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Sustainability in Surgery

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Because it's not just our patients who need saving.

Read our Sustainability in Surgery Strategy, launched in April 2021, which outlines how we plan to embed financial, environmental and social sustainability with ethical purchasing into everything we do. We are also working on guidance to support this work and to help our industry to meet net zero carbon by 2045, in line with the Greener NHS strategy.

Climate change is the defining issue of this decade, and it is imperative that the role of individuals and organisations is understood. The NHS contributes significantly to the UK’s CO2 production, including travel, infrastructure and waste management. Operating theatres are responsible for a major part of this.

The Royal College of Surgeons of England is a member of the UK Health Alliance on Climate Change and we will align with relevant national and international initiatives aimed at mitigating further global temperature rise and climate change, such as the UN Sustainable Development Goals

The Academy of Medical Royal Colleges (AoMRC) has provided a definition and framework for our emerging strategy:

Sustainable healthcare involves ensuring the ability to provide good quality care for future generations by balancing the economic, environmental, and social constraints and demands within health care settings. A sustainable healthcare system maintains population health, reduces disease burden and minimises use of healthcare services.

The triple bottom line framework was developed to help organisations to understand their broader impacts and consists of economic, environmental and social domains. To improve sustainability, organisations must ensure that their use of resources does not exceed available supplies, and that their impacts do not negatively affect the wider community, the environment, or future generations.

New guidance

Our new Good Practice Guide Sustainability in the operating theatre supports you to make improvements in surgical care through small, sustainable practices that maintain patient care and support environmental health. You will learn about:

  • Solid waste reduction
  • Green purchasing
  • Water conservation
  • Care pathways
  • Cultural change and surgical leadership.

Working Groups

Two working groups will guide the development and implementation of our sustainability strategy.

Sustainability Staff Group

Our staff are passionate about a greener future for RCS England. This group will lead on identifying areas to improve sustainability in day-to-day operational running, maximising opportunities in our redeveloped headquarters that will open in 2021. Details of members of this group and terms of reference are to follow.

The Sustainability in Surgery (SiS) Group 

This group was established in December 2019 to look at issues of sustainability in surgical practice, associated industries and within RCS England itself. Members of College council and staff, including the Faculty of Dental Surgery, are involved.

James Lind Alliance 

SiS Group Vice Chair Victoria Pegna, is leading The Royal College of Surgeons of England in supporting the James Lind Alliance, ‘Greener Operations’ which aims to identify and answer the most important research questions in order to help make operations (including surgery, anaesthesia, and healthcare provided around the time of an operation) more environmentally sustainable.

Articles and resources

Green Surgery Challenge

RCS England are proud partners of The Centre for Sustainable Healthcare’s Green Surgery Challenge. The 2021 challenge involved five finalists devising and implementing a quality improvement project to make surgical practice more environmentally, socially and economically sustainable, whilst maintaining or improving standards of clinical care.

Congratulations to the team from Leeds Teaching Hospital NHS Trust for winning the Green Surgery Challenge with their holistic review of a laparoscopic appendicectomy. All five teams presented innovative projects to help make surgery greener, with initiatives ranging from reusable materials to examining preoperative care. If all of the projects were continued for one year they would save a combined 133.3 tonnes of CO2e.

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