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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 of positive change. 


We recommend that SusQI principles be integrated directly into existing QI learning outcomes in curricula- as per recommendations in the 2019 Academy of Medical Royal Colleges report on 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  set standards for embedding sustainable healthcare into professional practice.  ​The Academy of Medical Royal Colleges has even embdedded sustainable healthcare pronciples into 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.

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 for educators and students to engage with QI. In our teaching experience, linking up sustainability and Quality Improvement can make projects more meaningful.


All sectors need to be involved in the transformation to a sustainable society, but the health sector should lead on it.

Health professionals are respected voices and therefore ideally positioned to educate, advocate, model and lead sustainable change with colleagues, patients, policymakers and the public. 

The good news is that, in addition to their role in reducing the threat that climate change poses to human life and health, health professionals have excellent reason to lead on sustainable transformation in a positive way. If we stop our negative impacts on the environment, we don't just reduce the risk of planetary collapse, we benefit health in a very immediate way. 


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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