), a document stipulating 3-5 decarbonisation actions formulated as SMART goals. A video presentation summarised currently available decarbonisation resources and provided examples of potential actions. This video was followed by a facilitated, recorded discussion, with a focus on action planning. Topic guides were informed by sociological and behavioural theories, the Normalisation Process Theory (NPT), and Theoretical Domains Framework (TDF).

2-weeks later, a meeting was held with a designated member of the practice team to confirm the GAP actions and explore the process of its development. Data was provided by the practice to facilitate the completion of a baseline non-clinical carbon calculation.

Every 3-months, check ins were held with a designated team member to explore the process of implementation. Topic guides for these meetings were developed iteratively, and informed by the NPT and TDF.

At 12-months, a final focus group will be held with the same practice team as present at the first focus group. This will be used to explore the teams experience of implementing the GAP, actions, team dynamics, and future plans. A second set of data will be provided to allow for the completion of a follow-up non-clinical carbon calculation to provide a measure of change.

Data collection is ongoing and will finish in September 2025.

Data analysis:

Data analysis is running concurrently alongside data collection and is ongoing. Framework analysis is being used, with the thematic framework being developed iteratively by the study team. Data is being mapped to a matrix which examines institutional, organisational, professional, patient and societal, and environmental factors influencing the implementation of decarbonisation actions in general practice. Two theories, the NPT and TDF, will be applied during the interpretation process.

Associated costs:

Participating practices receive £2500 to cover study-related expenses: £1000 after setup, £500 at 6 months, and £1000 post-follow-up workshop.

WP2 Publications:

Under review: A publication for the WP2.1 survey, entitled 'Readiness to reduce general practice-associated carbon emissions in England: a cross-sectional survey of clinical and non-clinical staff views' is under review in BMJ Open.

Under development: A publication describing the process of developing the workshop intervention is under development.

Enquiries:

Dr Ana Raquel Nunes

GPNET0@warwick.ac.uk

Work Packages: