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With the one-year anniversary of the national “Delivering a net zero NHS” report and now COP26 there is quite rightly increased focus on the NHS’ impact on the environment.

As a clinician, the principles from the Hippocratic Oath state that doctors should “do no harm” that is a useful reminder when we consider the equipment we use and how these items are procured.

Single use plastic used in a cataract operation

Single use plastic items used in a cataract operation

As well as my role as medical director at Bolton NHS Foundation Trust I am pleased to chair the Greater Manchester Clinical Procurement Group. This group, made up of procurement professionals and clinicians from Greater Manchester hospital trusts, not only looks at ensuring clinical input into key procurements but also supports increased efforts to procure in a more sustainable way.

With over 60% of NHS carbon emissions coming from our supply chain this is not only a massive challenge but a real opportunity to reduce our environmental impact by changing some of our procurement decisions and practices.  For example, around 100 single use items are used in one cataract operation and approximately 400,000 procedures of this kind are carried out each year.

In Greater Manchester we have been looking at several projects to help us make progress.

  • We have been trialling re-usable surgical instruments(trocars used in minimally invasive surgery) that have now been adopted by one trust, with other trusts now also looking to take this idea on board.
  • Work is underway to increase our re-use of walking aids. We know many of these are discarded after the initial use but could be re-used many times.
  • We are working with a supplier to re-manufacture some medical devices. This means they are stripped down and cleaned for a second use, rather than being used once and then thrown away.
  • We have identified the top 100 single use plastic items in use in Greater Manchester’s NHS and we’re looking at options to replace them with something reusable or find recycling options.

We’re just starting out on this journey and there’s still a lot to do but we’re very excited about our continued programme of work in this area.

  • We are undertaking detailed analysis of our scope 3 spend, so the emissions we don’t directly control, to identify key areas where we can reduce emissions further.
  • Our city region will see some of the first electric HGVs in the country to support our hospitals’ laundry services.
  • High volume ordering patterns of some items will be reviewed to look at where we can switch to consolidated ordering in bulk. This will not only reduce emissions from deliveries but also reduce packaging waste.
  • Specific sustainable procurement training is being organised for procurement staff to ensure new tenders and contracts support our ambitions.
  • Further innovative products and ways of working will also be investigated and piloted where appropriate.

It’s clear to me as a clinician that we need to take responsibility for the goods and equipment that we use. We need to help promote and support changes to these items and how we use them. I believe that by working together, both clinical and procurement colleagues, we will be able to make the urgent changes needed to enable our supply chain to become net zero for carbon.

But why does this matter for a health service? Climate change presents a major threat to the health of our patients, staff and communities. By reducing our carbon emissions, we’re helping to build a greener NHS, playing our part in keeping the planet safe for future generations and ultimately saving lives.

NHS scope 3 emissions

Diagram showing sources of NHS carbon emissions


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