The climate crisis is no longer a distant threat:1 it has arrived, significantly impacting the health and wellbeing of individuals and communities worldwide.2,3 In the UK, the urgency to address climate change, highlighted by the Delivering a ‘Net Zero’ National Health Service report,4 underscores the need for all organisations to reduce carbon emissions and incorporate sustainability into their practices.4 Extreme weather events, exacerbated by climate change, are becoming increasingly frequent, intense, prolonged, and devastating,5 presenting considerable challenges to primary care services both domestically and internationally.2,3,6 These events strain healthcare resources, exacerbate health problems,7 and profoundly affect physical and mental health.3
Acknowledging the scepticism regarding the NHS’s prioritisation of planning for extreme weather events amid existing challenges and financial pressures is crucial. While the UK has experienced relatively moderate extreme weather events compared with other regions, the imperative to prepare for potential escalations cannot be overstated. Despite longstanding awareness of the risks posed by climate change to health systems, convincing stakeholders of the immediate need for preparedness remains a challenge.
Focusing on preparedness
Primary care teams are at the forefront of tackling this unprecedented challenge. The increasing likelihood of extreme weather events demands a shift in mindset, recognising the implications on patient health, community resilience, and healthcare delivery. General practices and their teams should not only prepare for the immediate health issues associated with such events but should also act as champions of resilience and preparedness. Sooner or later, they may be called upon to play a vital role in addressing the needs of patients affected by extreme weather events, promoting resilience, and facilitating recovery. The imperative for primary care is clear — to be not only a responder but also an agent of change in the face of extreme weather events.
A multifaceted approach to preparedness
Preparedness requires a multifaceted approach that includes primary care perspectives. Public health agencies, in collaboration with primary care, mental health, social care, and other stakeholders, have a key role in developing strategies, educational campaigns, and community programmes that are needed to enhance resilience and preparedness. Vulnerability assessments, early warning systems (EWS), preparedness workshops, and the dissemination of information to the public all need to be considered. Meanwhile, primary care services should prepare to focus on maintaining continuity and accessibility of health care while providing patient support.
Addressing evidence gaps
While we know that last year was the hottest year on record, and extreme weather events are becoming more frequent and more severe as the predicted climate models occur, the evidence base on how this is affecting primary care is still very limited. This is constraining the extent to which consideration is being given to the importance of prioritising planning, EWS, vulnerability assessments, resilience planning, and so on.
To move forward, it is essential to acknowledge the gaps in evidence that hinder effective planning. An agenda-setting exercise involving a multidisciplinary approach would help identify such gaps and prioritise research areas. Investment in research to address these gaps would be crucial in enhancing preparedness and response. For example, a recent systematic review assessed the association between extreme weather events and the impact on health in Europe.8 It found that most studies identified that extreme heat or cold events lead to increased overall and cause-specific mortality. Wildfires raise overall mortality and cardiovascular mortality, and floods were particularly associated with the deterioration of mental health. There was a lack of evidence about how primary care services were directly challenged by such events. Further research is necessary to understand the specific implications in more temperate countries such as the UK.
Collaboration, leadership, and extreme weather planning
Effective planning for these challenges requires professional leadership, policymaking, and, most importantly, adequate resourcing. Expecting primary care services to acquire new skills and make plans in the face of all the other challenges that they are facing is likely to be futile in the absence of a properly resourced, comprehensive approach. Prioritising and incentivising decarbonisation efforts, alongside infrastructure improvements, and community engagement9 are crucial steps.
Collaboration with community organisations and local authorities can lead to the development of resilience-building programmes and planning for equitable access to healthcare services.10–12 Leadership from professional bodies, such as the Royal College of General Practitioners (RCGP), is critical in driving these initiatives forward.13 The RCGP, the UK Health Alliance for Climate Change (UKHACC) (https://ukhealthalliance.org/), and similar bodies can play a vital role in driving these initiatives forward.
Figure 1. Components of primary care’s preparedness for extreme weather events.
EWS are vital for providing timely and targeted information to mitigate risks and enhance preparedness for extreme weather events. While public health alerts to the NHS are crucial, specialised EWS focusing on primary care, for instance, offer several advantages. For example, public health agencies and local authorities could collaborate with primary care to implement EWS. This could involve leveraging technology such as mobile apps or automated messaging systems to disseminate alerts and advice to individuals, patients, and communities, thus playing a vital role in empowering communities to effectively respond to and recover from extreme weather events.
Key preparedness components
First, preparedness enables proactive measures such as infrastructure improvements, EWS, evacuation plans, and public education campaigns, which help anticipate and mitigate the effects of extreme weather events. Second, preparedness efforts contribute to long-term resilience by strengthening infrastructure, developing response plans, and fostering collaboration, ultimately reducing vulnerability and minimising disruption. Third, it involves strategic resource allocation, including emergency supplies, training personnel, and investing in technologies, enhancing the capacity to respond effectively. Lastly, preparedness initiatives engage the community, empowering individuals and local organisations to actively participate in disaster preparedness and response, fostering social cohesion and collective resilience.
The components of primary care’s preparedness thus relate to adaptation, mitigation, resilience, practitioners, and community (Figure 1).
Policy imperatives and future directions
A key lesson from the COVID-19 pandemic was that preparedness is paramount. In the context of extreme weather events, preparedness requires collective action, informed by research, and driven by a commitment to create a healthier, more sustainable world. Balancing immediate pressures with the urgent need for adequate planning, funding, and resources is vital. The health and wellbeing of our communities depend on it. The time to act is now, for safeguarding patients and the resilience of primary care in the face of the climate emergency.
Notes
Provenance
Commissioned; not externally peer reviewed.
Competing interests
The authors have declared no competing interests.
- © British Journal of General Practice 2024
