Green Surgery Challenge

The Green Surgery Challenge 2021 was an opportunity for the UK’s surgical community to recognise the value of sustainable healthcare for surgical conditions: to share and promote ways of practising that are less harmful to the environment and our planet and build social sustainability: to continue to transform surgery for the future. Read the summary green surgery impact report here

Five teams were selected to receive mentoring from sustainable healthcare specialists at the Centre for Sustainable Healthcare over a ten-week period in order to hone a specific question, design a project, implement the project, and measure the outcomes. The teams were encouraged to use sustainable quality improvement (SusQI) methodology to create sustainable transformation.

Find out about setting up a Green Specialty Challenge in your specialty here.

The Green Surgery Challenge Teams

• Peter Labib, Bryony Ford and their team: Maximising reusable surgical instrument use, including laparoscopic ports, for a sustainable appendicectomy pathway at Derriford Hospital Trust.
• Aaron Quyn, Adam Peckham-Cooper and their team: Innovative, gasless appendicectomy procedure: lean instrument trays: reducing pre-operative urinary catheterisation: for a sustainable laparoscopic appendicectomy pathway at Leeds Teaching Hospital Trust
• Alyss Robinson, Shameen Jaunoo, Mansoor Khan and their team: Reducing blood testing in the pre-operative work-up for laparoscopic cholecystectomy at University Hospitals Sussex NHS Foundation Trust.
• Preetham Kodumuri, Prash Jesudason and their team: Reducing energy use by moving out of the operating theatre: streamlining surgical sets: reducing single-use instruments: for a sustainable carpal tunnel release pathway at Wrexham Maelor and Ysbyty Gwynedd.
• Jasmine Winter Beatty, Jonathan Gan and their team: Substituting local in place of general anaesthesia for inguinal hernia repair and introducing reusable surgical gowns at Imperial College Healthcare NHS Trust.

The teams presented their projects at the Green Surgery Conference, highlighting the environmental, social, and financial impact made. The combined projects have projected annual savings of 133.4 tonnes CO2e, which is the equivalent of 38 round-trip flights from London to Hong Kong!

What is the problem in surgery?

Climate change is having far reaching consequences for planetary health, including within the UK, and is accepted as one of the greatest threats to the health of global populations. In addition, the integrity of our environment is threatened by air pollution, plastic overuse, chemical pollution, water scarcity, soil degradation, deforestation and loss of biodiversity.  

Whilst healthcare organisations work to improve the health of populations, their day to day activities are contributing to climate change and to the impoverishment of the environment. The NHS is responsible for over one third of total public sector carbon emissions. Operating theatres contribute towards this, with energy requirements four to six times that of other hospital areas and as significant users of medical equipment and supplies.  

It’s time for powerful solutions for a sustainable surgical future

The Greener NHS campaign and NHS Net Zero Report highlight the need and opportunity for healthcare to change its activities, processes and systems to address carbon-heavy interventions. The report draws upon The Centre for Sustainable Healthcare’s decade of experience in transforming healthcare for a sustainable future. Specifically, within surgical services there are opportunities for: 

• Preventing and optimising conditions requiring surgical intervention, including peri-operative optimisation. 
• Promoting patient empowerment and patient-centred surgical services. 
• Ensuring lean surgical pathways, including identifying and avoiding unnecessary procedures or unused single-use items in surgery. 
• Promoting low-carbon alternative products and processes in surgery, including reusable instruments, maintenance, repair, and recycling. 
• Raising awareness and changing culture amongst the surgical community. 
• Partnering with other allied healthcare professionals and supporting services to achieve these aims. 

The Green Surgery 2021 Challenge Opportunity 

The challenge launched on 3rd February 2021 at an online event, hosted by the Royal College of Surgeons England (RCSEng) with Ms Victoria Pegna, co-founder of the Sustainability in Surgery working group and the President of RCSEng, Professor Neil Mortensen.  The event included:

• An introduction to green surgery from Professor Mahmood Bhutta & Sustainable Surgery Fellow, Chantelle Rizan, from Brighton & Sussex Medical School
• Information on how to get involved in the challenge by Dr Olivia Bush, Clinical Programme Director at the Centre for Sustainable Healthcare.
• Q&A.

Teams applied to enter the Green Surgery Challenge by submitting an idea for what area of the surgical pathway their team decided to focus on to make it "greener" and more sustainable...and why.  

Green Surgery Challenge Partners 

The Green Surgery Challenge is an adaptation for clinical specialties of the Centre for Sustainable Healthcare’s flagship programme, the Green Ward Competition (an award-winning clinical leadership and engagement programme to improve the environmental sustainability of healthcare). The 2021 challenge was created and delivered through collaboration between a group of supportive partners including:

• The Centre for Sustainable Healthcare 
• NIHR MedTech Co-operative in Surgical Technologies 
• Royal College of Surgeons, England 
• Royal College of Surgeons, Edinburgh
• The Sustainable Healthcare Coalition 
• Brighton and Sussex Medical School 
• The Association for Perioperative Practice

Green Surgery Challenge Funders and Sponsors 

The Green Surgery Challenge was supported by Gold Funders and Sponsors NIHR MedTech Co-operative in Surgical Technologies and Elemental Healthcare, Silver Sponsors Royal College of Surgeons England and Royal College of Surgeons Edinburgh, Bronze Sponsors the AHSN Network, Vanguard Medical Remanufacturing, and Bowa Medical UK.

Would you like to devise your own sustainable quality improvement project?

Join our next Sustainable Quality Improvement Course

This intensive course introduces health professionals and educators to the concept of ‘sustainable value’ and the ‘SusQI’ framework for integrating sustainability into quality improvement. Learning from real examples, participants explore in depth how the framework can be applied in practice to develop preventative, holistic, lean, low carbon care. The course includes 4-6-hours of multi-media self-study, a 4-hour interactive workshop and a follow-up interactive masterclass 1-2 months after the workshop to discuss projects-in-progress.  Learn more