The NHS aspires to achieve net zero direct carbon emissions by 2040. Currently its carbon footprint amounts to around 20 million tonnes of carbon dioxide emissions annually. In order to offset this amount, 7 million tonnes of waste would have to be recycled every year. Given that colleagues continue to put disposable coffee cups into a mixed recycling bin, significant cultural and systemwide change is required to achieve net zero by 2040.
Considerable progress has been made in recent years, both at the individual level and from a systems perspective. At County Durham and Darlington NHS Trust, job descriptions will describe employee expectations when it comes to sustainability and this will be a domain that is evaluated in staff appraisals. Looking at infrastructure and medical interventions, inefficient boilers have been replaced and a reduction in the use of environmentally harmful anaesthetic gases resulted in a carbon footprint reduction that equates to 326 tonnes CO2 over two years. Only 19,999,674 million tonnes to go!
Although the problem can seem insurmountable, innovations that reduce carbon emissions in healthcare have the potential to make a significant difference while improving patient care. A more sustainable system and improved patient care are goals that cannot be considered in isolation since climate change and human health are inextricably linked.
County Durham and Darlington Trust worked with Philips to identify five areas for enhancing sustainability in intensive care, an area that represents a significant proportion of the NHS Carbon Footprint. ICU discharge optimisation is an area of focus and data driven models are being evaluated to make more informed decisions about when to step patients down to a general medical ward.
The Trust is also using Rewire to help increase the intensity of stroke rehabilitation, both in the acute setting and in the community. Using Rewire to deliver community stroke rehabilitation could help to optimise how community physio- and occupational therapists spend their time. Doing so will reduce the carbon footprint of the rehabilitation team, particularly given the number of patients in the North Pennines. We are also working on a feature which reduces polypharmacy in stroke: research indicates that two thirds of stroke patients take six or more medications. Medicines are responsible for around 25% of emissions within NHS England so polypharmacy must be addressed to reach the zenith of Net Zero by 2040.
We hope that everyone will take responsibility for reducing the carbon footprint of the NHS, in the same way that everyone is encouraged to take responsibility of their health. To this end, we have scrutinised our own carbon footprint, with the aim to be carbon neutral by 2030. Rewire uses Google Cloud to host its servers and process data requests, with 85% of electricity consumed having been generated or matched with carbon-free energy. The remaining scope 2 emissions from the London data centre are neutralised by carbon offsets. We really care about this stuff and anyway, coffee tastes much better from a mug!