The resources required to meet new accreditation standards for environmental sustainability will take a significant toll on practices’ ability to provide the best possible patient care for 48% of nearly 300 practice owners who responded to a national Healthed poll last month.

Of those who were familiar with the requirements, 73% said the impact was moderate or substantial, and only 6% claimed no impact.

Environmental  sustainability and responsibility standards were added for the for the first time this year, with a host of requirements, including installing rainwater tanks or grey-water systems and low-water use toilets, improving insulation and ventilation to reduce energy use and minimising single-use items  wherever possible, documenting strategies to improve environmental impact and reducing carbon greenhouse gas emissions, appointing someone to champion sustainability – among the lengthy list of examples described.

But while some have celebrated this as long overdue, others say it’s an overreach.

One outspoken critic has been Newcastle GP and practice owner Dr Max Mollenkopf, who said the RACGP had “absolutely stooged practice owners,” under the new standards, citing internal inconsistencies and tokenism, among his concerns.

“The RACGP wants me to save the planet. They also want me to use disposable instruments,” Dr Max Mollenkopf wrote in the Medical Republic, adding that when his practice is next assessed, they’ll retire their steriliser. “The standards demand a new washer disinfector will need to be purchased and we don’t have $16,000 in the budget.”

“Things like bike racks, EV chargers and power audits are now given equal weight to keeping vaccines at a safe temperature and ensuring the privacy of sensitive health data is maintained,” Dr Max Mollenkopf opined in TMR.

The standards demonstrate “the tokenism that modern accreditation has become,” he wrote, noting that while one section requires practices to consider the environmental impact of procurement, other add more hurdles, “making disposable instruments the only way for small practices to be able to keep compliant stock.”

Dr Mollenkopf is not alone in his criticism.

“I think the ideological environmental impact issues proposed in the media are a step to far for multi-tasking GPs trying to practice and run clinics and that help needs to come from higher up not at the GP level,” one GP in the Healthed survey commented.

“There are conflicting demands – e.g. have a climate responsible person, and use disposable instruments if you can’t afford the new sterilisers.” – GP in Healthed’s survey

“Stay out of the ‘climate change’ arena. It has absolutely nothing to do with the delivery of primary medical care. The RACGP should stick to being a college that helps us to become better GPs, not one that engages in dubious political debates that are not patient focussed,” another GP said.

The concerns stretch beyond sustainability requirements

Healthed’s survey of around 1200 GPs, including almost 300 practice owners, found that 94% believe the accreditation process needs to be more collaborative and less authoritarian.

Overall, responses between practice owners and other GPs were similar in most cases – but there were a couple of exceptions:

• Practice owners were more likely to believe the current process is obstructive to good practice (75%, compared with 61% of other GPs).
• They were also less likely to think accreditation is a good learning tool for improving practice management (64%, compared with 72% of GPs who don’t own a practice.)

RACGP President Dr Michael Wright said the standards are “strongly outcomes-focused, and don’t prescribe rigid processes.”

“They provide flexibility for practices to implement systems that suit their circumstances, while meeting the expectations of our patients for high-quality care that’s tailored to their needs,” Dr Wright said.

While the College says the standards provide flexibility for practices, eight out of 10 GP in the survey, and 85% of practice owners, disagree.

The new edition has 31 fewer mandatory criteria than the last edition had. It includes 86 mandatory criteria and three ‘aspirational’ criteria.

Dr Louise Acland, Chair of the RACGP expert committee of standards for general practices, said the new standards represent “continuity amid change.”

As healthcare continues to evolve, general practice faces both new opportunities and new challenges, Dr Acland said.

“Digital transformation, changing patient expectations, and the health impacts of climate change are among the issues shaping the future landscape,” she said.

“The sixth edition provides a framework that is both forward-looking and grounded in the profession’s enduring values.”

“The Standards reinforce the role of accreditation not simply as a regulatory requirement, but as a driver of quality improvement, professional integrity and public trust.”