Imogen Stringer, Head of Sustainability Education and Implementation Manager at Great Ormond Street Hospital (GOSH), United Kingdom

Welcome to Pioneers of Safer Healthcare, an interview series celebrating the transformative efforts of Born Green Generation partners in advancing sustainability in healthcare.

Can you share a bit about your background as Head of Sustainability Education and Implementation Manager, and what led you to this role at Great Ormond Street Hospital (GOSH)?
I started out as a critical care nurse, working in ICU at Imperial College Healthcare NHS Trust, where I quickly progressed into leadership and then education roles. I became a Senior Clinical Nurse Educator, leading training and development programmes for critical care staff. This is where I really honed my skills and where my passion for sustainability expanded from being a personal passion to becoming a professional one.

That experience led me to successfully apply for a secondment as a Chief Sustainability Officer’s Clinical Fellow at NHS England. There, I worked on national projects developing national policy and guidance for decarbonisation in healthcare.

Now, in my role at Great Ormond Street Hospital, I have the opportunity to combine my clinical nursing, leadership and sustainability skills and expertise into one. I lead the ‘Born Green Generation Project’, but as the Head of Sustainability Education, I also oversee the development and implementation of a pan-trust sustainability education programme, ensuring that all staff—regardless of role—are equipped and empowered to contribute to environmental sustainability in healthcare.

What personally motivates you to lead sustainability initiatives in healthcare?
If we do not address climate change, the fundamental purpose of healthcare cannot be achieved. Sustainability in healthcare is about making sure we are delivering the best possible care today without compromising the health of future generations. As a nurse in critical care, I was often presented with the sickest, most vulnerable patients in the hospital, yet I realised that my skills and contribution wasn’t enough: the care for the patient often expands far beyond the four walls of the hospital and if we do not address climate change, the fundamental purpose of healthcare cannot be achieved.

My motivation comes from both a personal and professional place. Clinically, I’ve witnessed the vast amount of single-use plastics, resources and energy consumed daily, but also the long term health impacts this has on my patients. It made me question how we can balance patient safety with more sustainable practices. That curiosity led me to take on leadership roles in education, policy, and promoting system-wide change because I believe that empowering healthcare professionals with the right knowledge and tools is key to making sustainability a standard part of care.

Driven by the potential of collaboration and innovation, my experience leading national sustainability projects at NHS England showed me the impact we can have when clinicians, policymakers, and industry partners collaborate. 

Ultimately, I’m inspired by the belief that small changes—whether it’s reducing waste, making procurement more sustainable, or shifting mindsets through education—can lead to huge improvements in patient care and planetary health. That’s what keeps me pushing forward in this work every day.

How did Great Ormond Street Hospital (GOSH) become involved with the Born Green Generation initiative, and what has been the response within your team?
GOSH became involved with the Born Green Generation initiative through its ongoing commitment to sustainability and innovation in paediatric healthcare. In collaboration with HCWH Europe and other partners, BGG aligns perfectly with GOSH’s ambition to reduce environmental harm while delivering world-class care to children. 

The response within the team has been incredibly positive. Sustainability resonates deeply with many healthcare professionals, and once they see the tangible ways in which it can be integrated into daily practice without compromising patient safety, they’re eager to get involved. There’s a real sense of collective ambition and enthusiasm, not just among clinical teams but across the entire organisation, from procurement to estates management and beyond.

We’ve already started embedding sustainability principles into education and training, which has been met with a lot of engagement. The appetite for change is huge, and I think what’s most exciting is that GOSH has the potential to actively shape the future of greener paediatric care on a global scale.

Great Ormond Street Hospital (GOSH) has taken several pioneering steps in implementing sustainable practices. Could you share an overview of these initiatives?
As part of the project, we have been implementing a range of different initiatives. One of the key areas for change has been the operating theatre. There has been a collaborative effort within theatres to move away from disposable to reusable, and as part of that, we have now replaced our single-use theatre gowns, theatre hats and some of our surgical drapes. We have also more broadly removed all the single-use curtains across the hospital and replaced them with reusable ones. Not only do these initiatives reduce plastic exposure, plastic wastage, and cost savings, but they also promote a behavioural shift for more circular principles in the theatre setting. We have also implemented reusable feeding bottles, which can be used five times in comparison to single use, for all of our patients receiving special feeds.

To encourage engagement with BGG and to provide support, structure, and protected time to help address some of the barriers, we introduced a ‘Green Team Champion Competition’. Through this initiative, clinical and non-clinical teams are receiving coaching and mentorship to develop and implement practical, innovative solutions to reduce plastic waste in their specific areas of the hospital. It’s not just about cutting down on plastic use—it’s about empowering staff at all levels to take ownership of sustainability efforts and find creative, locally-relevant solutions. Another initiative to address some time and capacity challenges around implementation has been to create bespoke ‘Climate and Health’ specific shifts for clinical staff to have protected time to work on their project. This approach has been especially helpful by focusing on bedside education and collecting information to reduce decision fatigue for clinicians, making reusable options the default choice. For instance, by placing probes in the stock cupboards.

What challenges have you encountered in making these changes, and how have you overcome them?
Implementing these pioneering sustainability initiatives at GOSH has been incredibly rewarding, but it hasn’t been without its challenges. Transforming long-standing clinical practices and procurement processes requires careful planning, strong engagement, and a commitment to patient safety.

Shifting to reusable alternatives—such as surgical hats, gowns, oxygen saturation probes, and feeding bottles—requires ensuring that teams feel confident these changes maintain or even enhance safety and efficiency. We’ve overcome this by working closely with infection prevention and control teams, gathering robust evidence on safety and effectiveness, and running education and training sessions to help staff feel comfortable with the transition.

Another challenge has been navigating procurement and supply chain barriers. Not all suppliers offer sustainable alternatives, and even when they do, the initial information around their life cycle assessment or cost isn’t always transparent. To address this, we’ve worked on building strong business cases that highlight the long-term cost savings of reusable products, such as the reduction in waste disposal fees and the durability of multi-use equipment. We’ve also partnered with industry leaders and sustainability networks to drive demand for greener alternatives.

Throughout these challenges, one of our biggest strengths has been the enthusiasm and dedication of staff. By involving clinical and non-clinical teams in these projects, and giving them ownership of the changes, we’ve built a culture where sustainability is seen as an opportunity rather than a burden.

In your view, why is it essential to reduce plastics and harmful chemicals in maternity and paediatric wards? What positive effects have you observed so far in your day-to-day practice?
Reducing plastics and harmful chemicals in our paediatric hospital is absolutely essential because newborns, infants, and children are particularly vulnerable to environmental toxins. Their developing bodies are more sensitive to chemical exposure, and they breathe, eat, and drink more relative to their body weight than adults, making them more susceptible to pollutants, plastics and microplastics. In a healthcare setting, where they should be receiving the safest, most protective care, it’s crucial that we eliminate unnecessary risks linked to plastics and harmful toxins.

From a broader perspective, healthcare has a responsibility to not only treat illness but also prevent harm, including environmental exposures that could contribute to long-term health issues. Plastics and chemicals used in medical supplies, equipment, and even packaging can leach toxins that disrupt hormones, affect immune function, and increase the risk of chronic diseases. By reducing these materials, we’re not just protecting the environment—we’re directly improving patient health.

In terms of positive effects in day-to-day practice, we’re already seeing some shifts in awareness and behaviour. Through the Born Green Generation initiative, we’ve started to integrate sustainable procurement practices and reduce plastic in places like theatres, infant feeding and medical devices. There’s a real willingness to explore alternative, safer options.

How do you think these practices could inspire broader change in the healthcare sector and society as a whole?
One of the most exciting aspects is that these changes don’t just benefit our hospital—they’re helping to shape best practices for paediatric care globally. By proving that we can maintain high-quality, safe care while reducing environmental harm, we’re setting a precedent for other hospitals to follow. I think this is demonstrated particularly in our work to improve air quality around the hospital and how our published ‘Clean Air Hospital Framework’ is now referenced as part of national NHS guidance.

What advice would you give to other healthcare professionals or institutions interested in starting similar sustainability projects?
My biggest piece of advice for healthcare professionals or institutions looking to start sustainability projects is to start small but think big. Sustainability in healthcare can feel overwhelming, especially when dealing with complex systems and regulations, but small, meaningful changes can have a ripple effect and lead to larger systemic shifts.

Just get started. The perfect plan doesn’t exist, and waiting for all the answers can delay meaningful progress. Even small, incremental steps can contribute to a much bigger transformation in healthcare sustainability.

Thanks to Imogen Stringer for answering our questions and Great Ormond Street Hospital (GOSH) for participating in the Born Green Generation initiative.