NHS managers said they spend seven to eight hours a day on admin. A survey has found that nurse managers are wasting hours of their day on time-consuming admins and bureaucracy.

Sharpsmart is innovating clinical waste management to reduce unnecessary wastage. See the difference they have made in Wales below.

Aims:
Aim 1 for Inguinal hernia repair (IHR) project:
• To convert as many IHR from general anesthesia (GA) to local anesthesia (LA) as clinically
appropriate and in line with the wishes of the patient.
Aim 2 for reusable gown project:
• To replace single-use disposable surgical gowns with reusable surgical gowns in the Imperial
Surgical Innovation Centre

Asthma is the most common respiratory condition in the UK, and Asthma + Lung UK states that 5.4 million people receive treatment yearly. Inhalers are a key treatment for respiratory conditions, with approximately 60 million dispensed in England every year. However, inhalers are not always used in an optimal way, which can lead to poor disease control and avoidable deaths. Overprescribing of reliever (most often salbutamol) inhalers and under prescribing of preventer inhalers have been identified as two drivers of poor outcomes.

Inhaler emissions account for approximately 3% of the NHS carbon footprint. The propellant gases used in Metered Dose Inhalers (MDIs) are responsible for most of these emissions. Alternative options with a significantly lower carbon footprint are available and are clinically equivalent for many patients over the age of 12, such as Dry Powder Inhalers (DPIs) and soft mist inhalers (SMI).

There is an opportunity to tackle both challenges, poor outcomes for asthma and COPD (chronic obstructive pulmonary disease) and reducing carbon emissions, simultaneously, and thereby deliver high quality and low carbon respiratory care.

The move also supports improved patient choice. A study from Asthma + Lung UK (ALUK) indicated that most patients would like the environmental impact of inhalers to be a consideration in treatment choice.

Inhalers are a key treatment for respiratory conditions, with approximately 60 million dispensed in England every year. However, inhalers are not always used in an optimal way, which can lead to poor disease control and avoidable deaths.

Inhaler emissions account for approximately 3% of the NHS carbon footprint. The propellant used in metered dose inhalers is responsible for most of these emissions. Alternative options with a significantly lower carbon footprint exist, such as dry powder inhalers.

The UK has a higher metered dose inhalers prescribing rate compared with other European countries. These countries have demonstrated that safe and effective care can still be delivered using other inhaler devices.

Supporting patients over the age of 12 to consider using lower carbon inhalers, where clinically appropriate, creates an opportunity to improve patient outcomes while reducing harmful carbon emissions.

The move also supports improved patient choice. A study from Asthma+Lung UK (ALUK) indicated that most patients would like the environmental impact of inhalers to be a consideration in treatment choice.

Wyre Forest Health Partnership (WFHP) was formed from a merger of 5 GP practices and now comprises of 6 sites across Worcestershire with over 50 doctors, 200+ staff, and more than 73,000 patients. WFHP identified that, in line with the UK, they too had high prescribing rates for metered dose inhalers, and decided to act – to improve the health of their respiratory patients, while reducing their environmental impact.

Across the NHS, anaesthetic gases are commonly used as a part of everyday surgeries. These gases alone, along with analgesic gases like nitrous oxide, are responsible for over around 2% of all NHS emissions.

Amongst anaesthetic gases, desflurane is one of the most common, but also one of the most harmful. It has 20 times the environmental impact of other less harmful greenhouse gases and using a bottle has the same global warming effect as burning 440 kg of coal.

2% of the NHS carbon footprint comes from anaesthetic and analgesic practices. The NHS Long Term plan commits to lowering this by 40% by “transforming anaesthetic practices” such as using alternatives to desflurane.

Around 4% (9.5 billion miles) of all road travel in England relates to the NHS, contributing around 14% of the system’s total emissions.

Traffic in and around Oxford is often congested which causes delays for vans delivering critical and patient-specific medical supplies, such as chemotherapy drugs, antibiotics and intravenous nutrition products to Oxford University Hospital NHS Foundation Trust (OUH) sites. This unpredictability has put pressure on NHS staff to deliver treatment in a timely manner and has negatively affected patient experience. The Trust needed to find a more efficient way of getting key medical products to hospital sites and patients, that also benefitted the environment.

In 2018, one of the largest acute trusts in the UK formed when two NHS trusts in Manchester merged to create  Manchester University NHS Foundation Trust (MFT). Consequently the trust now  sees over two million visitors every year and employs over 20,000 staff, many of which travel to the trust using the city’s busy roads.

This reliance by many staff and visitors on road transport has contributed to the organisation’s scope 3 carbon emissions. Scope 3 emissions are a consequence of the activities of a company but occur from sources not owned or controlled by the company such as staff travel and procurement.

The merger of the two trusts posed several  challenges for the sustainable travel programme, partly due to the increased requirements for staff to travel between sites. Other challenges included changes in staff’s travel behaviours, availability of cycling facilities and public transport provision to some of the sites.

From sample collections for testing to patient record transfers and transporting medicines, the NHS relies on daily courier services to effectively carry out lifesaving work across the country.

This operational necessity is often contracted externally, with transport and deliveries being carried out  by diesel van-based services – ultimately resulting in additional pollution, carbon emissions and congestion (with the NHS reportedly generating a total of 3.5% of all road travel in England which is equivalent to 9.5 billion miles).

As part of its pioneering work to tackle the climate and health emergency, Newcastle upon Tyne Hospitals NHS Foundation  Trust looked at reliable alternatives which could be used for short journeys, especially within the congested city centre.

Nationally, the NHS fleet and business travel account for around 4% of the NHS Carbon footprint, but as a community trust Sussex Community NHS Foundation Trust’s (SCFT) is closer to 5.5%. Travel is a necessary part of its work in delivering care out in the community, seeing patients in their homes. A geographically diverse region means locations are harder to reach than others without a vehicle.

Travel can have a significant impact on health and environment so the trust is working hard to travel less when possible, and as efficiently as possible when it is unavoidable.