Sustainability
Clinicians: The missing link in NHS sustainability NHS Carbon Footprint PLUS (GHGP Scope 3) success stories are clearly not as common as those within Scopes 1 and 2 – not because they don’t generate a significant impact, but because: 1. Clinician involvement on a wider scale has only really ramped up more recently
2. The relative ‘newness’ of some NHS Sustainability teams a. Understanding even one clinical area takes a lot of time, let alone the full scope of NHS care provided
b. Scope 1 and 2 are ‘known’ contributors with existing greener solutions e.g. integrating solar power making these more straight forward to address
Due to the specialist knowledge contained within every therapy area, without a clinical background, Sustainability teams lack the clinical expertise to therefore: 1. Identify areas for emissions reduction relating to medical devices
2. Implement medical device changes without compromising care quality
Driving clinician involvement is supported by new NHS Green Plan guidance3
released in
February 2025 mandating: “Clinical leads must be allocated and tasked to deliver at least one project that improves quality of care while reducing emissions.” This marks a turning point. Clinician engagement is no longer optional – it’s essential.
Medical device case study: preventing carbon emissions in vascular surgery Ross Lathan, Research Fellow in Vascular Surgery at Hull University Teaching Hospitals NHS Trust, compared the environmental and financial impact of treating vs. preventing surgical site infections (SSI).4 The study evaluated environmental and
financial costs associated with post-surgical care, starting after the planned discharge
Table 2
date and continuing for three months post- procedure. Costs and emissions from the initial procedure and inpatient stay were excluded, assuming they were consistent across cases. Key areas assessed for emission and cost impact included: l Follow-up reviews: evaluated time, staff (profession and grade), consumables (e.g. dressings, gloves), water use, room size, and lighting. Patient travel costs and emissions were included
l Re-admissions: additional ward days (low/ high dependency)
l Pharmaceuticals l Consumables l Further surgical procedures
For every SSI incurred, the emissions generated and cost implications from treatment ranged from: l Mild SSI: 88.7 kgCO2e / £314.65 l Deep / organ space SSI: 3,047.3 kgCO2e / £42,041.42
Environmental Cost - SSI Severity Summary Chart
Tom Wallace, Consultant Vascular and Trauma Surgeon at Leeds Teaching Hospitals NHS Trust, applied Ross’s work to a medical device project focused on prevention of SSIs. This study was a single-centre cohort study comparing two time periods; 1. July 2021-June 2022 (‘Pre-Leukomed Sorbact’) 2. July 2022 – June 2023 (‘Leukomed Sorbact’) All groin incisions for femoral artery exposure
were included, provided it was clean surgery. Infected cases were excluded. In the Pre-Leukomed Sorbact cohort, wounds
were covered with a simple film-backed island dressing, and the Leukomed Sorbact cohort received a Leukomed Sorbact dressing. No other changes were made to clinical practice during the study period, only a simple switch of post operative dressing to Leukomed Sorbact dressings. This required no change to dressing application (minimal behavioural change) and only a minor increase in cost of dressings.4-7 The results:
l SSI rates dropped from 19 (Pre Leukomed Sorbact) to 4 (Leukomed Sorbact), a 68% relative risk reduction in SSI in the Leukomed Sorbact dressing group (P=.021)
l A 97% reduction in CO2 impact was achieved,
preventing up to 21,168 kgCO2e, equivalent to 21 return flights from London to New York.6-7 l £31,080 cost saving (NICE MTG55 SSI base cost)
This project was presented at the Health Care Without Harm CleanMed Conference 2025. The talk is available to watch free on-demand on Essity’s PATH medical education platform. The efficacy of the use of Leukomed Sorbact within c-section and vascular surgery has been reviewed further in a recent systematic review. In this it was concluded that Leukomed Sorbact dressings reduced the relative risk of an SSI by 41% with a 95% confidence interval.8 Before making changes to clinical practice, it
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