Sustainability is a complex, multifaceted concept that continues to evolve depending on the perspectives of different sectors and professions, and their respective expertise and interests. It is shaped by people’s views, and in turn, shapes how issues are formulated, and actions proposed. The environment, society and economy are often reflected as separate, interconnected dimensions of sustainability, and yet recognising their interdependence will be essential to the pursuit of sustainability.

In Australia and around the world, a value-based approach to health care is being used to transform health services and systems as they face similar challenges to sustainability including aging populations, a growing burden of disease, changing individual and community expectations and escalating health care costs. Yet health systems and services appear to be considering environmental sustainability independently of value-based health care, with limited evidence of initiatives or entities purposefully aligning the two concepts in practice.

Given that the frequency and intensity of extreme weather events is increasing with considerable impacts on health and wellbeing, the holistic perspective provided by value-based health care can deliver a framework structure that is able to support transformation towards more sustainable healthcare models - provided we achieve a definition of value that encompasses all dimensions of sustainability.

Strategies are needed that recognise the impact of climate change on the health of todays and future generations, including in rural and remote areas, on health workforce shortages and on vulnerable communities. These require:

• understanding climate-related health needs of patients;
• designing solutions to improve climate-related health outcomes and costs;
• integrated teams to address climate-related impacts;
• climate related health outcomes and costs in the value equation; and
• partnerships.

Designing and delivering care that provides a comprehensive solution to meet the needs of patients requires teams that not only address the clinical needs of patients affected by climate change but also consider their non-clinical needs, which when left unmet can undermine the health outcomes that can be achieved by patients.

A crucial principle in the delivery of health care must be that improvements in health outcomes do not come from treatments which themselves cause poorer health outcomes because of their impact on the planet.