Quick Steps That Can Improve Your Environmental Impact

12 Steps to NetZero Surgery

The College is making efforts to drive change and has a team of Sustainability Champions to raise awareness. By modifying our own behaviour, raising the issue in local spheres, and engaging in organisational efforts, we can take the next steps in improving our environmental impact.

Here are 12 ideas for environmentally friendly interventions you can take yourself, at home and in the workplace. Take your first step today!


Prevent Surgical Diseases

The most efficient way to reduce the footprint of surgery? Reduce the number of patients going to theatre through health prevention, patient education and use of procedure room, where possible.

Sustainability in quality improvement: redefining value

Graphic: C Rizan, M Reed, F Mortimer, A Jones, R Stancliffe, MF Bhutta, July 2020.


Reusable Textiles

Around 36,593,000 surgical gowns were used in the NHS in 2020. Reuseables help us cut emissions and reduce water and energy consumption. Could you introduce reusable gowns and drapes in your Trust? There are lots of UK suppliers ready to help!

Experimental statistics – personal protective equipment distributed for use by health and social care services in England


Get Active or Online

NHS and staff commuting accounts for an eighth of cars on the road and 4% of the entire NHS carbon footprint. Active travel, such as walking or cycling, is healthier for you and your patients. Can your department meetings be held online? Does your patient need in-person follow-up, or could it be virtual? Could you arrange scans during the same visit? Why not set up a one-stop clinic for your service?

Delivering a ‘Net Zero’ National Health Service


Ditch the Des and Nix the Nitrous

Desflurane is 20 times more potent than Sevoflurane as a greenhouse gas, releasing 886 kgCO2e as opposed to 49 kgCO2e per canister; one canister is the equivalent of 2,227 miles driven by an average car. Nitrous oxide also has a significant impact and contributes to destroying the ozone layer. Consider using volatile capture technology, switching to local/regional anaesthesia and checking nitrous pipes for leaks.

The environment, the gas bill and the route to sustainable anaesthesia 


Source Reusable Items

Around 32% of an operation’s carbon footprint results from procurement. Reusable items are now available. Could anything on your set be swapped for a reusable version e.g. metal kidney dishes or gallipots? How about reusable ports, refillable ligaclips or remanufactured energy devices?

Surgery and the NHS carbon footprint

Graphic: Whiting A, Tennison I, Roschnik S, Collins M. Surgery and the NHS carbon footprint. The Bulletin of the Royal College of Surgeons of England. 2020;102(5):182-5


Ask Your Industry Reps

From April 2023 all NHS tenders will require a 10% scoring value associated with social value and net-zero contributions so it’s time to get cleaned up. Ask industry reps what they are doing to tackle the climate crisis. For example, do they have recycling and repurposing schemes? Could transportation be reduced? Do they use air freight within the supply chain?

Greener NHS


Green Hats On

Treat yourself and your team to your own reusable surgical hats. This will help reduce the millions of single-use theatre hats the NHS gets through every year. If your name is emblazoned on it, you might improve patient communication, flatten the hierarchy, and boost morale too!


Rub Don't Scrub

If local policy allows, after first wash of the day, subsequent antisepsis of clean hands can be done with alcohol-based hand rub, which has a lower carbon footprint than water-based scrub, and you don’t get your scrubs soggy either! 


Lead By Example

Highlight sustainable practices outwith the theatre too. For example, bring your own cup and water bottle, avoiding single-use plastic; try reducing your meat and dairy intake; and switch off the lights and your computer at the end of the day.

Clean and Green: Saving Water in the Operating Theatre 


Gloves Off

The NHS used nearly 5.5 million single-use gloves between 2020 and 2021. Gloves are only necessary for contact with bodily fluid, non-intact skin or mucus membrane. For routine examinations, hand washing/alcohol gel will do. Cutting out unnecessary glove use can significantly reduce carbon emissions and is better for your hands and for your patients.

GOSH: The gloves are off!

Experimental statistics – personal protective equipment distributed for use by health and social care services in England


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