In February 2019, Dr. Cathy Lawson became the first to take up an annual Fellowship in Environmentally Sustainable Anaesthesia, which has been created through collaboration between the Association of Anaesthetists, CSH and Newcastle upon Tyne Hospitals NHS Foundation Trust (NUTH).
Anaesthetics is a particularly important area for improving the sustainability of healthcare because of the impact of anaesthetic gases on climate change. Nitrous oxide and anaesthetic vapours together account for 0.47 MtCO2e or 1.7% of the carbon footprint of the NHS and social care in England. The NHS is committed to a 10.36 million tonnes/year carbon saving over the next 11 years (from 21.54 MtCO2e in 2017 to just 11.18 MtCO2e by 2030) and the NHS Long Term Plan has identified that 2% of this (i.e. 0.21 MtCO2e) will be delivered “through transformation of anaesthetic practice”.
This goal is ambitious, but what makes it achievable is that anaesthetists already have a range of clinically effective alternatives to choose from, including:
- intravenous anaesthesia as an alternative to inhalation agents
- greater use of regional or local nerve blocks, which allow patients to be operated on while awake
- discontinuing routine use of nitrous oxide alongside other gases (many anaesthetists have already done this)
- preferential use of sevoflurane over other gases, especially desflurane (which is especially damaging).
Over the course of this year, CSH is working with the Association, NUTH, the NHS Sustainable Development Unit and others to create widespread recognition of the role of anaesthetists in reducing climate change emissions, and to support anaesthetic departments and individual anaesthetists to change practice. We are also exploring how anaesthetists can lead on teaching sustainable healthcare to medical students.
People can keep in touch and connect with others working to improve the environmental impact of surgery and anaesthesia through the Sustainable Operating Theatres network.