04 NHS Dentistry: How Reforming a Misunderstood Service can Better Serve Communities
08 A Holistic Approach to Rare Drug Development: Integrating ESG, Patient Management, and Commercial Strategy for Improved EU Access
20 Podcast Highlight: Should the NHS Adopt a Plant Based Diet?
16 Sustainable Healthcare: An Overview of 2024
12
Building a Futureproofed NHS Workforce
24
Navigating Parenthood and Healthcare as a Same Sex Couple in The UK
FOREWORD
f.march@peloton-events.co.uk
Welcome to the latest issue of Health Industry Leaders Magazine, where we delve into the transformative intersections of technology and sustainability shaping the future of healthcare. As the world grapples with unprecedented challenges and opportunities, the role of innovation infostering a healthier, more sustainable planet has never been more critical.
The integration of cutting-edge technology in healthcare is revolutionising patient care, enhancing precision in diagnostics, and streamlining operations. From artificial intelligence and machine learning to telemedicine and wearable technology, these advancements are not only improving outcomes but also making healthcare more accessible and equitable. The digital transformation journey we are on is driving efficiencies and opening up new possibilities for personalised medicine, predictive analytics, and remote monitoring, fundamentally changing how we approach health and wellness.
In this issue, we feature thought leaders and innovators who are at the forefront of these changes. You will read about groundbreaking projects and initiatives that are setting new standards for sustainability in healthcare, as well as the latest technological advancements that are poised to redefine the industry. Our contributors share their insights on how to balance the dual imperatives of technological innovation and environmental stewardship, providing a roadmap for a sustainable future in healthcare.
HOW REFORMING A MISUNDERSTOOD SERVICE CAN BETTER SERVE COMMUNITIES
BY HANNAH WINTLE
On his first day in post as Health Secretary in July, Wes Streeting met with the British Dental Association to begin discussions about the long-term reform of NHS dentistry.
Just two months later, Lord Darzi’s review into the NHS also investigated dental care, stating: “If dentistry is to continue as a core NHS service, urgent action is needed to develop a contract that balances activity and prevention, is attractive to dentists and rewards those dentists who practice in less served areas.”
Additionally, NHS England released data in November that revealed, as of March 2024, over a fifth of positions (21%) for NHS general dentists were unfilled, with these vacancies amounting to nearly half a million days (495,774) of lost NHS activity. 87% of all dentist vacancies were reported as within the NHS.
Wes Streeting’s wishes to reform NHS dentistry seem to be well-founded, and recent news and research only further demonstrates the need and desire to rethink how dental care is delivered in England.
DENTAL CARE WAITS ARE ‘JAW DROPPING’ AND REQUIRE ACTION
In early November, Tim Farron, MP for Westmorland and Lonsdale, Cumbria, wrote to the Chief Executive of Morecambe Bay Hospitals Trust to call for action on the dentistry crisis, after learning that some patients had waited more than 15 months for treatment.
A letter from the Trust’s Chief Medical Officer, Jane McNicholas stated: “Within our Trust, we currently have 1,100 patients on the waiting list - with some patients waiting in excess of 65 weeks for their care. In addition, there are approximately 70 patients whose referrals are awaiting triage”.
In response, the Liberal Democrat is now calling something to be done to amend the situation. He wrote: “A 65 week wait time is jaw dropping and l wonder how that compares with other Trusts?
“The fact that there will be children and young teens on there who are waiting well over a year and then getting very irregular appointments thereafter to complete a course of treatment that often lasts a couple of years is dire, as they may miss the boat and end up carrying problems into their adult life.
“I wonder what assistance you need from me, as l am keen to see some much needed progress and increased capacity coming on stream so that those who enter the orthodontic system have some confidence of continuity of care and reliability that their treatment plan will be adhered to and not elongated due to missed appointments and lack of staffing to deliver that care.”
NHS figures also show that almost 60% of adults in South Cumbria and Lancashire haven’t seen an NHS dentist in the past two years, and 45% of children in the area haven’t seen a dentist in the last 12 months.
A 65 WEEK WAIT TIME IS JAW DROPPING
“ “
NHS DENTISTRY IS MISUNDERSTOOD AND DEMANDS REFORM
While extended wait times pose obvious issues on their own, a recent Healthwatch report also highlighted the misconceptions around NHS dentistry, and the changes the public would like to see implemented in the dental system.
It found that more than two-thirds (68%) of participants in the research believe they have the right to register with an NHS dentist and be taken on as a permanent patient in the same way as they do with an NHS GP, which isn’t currently the case.
Participants were also asked what they would like to see from NHS dentistry. More than half (54%) want the ability to register with a dentist as they do with a GP surgery.
Of the rest of the participants, 27% said they ‘want the flexibility to seek an appointment at any NHS dentist each time, including those outside their area’, 16%, wish to register with an NHS dentist in the location that suits them best, and only 3% would prefer to visit a private dentist.
Following the poll, Healthwatch have made several recommendations to government as they seek to reform NHS dentistry:
• The government to fundamentally reform NHS dentistry to give everyone a GP-style right to be permanently registered with a dental practice, to get check-ups and urgent care when needed.
• The government to consult with the public, as well as dental leaders, on proposals for longterm reform of NHS dentistry.
• NHS England and the government to publish an evaluation of the new patient payment introduced in March this year for dentists.
• Practices to communicate any policies they have on minimum visits required in set periods, to be kept on as a regular patient.
• NHS England and dental commissioners to improve public awareness of how the NHS dental system works, to help people plan for alternative care if their practice opts out of NHS work.
• Dental practices to provide clear information about charges.
• NHSE to remind dentists that it is a breach of contract to require parents join as private patients in order to see children on the NHS.
(Source: Healthwatch, Access to NHS dentistry)
THE HEALTH 100 - NHS FUTUREFIT EVENT WILL EXPLORE THE CHALLENGES FACING NHS DENTISTRY TODAY
With NHS dentistry becoming an increasingly topical dialogue within the UK healthcare sector, Health Industry Leaders will be reigniting the conversation at our Health 100 - NHS FutureFit event on 16 September 2025.
At this one day conference, you’ll hear from NHS professionals and healthcare experts as they cover a range of issues currently facing the NHS, including the challenges relating to dental care and how these could be overcome.
To secure your involvement in this exclusive event and hear key insights from industry leaders, visit: https://healthindustryleaders.com/health-100decarbonising-the-nhs/
INTEGRATING ESG, PATIENT ENGAGEMENT, AND COMMERCIAL STRATEGY FOR IMPROVED EU ACCESS
BY KIERON LEWIS, DIRECTOR OF STRATEGIC CONSULTING AT CLINIGEN
Rare disease drug development is one of the most challenging yet critical areas of modern medicine. There are over 300 million people with a range of more than 7,000 rare diseases in the world. As of February, only about 5% of rare diseases have treatments that are approved by the U.S. Food and Drug Administration (FDA). With only a small proportion of patients benefiting from existing therapies, the stakes are high—both for those affected and for the pharmaceutical companies seeking to serve them. Success demands a holistic approach, integrating Environmental, Social, and Governance (ESG) principles, patient engagement, and tailored commercial strategies. Together, these elements form a framework that ensures therapies are not only developed but also accessible and impactful, particularly within the European Union’s (EU) complex regulatory environment.
ESG: MORE THAN A MORAL IMPERATIVE
In recent years, ESG principles have become central to healthcare, aligning with broader societal goals for equity and sustainability. In the rare disease space, where vulnerable and underserved populations are the primary beneficiaries, ESG’s importance cannot be overstated.
And we’re starting to see big changes in big pharma. For instance, most now adopt patient partnership programmes, integrating patient perspectives into every stage of drug development. This approach goes beyond meeting regulatory requirements— it reflects a commitment to creating equitable, socially responsible therapies. Similarly, some are experimenting with tiered pricing strategies in lower-income countries, ensuring access to vital treatments without compromising profitability. Such initiatives not only demonstrate corporate responsibility but also enhance trust among patients, regulators, and stakeholders.
Environmentally, pharmaceutical companies are under growing pressure to reduce their carbon footprint and ensure sustainable manufacturing. At Clinigen, for example, we’re prioritising decarbonising healthcare by reducing emissions and actively creating a circular economy in the supply chain. These efforts align with EU regulations, which increasingly demand sustainability as a core business practice.
We’re starting to see big changes in big pharma. “ “
PATIENT ENGAGEMENT: FROM PARTICIPATION TO PARTNERSHIP
Historically, patients have been seen as passive participants in drug development. Today, they are indispensable partners.
However, patient engagement is currently low. According to our research, only 12% of pharmaceutical and biotech companies are bringing patients and patient groups to contribute to their access planning, insights and innovation. 25% are partly doing it and a vast majority of 63% of these companies are not yet reaching patients for strategy.
But patient engagement ensures that therapies address real-world needs, increasing the likelihood of clinical and regulatory success. For example, the inclusion of patient advisory boards during the development of rare disease drugs has proven transformative. In trials for neuromuscular disorders, Community Advisory Boards (CABs) influenced the design of clinical trials by addressing concerns such as travel burdens, inclusion/exclusion criteria, and the length of placebo periods. By incorporating patient feedback, trials and Managed Access Programmes (MAPs) can be redesigned to improve accessibility for participants with rare conditions like Duchenne Muscular Dystrophy.
Real-world data also plays a key role. Pharmaceutical companies which collaborate with patient advocacy groups and access their datasets will inevitably produce therapies with better reflect the lived experiences of patients. 36% of our MAPs now include real-world data collection, and we’re working to make this the standard. This patientcentred approach enhances the relevance of clinical endpoints, increases recruitment and retention, and ultimately strengthens regulatory submissions.
COMMERCIAL STRATEGY: INNOVATING FOR RARE DISEASE MARKETS
Launching a rare disease drug is not like launching a mainstream pharmaceutical product. With smaller patient populations and widely varying reimbursement frameworks, commercial success requires innovative, agile strategies.
Outcome-based pricing models have gained traction as a solution to these challenges. For example, NICE (National Institute for Health and Care Excellence) assessed metreleptin, a therapy for a rare metabolic condition, and emphasised the need for evidence linking the drug to measurable improvements. By demonstrating clear outcomes, companies can negotiate sustainable reimbursement agreements that satisfy both payers and patients.
Additionally, market preparation must begin early. Engaging with regulators and healthcare providers during the development phase ensures smoother pathways for approval and distribution. Partnerships with non-governmental organisations (NGOs) and patient advocacy groups can further enhance reach, as seen with the recent provision of pneumococcal vaccines at reduced prices in underserved regions. Another key part of market preparation is preparing for demand from patients who may not be able to access treatment via a clinical trial, this is where MAPs might be appropriate in some cases and can help improve the access to medicines component of ESG.
ADDRESSING EU MARKET ACCESS BARRIERS
Navigating the EU’s complex market access landscape requires localised strategies. Reimbursement policies, regulatory frameworks, and healthcare systems vary widely across member states, making a one-size-fits-all approach unviable. Companies must engage early with Health Technology Assessment (HTA) bodies and align their strategies with country-specific priorities. For rare disease treatments, its unlikely that a sponsor can afford to pursue marketing authorisation in all countries where there’s demand, which will need to be considered from both an ethical and ESG perspective.
Outcome-based reimbursement models are another critical tool. These frameworks link payment to the therapy’s performance, ensuring financial sustainability while prioritising patient outcomes. This approach is especially valuable for rare diseases, where high costs can be a barrier to widespread adoption.
INTEGRATING FOR SUCCESS: THE POWER OF A HOLISTIC FRAMEWORK
The integration of ESG principles, patient engagement, and commercial strategy is the key to sustainable success in rare disease drug development. These elements are interdependent, each reinforcing the others to create a comprehensive solution to the field’s challenges.
This integrated approach is not just a theoretical ideal—it is a practical necessity. However, we know there is still work to make this necessity a reality. A comparison of 24 Pharma ESG reports in 2023 v 2024 reveals Patient Engagement was included in 10 out of 24 in 2023. This did significantly increase to 15 in 2024 but the inclusion of Patient Engagement commitments as a standalone statement only featured in 7 of the reports in both 2023 and 2024.
LOOKING TO THE FUTURE: TRENDS SHAPING RARE DISEASE INNOVATION
Emerging trends in rare disease drug development do promise to further enhance this integrated approach. Digital health tools, such as decentralised trials, are already reducing barriers to patient participation while generating robust real-world evidence. Advances in personalised medicine will enable therapies to be tailored even more closely to individual patient needs, improving efficacy and reducing wastage.
The emphasis on ESG will continue to grow, with companies increasingly adopting circular economy principles and aligning with global sustainability goals. Patient engagement will also evolve, with greater use of digital platforms to capture insights and ensure diverse representation.
In an era of growing demand for rare disease treatments, embracing holistic strategies is no longer optional—it is the path forward for meaningful, lasting impact.
BUILDING A FUTURE PROOFED NHS WORKFORCE
BY FLOYD MARCH
Birmingham has been chosen as a base for the UK’s first Medicines Manufacturing Skills Centre of Excellence, which will use virtual reality to train in laboratory skills and support the NHS’ net zero goal.
The new initiative, known as Resilience, will address the acute skills shortage faced by the medicines manufacturing industry in the UK, and the University of Birmingham will be one of the partners delivering the programme.
Funded by the Office for Life Sciences, part of the UK Government’s Department for Science, Innovation & Technology, and managed through Innovate UK, Resilience is a £4.5 million, two-year programme.
At the recent launch event, the Minister of State for Science, Research and Innovation, Lord Patrick Vallance, said: “With over £108 billion turnover, as a provider of over 300,000 jobs nationwide, and as a source of treatments helping tackle some of the most debilitating diseases, the life sciences sector is one of the UK’s true industrial champions.
“Our medicines manufacturers’ work is critical to the economic success, and health, of the nation. For them to keep being successful, it is imperative that we help them bridge the industry’s skills gaps.
“This new Centre of Excellence will be an important part of those efforts – bringing industry, universities and the NHS together with schools and colleges to ignite the next generation of life sciences talent.”
THE INITIATIVE WILL ADDRESS SECTOR PRIORITIES INCLUDING INNOVATION AND SUSTAINABILITY
Resilience will create and deliver new training courses for industry, the NHS and education providers, addressing key sector priorities, including digital technology, artificial intelligence, data analysis and environmental sustainability.
Partner organisations across the UK delivering the programme also include University College London (UCL), Heriot-Watt University, Teesside University, and Britest Ltd, all of whom have a strong track record of delivering training for industry and supplying new talent for the medicines manufacturing sector.
The Life Sciences plan, A Prescription for Growth, outlines the government’s ambition to create a robust talent pipeline that meets the needs of industry, academia, the NHS, and the wider supporting workforce, driving both innovation and growth.
In line with this, the government is actively working to develop a talent pool that addresses the specific needs of UK companies and investing to support bespoke skills needs, like Resilience.
The recently published Life sciences competitiveness indicators 2024 noted that pharmaceutical manufacturing’s gross value added (GVA) was £13.7 billion in 2021.
The Resilience partner organisations will deliver in-person and remote training courses in advanced laboratory and medicines manufacturing skills to schools, higher and further education colleges, universities and the NHS.
The Resilience STEM Outreach programme will produce curriculum-aligned materials and careers awareness events. It aims to partner with 20 schools or colleges, providing them with an annual free loan of VR headsets.
Professor Ivan Wall, co-director of Resilience, added; “The use of VR technology will be central to the project, helping young people safely learn skills that it would be impractical to gain in the real world due to logistics and capacity.
“It will also help the NHS to meet its long-term goal of achieving net zero. 25% of their emissions are in the supply chain, and VR will help the industry deliver net zero medicines manufacturing.”
“ “
It will also help the NHS to meet its long-term goal of achieving net zero.
THE PROGRAMME ALSO AIMS TO ENGAGE WITH 150 SCHOOLS, COLLEGES, AND FE CENTRES ACROSS THE UK
It will include laboratory placements and participation in STEM Festivals.
The Medicines Manufacturing Industry Partnership (MMIP), which represents medicines manufacturers in the UK, noted in 2023 that medicines manufacturing generates the majority of life sciences jobs. It is a competitive international sector with other countries such as Ireland, Singapore, France and the US, already have well-funded government support in place.
These plans fit in with wider industry goals such as the NHS long term workforce plan. The newly launched NHS Long Term Workforce Plan, published June 2023, sets out the aspirations of the NHS to address existing and predicted workforce challenges. Over a 15 year period the aim is to train and retain thousands of staff – supported through reform to ways of working and training delivery (most notably through the introduction of a doctor apprenticeship).
The plan shows that, without concerted and immediate action, the NHS will face a workforce gap of more than 260,000-360,000 staff by 2036/37.
NHS Long Term Workforce Plan
It is a vital tool that NHS organisations of every shape and size can use over the coming years to define and address service level provision and understand the steps they can take to increase both the skills and capacity of the healthcare workforce.
SIX STEPS METHODOLOGY TO INTEGRATED WORKFORCE PLANNING®
Our Six Steps Methodology is the only one cited in the NHS Long Term Workforce Plan as a tool that Integrated Care Boards (ICBs) can use to help develop workforce plans. And that is exactly what Skills for Health have been helping the NHS do for many years – either through delivery of a Six Steps training programme (now CPD certified), or through direct help in researching, creating or auditing workforce plans.
The Six Steps Methodology identifies the elements that are needed in any workforce plan, taking into account the current and future demand for services, the local demographic situation, and the impact on other services – whilst helping you understand and work to a budget you can afford.
Our Six Steps Methodology is the only one cited in the NHS Long Term Workforce Plan as a tool that Integrated Care Boards (ICBs) can use to help develop workforce plans. And that is exactly what Skills for Health have been helping the NHS do for many years – either through delivery of a Six Steps training programme (now a certified training programme), or through direct help in researching, creating or auditing workforce plans.
Skills for Health’s Six Step Methodology® builds into the process of workforce planning essential elements to ensure the quality of services are both discussed and planned for.
David Withers, Head of Education, Hull and East Yorkshire Hospitals NHS Trust
SUSTAINABLE HEALTHCARE: AN OVERVIEW OF 2024
BY FLOYD MARCH
2024 has been an encouraging year for the decarbonisation of the healthcare system. From infrastructure to technology and AI implementation, the small wins from Trust to Trust paint a much larger picture of the efforts and progress being made.
With huge industry-leading reports and direction from Government on the frameworks companies should undertake, it is still the innovation coming from R&D and SMEs that will help deliver a net zero NHS and wider healthcare system.
This article will give insight into some of these ‘small win’ decarbonisation efforts, from new low-carbon treatments for pre-existing conditions, hospital emission reductions, and digitalisation.
ECO-FRIENDLY COMBINATION ASTHMA TREATMENTS FOR NEWLY DIAGNOSED
A new guideline recommends chronic asthma should be diagnosed by healthcare professionals when people first show symptoms by using simple tests.
The guideline also says healthcare professionals should always prescribe maintenance or combination treatments, which prevent and relieve symptoms, rather than the familiar blue ‘reliever-only’ inhaler, when asthma is first diagnosed.
For the first time, the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) have worked together to produce a new UK-wide joint guidance for the diagnosis and management of chronic asthma in adults, young people and children.
It recommends healthcare practitioners should offer a low-dose combination of inhaled corticosteroids (ICS) and formoterol to be taken as needed for everyone aged 12 and over with newly diagnosed asthma to reduce inflammation as well as relieve symptoms.
It recommends not prescribing short-acting beta2 agonists (SABA), the most widely used blue ‘reliever’ inhaler/medication, without inhaled corticosteroids, to anyone diagnosed with asthma.
Dr Paul Walker, BTS Chair, said: “The British Thoracic Society and respiratory professionals welcome the new asthma guideline and the impact it will have on asthma care across the whole United Kingdom.
“The change in diagnostic investigations will simplify diagnostic processes and help with current diagnostic delays for adults, children and young people.
Dr Paul Walker continues, “The treatment changes represent a true pivot in the principles of asthma care and will contribute to improved outcomes. The society wishes to thank the very many people who have worked to deliver this guideline. This is only the start of much hard work in dissemination, education and implementation but this will ultimately deliver better care for people with asthma.”
The
treatment changes represent a true pivot in the principles of asthma care
The independent guideline committee looked at evidence which showed using the combined ICS and formoterol inhalers when required led to people suffering fewer severe asthma attacks.
As part of the final guideline publication BTS, NICE and SIGN have also developed a new digital resource which will act as a ‘one stop shop’ online. The digital asthma pathway links to tools, resources and information, all stored in a central hub, accessible from each organisation’s website.
The pathway has been designed to support health professionals in making accurate diagnoses, promoting good practice, and providing effective, personalised treatment to control and prevent acute asthma attacks.
The asthma pathway includes existing BTS/SIGN guidance on management of acute asthma, non-pharmacological management, and occupational asthma. Other resources include a joint patient decision aid on asthma inhalers and climate change, all asthma drugs and treatments recommended by NICE and advice from the Scottish Medicines Consortium.
THE CHRISTIE REDUCES CARBON EMISSIONS BY 10%
A multi-technology decarbonisation project at The Christie NHS Foundation Trust has reduced its building energy carbon emissions by an estimated 1,000 tonnes a year (around 10%) and is saving over £500,000 annually on energy costs.
The scheme is a vital component of The Christie’s sustainable development management plan and a significant stride toward achieving the NHS’s net-zero emissions goals.
The project was partly funded by an £8 million grant from the Department for Energy Security and Net Zero through the Public Sector Decarbonisation Scheme (PSDS), supplemented by £6.9 million from the Trust and supported by Salix who deliver government funding schemes across the UK for energy efficiency and heat decarbonisation projects in public sector buildings and the housing sector.
The integrated energy solution combines various renewable technologies including a new combined heat and power plant, a new energy-efficient boiler, two air source heat pumps, 640 solar panels for independent electricity generation, and a 2MW battery energy storage system (BESS) for storing excess electricity.
These measures not only reduce reliance on external power sources and the need to import electricity at the most expensive times but also create a smart grid from which the local community can benefit.
Energy efficiency upgrades include 3,000 LED lights, replacement of part of the aged steam heating infrastructure with modern high-efficiency lowtemperature hot water distribution, improved insulation, and optimisation and upgrades to the existing Building Energy Management Systems.
The milestone is a step towards achieving NHS net zero goals.
Alex Beedle, Head of Estates at The Christie, said: “We are very pleased with the decarbonisation scheme. The reduction in carbon emissions is estimated to be around 10% of the total from our site and is a big step towards achieving our ambitions for net zero in accordance with NHS Targets. We will also make significant savings on our energy bill year after year.
“I want to thank all those who have helped us to deliver this scheme despite numerous challenges, including fitting a retrofit design to a densely-used hospital site.”
“ “
The reduction in carbon emissions is estimated to be around 10% of the total from our site and is a big step towards achieving our ambitions for net zero in accordance with NHS Targets.
DEPARTMENTS EMBRACE
DIGITAL SUSTAINABILITY
Emergency departments across Wales are being challenged to embrace digital technology in a bid to make patient care more efficient and become environmentally sustainable.
As part of efforts to speed up treatment of patients and reduce carbon emission, lab reports at Morriston Hospital are now shared electronically instead of being printed.
This has stopped the production of up to 2kg of printed paper daily. This will save more than £1,200 and 1,200kg of carbon emissions annually in paper alone.
Sites across Wales are also reducing paper usage through the use of QR codes for patient information, as well as reducing electricity output where practicable via computer screen dimming and more efficient use of office lighting.
Wales is the first nation in the UK where all emergency departments are bidding to reach GreenED bronze accreditation.
The initiative, launched in collaboration with the Royal College of Emergency Medicine (RCEM), aims to measure and reduce the environmental impact of emergency departments in the UK. The framework is divided into bronze, silver and gold levels, with the guidelines and resources required to help achieve them. Achieving GreenED can have a positive impact on the reduction of emissions, waste and costs.
Evidence from recently accredited pilot sites in NHS England showed significant carbon savings and cost savings of around £10,000 per site, thanks to efforts to reduce electricity output, as part of the initiative.
Other measures being adopted in Welsh emergency departments through the GreenED initiative include using recycled paper, eliminating the use of plastic cups and cutlery, improving energy efficient waste segregation and disposal, and increasing the availability of dry-powdered inhalers.
It is hoped these measures will help reduce carbon emissions in NHS Wales, helping achieve the ambition for a collectively net zero public sector by 2030 and the target for a net zero Wales by 2050.
SHOULD THE NHS ADOPT A PLANT BASED DIET?
PODCAST EPISODE
Dr Shireen KassamConsultant Haemotologist
WHAT IS ‘PLANT-BASED HEALTH PROFESSIONALS’ AND WHAT DOES IT AIM TO DO?
Shireen: Back in 2018, I founded a community interest company called Plant-Based Health Professionals UK, because I was acutely aware that as healthcare professionals, we get very little training on the application of healthy nutrition to our clinical practise, and there was nobody talking about the health benefits of adopting a plant-based diet within the healthcare service.
There’s lots of advocates out there for plant-based diets for the environment and of course for the animals, but I think we sometimes miss that important piece where we could really support our patients and our families and communities to live better by simply eating more plants and reducing the other types of foods that are so prevalent in our diet.
HOW
CAN
THE NHS FOLLOW GOOD GLOBAL PRACTICE AND TAKE ON THIS APPROACH IN THE UK?
Shireen: We’re in this really fortunate position that we’ve got these good practice examples from around the world. I think the next step, which is a difficult step, because it goes against the norms, is putting this into action.
In New York City, they’ve got a really passionate advocate in their mayor, Eric Adams, who talks about his health transformation by adopting a plant-based diet and healthy lifestyle habits, reversing his own type 2 diabetes. He has implemented plant-based menus within 11 city hospitals in New York. They started slowly back in 2019, but today in 2024 the primary and secondary meal choices for patients is a fully plant-based meal.
Two years after implementing this fully plant-based default approach, more than 50% of patients in hospitals stick to that plant-based option, and patient satisfaction has been excellent. More than 90% are satisfied with the meal that they receive, and that’s quite the opposite to what you might expect in an NHS hospital.
WHAT WOULD THIS LOOK LIKE PRACTICALLY
IN THE NHS?
HOW EASY WOULD IT BE TO INTRODUCE?
Shireen: What we’re talking about is really flipping the norm. It’s not about making everyone vegan or vegetarian, it’s about normalising plant-based meals so that it’s the most prominent option. It’s the option that people see first and second and third and then if they want something different, it’s still available.
It’s not restricting choice, but it’s around normalising these plant-based meals. It could look different in different environments. In the staff canteen, it would be really great if we could have special deals on plant-based meals that could save money. We know people choose the thing that’s closest to them, that they see first, and that they may see other people choosing as well, so it’s about shaping the dining hall in a way that we can encourage people to make that choice.
If we look at patient menus, it could be that the majority of dishes are plant-based meals, so most people see that first and foremost on the menu, and we have some messaging to encourage people to choose those options, whether it be talking about their health, the environment, talking about food costs. There’s lots of different ways of prioritising and normalising plant-based meals within the healthcare space which is really broad.
HOW CAN THIS PROMOTE ENVIRONMENTAL BENEFITS AS WELL?
Shireen: I think that’s really key to the NHS priorities at the moment. The NHS was the first healthcare service that declared a climate emergency, and then it’s the first to make commitments to achieve net zero by 2040, and so it really has bold ambitions.
Food provision contributes to about 6% of the NHS’s emissions, and it’s worth saying, there’s over a million staff within the NHS, over 200 million meals served to patients. It’s a real key opportunity where we could make a change relatively quickly, without additional cost. It’s not just about emissions when we talk about food. Of course there’s carbon emissions but also emissions of methane and nitrous oxide, so all sorts of greenhouse gases are emitted from our farming sector. But also, in the UK, about 80% of agricultural land is dedicated to raising animals for food.
Studies show that if we were to all adopt a plantbased diet we could release 75% of farmland back to nature, not only restoring biodiversity but we could use that land to capture carbon. When we think about planetary health within the NHS, we have to think of all of those aspects and we can benefit each and every one of those harms that are currently happening by adopting more of a plant-based menu within healthcare and within our communities.
If we look again at New York City’s experience, after two years they’ve calculated that just by prioritising and normalising plant-based meals within their healthcare service, they’ve reduced emissions just from food catering by 36%. So you know that in itself would be phenomenal if we could achieve that in the NHS.
YOU’VE CONDUCTED RESEARCH INTO THE GREEN PLANS OF 40 NHS TRUSTS. WHAT DID YOU LEARN?
Shireen: When we analysed 40 Green Plans from all four nations, it was quite clear that there was very little commitment made to changing the food environment within healthcare and certainly within the hospital setting. There were certainly a lot of trusts that were documenting the need to sort of prioritise locally sourced foods, which is great for food security, but the biggest impact we can have on reducing emissions from our food and catering service is actually changing the foods we eat, and that’s regardless of how it’s produced or where it’s travelled from.
Only 5% of the green plans we analysed showed that there was a commitment to prioritising plant-based meals and even then it wasn’t clear how it was going to be done. I think by 2025, many Trusts will be looking to refresh their green plans and what we need to see is a commitment to normalising plant-based meals as the default, whilst also providing education to staff and patients around why that’s so important.
NAVIGATING PARENTHOOD AND HEALTHCARE AS A SAME SEX COUPLE IN THE UK
BY PHILIPPA OAKLEY CHIROPRACTOR, OWNER OF ACORN HEALTH AND MEMBER OF THE BRITISH CHIROPRACTIC ASSOCIATION (BCA)
My wife and I embarked on a journey to expand our family, a path that required us to navigate numerous challenges and systemic barriers within the UK’s healthcare system for same-sex couples. Our experience, marked by both personal loss and professional growth, highlighted significant gaps in understanding and inclusivity within healthcare services, particularly for same-sex parents.
A VOID OF UNDERSTANDING AND INCLUSIVITY
During our pursuit of parenthood through IVF, we encountered several challenges. Despite the changing societal landscape, many IVF clinics still use outdated forms asking for “mother” and “father” details, instead of more inclusive terms like “parent 1” and “parent 2.”
When we voiced our discomfort with one of us being labelled as the father, we were met with resistance and dismissive solutions such as “scrub it out” on the forms. We lost count of the number of times staff assumed my wife was my sister.
Moreover, we faced a lack of understanding from healthcare clinicians, who often asked intrusive questions out of curiosity rather than clinical necessity.
As a same-sex couple, we incurred substantial financial costs which were upwards of £40,000 for IVF, while heterosexual couples can access various fertility tests through the NHS.
As a same-sex couple, we had to be ‘demonstrably sub-fertile’ or try up to 10 cycles of self-funded treatment before becoming eligible for funded treatment.
This varies depending on which area of the UK you live, leaving IVF for same-sex couples as a notorious “post code lottery”, with a wide disparity in support and standardisation of treatment.
Much of the LGBTQ+ inclusivity training offered to staff within the NHS is embedded within a wider EDI package which fails to offer the necessary degree of useful information, as it forms part of an online training programme which is ineffective and inadequate.
LEGAL AND RESOURCE RESTRICTIONS
Despite legal advancements, there are also still barriers to same-sex parenting rights in the UK.
Fundamental arguments about our rights and challenges in care still exist, with recent data indicating that LGBTQ+ communities continue to face discrimination, inadequate healthcare, and major concerns about accessing necessary services.
Our experience reinforced these findings, as we frequently felt that our specific health needs were not being met, and that our encounters with healthcare providers were marred by ignorance and insensitivity.
many IVF clinics still use outdated forms asking for “mother” and “father” details, instead of more inclusive terms like “parent 1” and “parent 2.”
Once we had completed the process and I fell pregnant, our journey took a heartbreaking turn when we lost one of our twins during pregnancy.
The COVID-19 pandemic further contributed to our isolation, as support groups were unavailable, and charities were ill-equipped to assist same-sex couples.
Resources were often tailored to heterosexual couples, and support groups did not accommodate the unique needs of a nonbiological bereaved mother, leaving myself and particularly my wife feeling isolated.
This lack of tailored support underscored the need for more inclusive and culturally competent care, and the need for research into the impact of traumatic birth on same-sex couples.
TURNING A TRAGEDY INTO LASTING CHANGE
After welcoming our daughter and saying goodbye to her twin sister, we felt particularly motivated to drive positive change from our experience.
We wanted to honour our daughter’s memory and create lasting positive change within the healthcare system, ensuring that no one else has to face the same challenges we did.
We initially focused on improving doctor-patient communication through running online CPD courses on motivational interviewing and health coaching.
However, we soon wanted to expand on this, so, we collaborated with a trans-specialist advanced clinical massage therapist and developed an online training course in inclusive care for manual therapists.
This initiative received an overwhelmingly positive response and led to further opportunities to provide training on inclusive care and communication skills for NHS trusts, with a specific focus on culturally competent care of LGBTQ+ people.
Our advocacy efforts have extended internationally. I have delivered training to NHS staff, informed LGBTQ+ Positive Action Plans, and worked with various healthcare organisations, including the Canadian Chiropractic Association and the British Columbia Chiropractic Association, to provide seminars on inclusive healthcare.
Additionally, I have been involved in consultancy services with the General Chiropractic Council to improve EDI standards and have developed a lecture series on Equity, Diversity, and Inclusion for chiropractic students in the Philippines.
Our journey has allowed me to unite my experiences as an LGBTQ+ individual, a parent, and a practicing British Chiropractic Association (BCA) chiropractor to advocate for inclusive healthcare.
There is no legal requirement for many healthcare professionals working in private practice to undertake mandatory EDI training as part of their ongoing CPD requirements, which, in my opinion, leaves us vulnerable to patient complaints, and at risk of providing inappropriate care.
As a member of the Chiropractic profession, I am delighted so many of my colleagues have taken the opportunity to join us in setting the standard for the provision of LGBTQ+ inclusive care in manual therapy.
Chiropractors have the opportunity to be proactive and forward-thinking, addressing the needs of LGBTQ+ patients before issues arise.
My hope is to leave the profession better than I found it, ensuring that LGBTQ+ individuals can seek chiropractic care without fear of assumptions, awkward questions, or misgendering.
I am delighted so many of my colleagues have taken the opportunity to join us in setting the standard for the provision of LGBTQ+ inclusive care in manual therapy.
“ “
By creating an environment of inclusive care, we can ensure that all patients feel respected and understood.
