It is such a challenging time within the hospital. The current round of budget cuts combined with the new framework for the NHS that is in pipeline makes Derriford Hospital a forbidding place in which to work. But then this came up: Derriford Hospital is working on its sustainability policy. How does a hospital of this size even start to become sustainable. Surely the priorities are medical not environmental? But then if you go back to the foundations of modern medicine, to Hippocrates (whose name persists in, amongst other things, the doctors’ Hippocratic Oath) and his text entitled Airs, Waters and Places you are met with this opening sentance: “Whoever wishes to investigate medicine properly should proceed thus: in the first place consider the seasons of the year…then the winds…then…the qualities of the waters…” Jump forward to now and you have the NHS, that is the Natural Health Service, part of the NHS’s website dedicated to sustainability. And so the circle turns. Maybe I am looking in the wrong direction at the moment; maybe it is outwards that I should be looking, focussing on the hospital in its environment.