Surgery can take a large toll on the environment. It is resource intense in many ways: infrastructure, personnel, and consumables. Operating theatres contribute up to 25% of a hospital’s overall carbon footprint. The NHS itself contributes 6% of the UK’s total carbon footprint. Our motivation to improve matters here can fall behind the day-to-day challenges of keeping a precarious service going, in these challenging times.
There is a growing public expectation that large public sector bodies need to lead the way, owing to their climate impact. Large organisations can drift away from ‘lean’ principles. The amount of waste in the NHS is huge – be it through lights left on, inefficient heating of buildings, unnecessary opening of equipment that must then be disposed of, and the list goes on and on.
With NHS founding principles enshrining the philosophy of services ‘free at point of care’, there comes a powerful drive to provide the best care for patients without being influenced by cost (as may happen in the private sector). One consequence, however, is that NHS workers are largely insulated from the knowledge of just how much items and services cost. As such, inefficiency and intolerance of waste is not perceived as it might be in the private sector.
Things can change. From a surgical perspective, we should return to using reusable gowns, drapes, and scrub caps. Targeted changes to anaesthetic techniques can directly reduce greenhouse gas emissions. Ensuring industry works to reduce single use equipment reduces use of unnecessary non-recyclable packaging. The NHS has clout due to its size and the market it generates.
Some changes are also occurring as unintended positive benefits from otherwise negative events. The covid pandemic has hugely increased virtual consultations. The consequent reduction in car journeys is beneficial. Russia’s invasion of Ukraine, and the consequent energy crisis, is accelerating our (overdue) realisation that renewable locally sourced energy is key to security. We can all do some simple things: talk about the issue in theatre, raise reusability with company reps, think twice about disposing of waste in the correct bin, and cycle or walk to work if possible!
Consultant Neurosurgeon and Honorary Senior Lecturer, Edinburgh
Cover photo by philippe spitalier on Unsplash