Sustainable theatres
Driving sustainability in the operating theatre
The role of perioperative practitioners in driving sustainability in operating theatres is key to reducing the impact of healthcare on the environment. The AfPP Oxford Regional Conference recently explored both the scale of the problem, and the practical solutions perioperative practitioners can adopt.
Climate change is no longer a distant concern; it is a pressing global emergency with real and devastating consequences. Rising sea levels, more extreme weather, biodiversity loss, and escalating health crises are among the stark warnings we face. For healthcare, the challenge is particularly acute. The NHS alone is responsible for 5.4% of the UK’s carbon footprint, with surgery and anaesthesia among the most carbon-intensive activities. Perioperative practitioners are uniquely positioned to help change this picture. Their daily decisions, from anaesthetic choices to equipment use, have a direct impact on sustainability in operating theatres. The Association for Perioperative Practice (AfPP) is at the forefront of guiding and empowering the profession to act, most recently through its support of the updated Green Theatre Checklist, developed with the Surgical Royal Colleges and partner organisations. In a recent session led by Nicola Stroud,
Senior Operating Department Practitioner (ODP) at Colchester Hospital, Lead Clinical
Practice Facilitator for Perioperative Projects with the University College London Hospitals (UCLH), Editor of the AfPP Innovation, People and Practice (IPP) magazine, and former AfPP Sustainability Special Interest Group Lead, delegates at the AfPP Oxford Regional Conference explored both the scale of the problem and the practical solutions perioperative practitioners can adopt. “Climate change is very real, and we just have
to look at the news to see how the effects of it are changing our world,” Nicola emphasised. “It is important healthcare practitioners understand how their own practice could be contributing to climate change and the implications of letting that continue.”
Understanding the impact The session began by grounding practitioners in the science of climate change. Since the 1800s, human activity has been the primary driver of global warming, with 2024 confirmed as the hottest year on record. Last year the global temperature rose 1.5°C above pre-industrial
levels for the first time - the critical threshold identified in the Paris Climate Agreement. If we don’t do anything, we are currently on track to go beyond four degrees. The effects on health are stark: unabated
climate change is predicted to cause 3.4 million deaths per year by the end of the century, through extreme heat, worsening air quality, spread of infectious diseases, food insecurity, and displacement of vulnerable populations. For theatres, the numbers are eye-opening. A single operation produces the same carbon emissions as driving 450-600 miles in an average petrol car. The majority of this comes from anaesthetic gases, single-use consumables, electricity use, and waste. “A typical operation might not seem like much, but when you multiply that across millions of procedures each year, the impact is enormous,” Nicola explained. “This is why it’s vital that we, as perioperative practitioners, take responsibility for reducing the carbon footprint of surgery wherever possible.”
Practical actions in theatre Nicola’s session highlighted practical and achievable changes practitioners can embed into everyday practice. These actions are not abstract, they are immediate, tangible, and proven to reduce environmental impact while often improving efficiency and saving money. l Reducing glove use: With 1.4 billion gloves used annually in the NHS, questioning whether gloves are always required is critical. Initiatives like the Gloves Off campaign encourage staff to re-think usage, particularly for low-risk interactions where thorough handwashing is equally safe.
l Optimising electricity use: Theatres are energy-hungry environments, with heating, ventilation, and air conditioning (HVAC) systems contributing to 60-70% of their carbon footprint. Simple actions such as ensuring lights, computers, and ventilation systems are switched off when not needed
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www.clinicalservicesjournal.com I December 2025
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