Prescribing Change: How Frome Medical Practice is Putting Sustainability at the Heart of Primary Care

For Karen Creffield, Managing Partner and PCN Manager at Frome Medical Practice, sustainability isn’t a project or an initiative – it’s a way of thinking. Since joining the practice in 2017, Karen has spent nearly a decade weaving environmental responsibility into every corner of how Frome operates, from the medications it prescribes to the food served at staff meetings.

Frome is a single-site practice and Primary Care Network serving around 30,000 patients in Somerset. It was among the first practices in the country to declare a climate emergency – a distinction that reflects the practice’s deep roots in a community that takes these issues seriously. Frome Town Council was itself the first council in the UK to make such a declaration, and that shared commitment has shaped a strong local partnership ever since. That shared commitment has also opened doors – including funding through the National Lottery Climate Action Fund in partnership with Frome Town Council and Edventure, which has given the practice the opportunity to deepen its sustainability work in ways that wouldn’t otherwise have been possible.

Planet, People & Pocket

The practice’s approach to sustainability is guided by a simple but powerful framework: decisions should be good for the Planet, good for the People, and good for the Pocket. It’s a philosophy that has delivered some striking results. A focus on reducing medication waste, particularly looking at how, as a practice, repeat medications were managed, has saved the NHS nearly £280,000 in a single year, while simultaneously cutting 122kg of CO2-equivalent emissions and improving patient outcomes. The practice has also undertaken a wide range of deprescribing in areas including supplements, anti–depressants, gabapentinoids and switches to much lower-carbon dry powder inhalers. Changes to lighting alone are projected to save over £20,000 and 22,000kg of CO2-equivalent across ten years. A review of waste management, including removing personal bins and streamlining collections, reduced monthly collection costs by around 30%.

“When you do the right thing for the patient, it is so often the best thing environmentally too and often ends up saving money. Bringing sustainability into your decision making simply means widening the lens through which you look at everything.”

That lens now extends far beyond clinical decisions. Frome has invested in a staff wellbeing garden, with 85% of staff reporting they felt more connected to colleagues as a result, and 72% saying it positively impacted the quality of care they delivered. The practice holds a local and fairtrade food policy, purchasing only fairtrade tea, coffee and sugar, and rewards staff with vouchers from local businesses. In 2025, the practice was named GP Sustainability Team of the Year – recognition of a journey that has been slow, steady, and deeply embedded in the culture.

Values in Common

This commitment to doing things differently is part of what drew Frome Medical Practice to Simpkins Edwards. When the practice reached a natural review point after five years with their previous accountants, they looked for a firm whose values they could genuinely share. An already-established connection with Jenna Clark, Director of Healthcare, provided an initial introduction, but it was the firm’s broader approach that sealed it – in particular Simpkins Edwards’ own sustainability credentials and the willingness to show up in the community. That commitment to sustainability isn’t just a stated value; it is evident in the firm’s own choices, from working with stand builders at events to create reusable exhibition stands that minimise waste, to making conscious decisions around branded materials.

“Knowing that sustainability was a core value for Simpkins Edwards was one of the things that really attracted us to working with them. It felt like a natural fit from the start.”

Day to day, the team supports Frome with everything from annual compliance and working closely with the finance manager, to helping partners with personal tax planning – a breadth of expertise that gave the practice confidence they had found the right fit.

That shared ethos has been felt in practical ways. One of the Simpkins Edwards’ team volunteering days last year was spent at Frome, out in the community, meeting patients, taking part in the day-to-day life of the practice. For Karen, moments like that matter more than a polished service offering.

“It’s the people that make the difference. The relationship we have built with the team at Simpkins Edwards has been genuinely strong – and that matters enormously to us.”

In a sector as demanding as primary care, finding partners who genuinely understand your values – not just your accounts – makes all the difference. At Frome Medical Practice, sustainability isn’t just where their focus goes, it’s who they are.