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Why teach SusQI? 

“This framework has radically altered how I approach quality improvement, in how I deliver quality improvement to the students I teach, in my own practice and in how I appraise the work of others”    


- Noreen Ryan, Domain Lead for Quality Healthcare, Imperial College London School of Medicine



QI is recognised as a key element of practice for health professionals. It underpins building capability and leadership, and is a driving force for engaging health professionals in positive change creation.


We recommend that SusQI principles be integrated directly into existing QI learning outcomes as per the recommendations of the 2019 Academy of Medical Royal Colleges report; Developing Quality Improvement into Practice. (p6-10, QI Curriculum).  

Both the GMC Outcomes for graduates 2018, the NMC Standards of Proficiency for Midwives 2019 and the World Federation of Occupational Therapists  have set standards for embedding sustainable healthcare into professional practice while the Academy of Medical Royal Colleges has  embedded sustainable healthcare principles into its QI curriculum. ​


Healthcare staff and students are increasingly voicing concerns about the ecological crisis and the need for the health sector to respond and lead by example.

For example, in June 2019, in the same week that Channel 4 News featured Newcastle Hospitals declaring a climate emergency, the Guardian published a letter from >1000 doctors endorsing direct action on climate change. In a survey by the Sustainable Development Unit in 2017, over 98% of the 3000 staff surveyed supported plans for the NHS to become more sustainable. 

An international student-led initiative called the Planetary Health Report Card (PHRC) expanded to the UK in 2020 and in it’s first year had students from 30 UK medical schools with students voluntarily leading a team at their university. The PHRC is a needs assessment tool assessing the medical school's engagement in planetary health and sustainable healthcare both in the curriculum and more widely. The report is published on the website annually on World Earth Day in April and continues to expand, demonstrating student demand. This SusQI website is one of the top recommended resources on their summary report.

In 2022, The Planetary Health Report Card initiative, was launched to evaluate current, and advocate for greater action on climate change by medical and health colleges, regulators and associations. Its first report was published in October 2022 and outlined the activity participating medical institutions were taken across four domains of climate action, including education.

Unfortunately many students perceive QI projects and teaching as tick box exercises and do not realise the true value of the practice. However, recent research by CSH collaborators has found that adding the SusQI framework can offer fresh motivation and meaning for educators and students to engage with QI. 


Although all sectors need to be involved in the sustainable transformation of our society, there are a number of reasons why the healthcare sector should take the lead. 

Health professionals have a respected voice in society and are therefore ideally positioned to educate, advocate, model and lead sustainable change with colleagues, patients, policymakers and the public. 


Climate mitigation efforts include actions with significant health co-benefits (such as a reduction in air pollution and an increase in plant-based diets)


A sustainable health-service would ideally include a redistribution of resources, and a reorientation of health activity towards health promotion and disease prevention, both of which could result in significant health gains while reducing environmental impact.

SusQI is a practical way for healthcare professionals to become agents for change in their daily practice and can form a foundation for driving cultural change.  

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