A landmark report published today (14 November 2023) presents the first detailed account of how to reduce the environmental impact of surgical care while maintaining high quality patient care and potentially saving the NHS money.

In the UK, surgical care is responsible for the equivalent of about 5.7 million tonnes of carbon dioxide emissions each year - equivalent to that from heat, electricity, transport and waste of 700,000 UK homes.

Reducing the emissions produced during surgery would be a significant step towards the NHS achieving its aim to be net zero by 2045. The report shows that solutions are available and in many cases could result in better options for patients while at the same time costing the NHS less.

Reducing and reusing products used in surgery, shutdown checklists for operating rooms to save energy when they are not in use, switching to less harmful anaesthetics, and surgeons and patients working together to optimise their treatment are all highlighted as ways in which carbon emissions could be reduced.

The report highlights a number of successful initiatives that have already been implemented. For example, a team at Imperial College Healthcare NHS Trust successfully reduced both carbon dioxide emissions and cost by switching from general to local anaesthesia for some procedures, and from disposable to reusable surgical gowns.

The report, which involved collaboration across multiple organisations involved in different aspects of surgical care, was produced by the UK Health Alliance on Climate Change, Brighton and Sussex Medical School and the Centre for Sustainable Healthcare.

Professor Mahmood Bhutta, Consultant ENT Surgeon and Professor of Sustainable Healthcare at BSMS, chaired the committee leading the project. Speaking about the publication, he said: “We know that staff in the NHS, including surgical teams, are keen to reduce the environmental impact of the care they provide. We hope this report will provide them with a roadmap and tool to support them on that journey. Providing surgical care and protecting the planet, can and should go hand in hand.”

Dr Richard Smith, Chair of the UK Health Alliance on Climate Change said, “The climate crisis is the major threat to health. The harm is already here and increasingly visible to everybody with fires, floods, storms, and heatwaves, although these are only some of the ways that climate change harms health. The world must do everything it can to reduce emissions of greenhouse gases, which means change at every level from the global to the personal, including in health systems and surgical practice.”

“This report assembles all the current evidence and is filled with recommendations, some of them easy to implement, others more difficult. Although the report has been produced primarily with the UK in mind, there is much that will be useful to surgical teams everywhere. Nobody knows how to achieve net zero in surgical practice, and the report makes clear that much more research and innovation will be needed. We need urgently to improve funding for getting all of health care, including surgical practice, to net zero, and we need to provide training and career paths for researchers.”

Dr Chantelle Rizan, Clinical Lecturer at BSMS and an expert in sustainable healthcare, was Academic Chair and a leading author on the report. Dr Rizan said, “We are developing a growing body of research that provides an evidence-based strategy for how we can reduce the environmental impact of surgical care. Now it is time to translate that research into real-world action, and to drive the transition to sustainable models of high quality patient care. We must build on win-wins, where there are co-benefits for patients, the environment, and the public purse.”

Read the report here >