Sustainability in the NHS is often associated with large hospital estates or high tech carbon cutting innovations. But in reality, some of the most meaningful sustainability work takes place far from hospital settings—on doorsteps, in living rooms and in the car boots of community nursing teams.

Working in out-of-hospital care gives us a unique window into the environmental, social and economic realities of peoples everyday lives. And yet, we rarely stop to consider how routine choices—such as the wound dressing we select, the way we plan our visits or how we dispose of waste—shape our environmental impact.

Community nursing generates large volumes of single-use items, PPE and packaging. When you add the miles travelled for home visits, the environmental footprint becomes clearer. Many nurses I speak to feel a strong ethical duty to “do the right thing,” but also frustration: Where is the training? Where is the guidance? And where is the time to make greener decisions?

Despite these challenges, community nurses are already finding innovative solutions. In Sheffield, teams have trialled reusable equipment to cut plastic waste. In Oxfordshire, improved diabetes monitoring has reduced unnecessary hospital admissions. Structured catheter reviews in Lewisham have lowered avoidable interventions. These changes may seem small, but they demonstrate what is possible when sustainability is embedded in everyday practice.

Climate change is not an abstract concept for community nurses. Its health effects—poor air quality, heatwaves, cold or damp housing—exacerbate long-term conditions and disproportionately affect the most vulnerable. Sustainability is therefore not just an environmental concern; it is a public health priority, and fundamentally, a nursing issue.

Significant obstacles remain. Fragmented systems, inconsistent recycling processes, pressure to prioritise immediate clinical care and limited leadership support can all hinder progress. However, we have powerful levers at our disposal: Greener NHS programmes, the NHS Long Term Plan and an increasing recognition across the profession that sustainability is central to high quality, safe care.
For me, sustainability in community nursing is ultimately about empowerment. It's about giving nurses the knowledge and confidence to ask: “Is there a greener way to do this without compromising care?” Sometimes there will be a practical alternative, and sometimes not. What matters is building a culture where the question becomes routine.

As we look ahead to RCN Congress 2026 and our learning event on Sustainability in Out of Hospital Nursing, I'm keen to hear your experiences. What examples of good practice can you share? What barriers do you face? And what small but meaningful changes could we make tomorrow to support a healthier, more resilient future for our communities?

For more information, visit: Sustainability in health and care