The first net zero operation has been conducted by surgeons in the NHS ­– with the patient safely recovering from a keyhole procedure to remove a bowel cancer

Involving surgeons, anaesthetists, nurses, cleaners, porters, and managers, the first net zero operation was completed by a surgical team at University Hospitals Birmingham NHS Foundation Trust.

Currently, the NHS contributes 6% of the UK’s total carbon footprint, and operating theatres make up as much as 25% of hospitals’ contribution, despite less than 5% of hospital inpatients undergoing surgery.

Collaborating with University of Birmingham experts, the net zero operation was performed at Solihull Hospital, combining evidence-based approaches and documents using a carbon output calculator developed specifically for this task by experts.

COP26 targets can’t be achieved without making healthcare more sustainable

The operation, led by Dr Dmitri Nepogodiev, used the carbon output calculator to estimate the reduction in carbon output for the operation compared to the usual output.

Overall, it was estimated that the carbon output was reduced by almost 80%, with the remaining output then offset through a variety of verified carbon offsetting projects, including the planting of trees on the grounds of Solihull Hospital.

This brought the total carbon output for the operation to net zero.

“I would want my operation in a hospital that cares about the environment, showing its commitment to patients and public health.”

UHB Consultant Surgeon and Senior Lecturer at the University of Birmingham Mr Aneel Bhangu said: “Operating theatres are resource-intensive environments, contributing to 25% of the Trust’s carbon output. We cannot achieve net zero health systems without making surgery more green, so this is a vital proof of concept step.

“Ensuring healthcare is environmentally friendly is important to patients and communities. These measures require changes in behaviour and care pathways across complex teams. We now hope to work with colleagues across the UK to create a wider impact across the whole NHS.”

What changes have been made from normal operation practices?

The changes made during this net zero operation were starting points for a much more sustainable NHS, including initiatives like using reusable gowns, drapes, and scrub caps, giving medications through the veins for general anaesthesia rather than anaesthetic gases, which have a strong greenhouse effect and recycling single-use equipment used in surgery.

Additionally, the team implemented a plan for minimising electricity use, including heating and lighting, and recycled ‘clean’ paper and plastic waste as well as used individually packed equipment, and only opened items as they were required.

One initiative even included one consultant surgeon who ran to the hospital and another that cycled there.

Patient advocate and research involvement lead Dr Lesley Booth CBE said: “Reducing the environmental impact of surgery is hugely important to improving health more broadly. We know that climate change and air pollution have wide impacts on health, many of which aren’t measurable until years to come.

“I would want my operation in a hospital that cares about the environment, showing its commitment to patients and public health.”


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