Technology


How digital technology can tackle waste in theatres


In England, the NHS produces around 600,000 tonnes of waste annually, costing more than £115 million to dispose of. Thomas Needs, from Incision, provides an insight into how digital technology can enable theatre teams to reduce waste, cut costs, and improve sustainability.


In a recent study, surgeons estimated that 27% of single-use items opened at the start of each procedure remain unused on the table at the end.1


This observation will be familiar to many who work in theatres, where a belt-and-braces approach to preparation takes priority above concerns over what materials might be left unused. Both environmentally and financially, however, this degree of waste comes at an enormous cost. In this article, we unpack the complex and


confronting topic of waste in the operating theatre, zooming out to assess the scale of the problem and zooming in on the initiatives of teams trying to reduce it. We present how hospitals can leverage digital tools centred around their theatre staff to help streamline workflows, increase efficiency, reduce waste, and drive changes toward a brighter, more sustainable future.


A snapshot for scale In England, the NHS produces around 600,000 tonnes of waste annually, costing more than £115 million to dispose of. Of this, 156,000 tons of clinical waste are generated by secondary care, the equivalent of 400 jumbo jets fully loaded with waste per year.2


Clinical waste is


generally treated using methods such as high- temperature incineration, which is far more energy-consuming, environmentally damaging, and expensive than general waste disposal, contributing up to 86% of a hospital’s waste disposal costs.3 Zooming in, operating theatres have a


disproportionate impact on these numbers. Theatres are estimated to be between three and six times more energy-intensive than clinical wards and are responsible for 50–70% of total hospital waste.4


In primary hip surgery,


for example, an average of 10.9 kg of waste was recorded for each procedure, working out to 1043 tonnes of waste produced annually in the NHS by these procedures alone.5


A typical


operation in the UK has a carbon footprint equivalent to driving from London to Edinburgh in a petrol car, with the major contributors to this being energy use, anaesthetic gases, and waste generated by single-use equipment.6


The rise of disposables Waste on this scale is now ingrained into our


A typical operation in the UK has a carbon footprint equivalent to driving from London to Edinburgh in a petrol car, with the major contributors to this being energy use, anaesthetic gases, and waste generated by single-use equipment


48 www.clinicalservicesjournal.com I January 2025


workflows and our culture. This is especially evident in the dramatic shift over past decades towards the manufacture and use of single- use supplies. In part, this reflects the adoption of increasingly complex surgical systems and instrumentation, which generate large amounts of waste and carbon dioxide from single-use supplies; for example, a vaginal or abdominal hysterectomy generates 280- 290 kgCO2


, a laparoscopic approach around


560, and a robotic hysterectomy over 800, with the variation due almost entirely to single-use equipment.7


However, increased


technological complexity does not explain the rise in disposable equipment, driven primarily by markets and industry supply chains. Even a simple tonsillectomy can generate over 100 pieces of disposable plastic.8


The role of reusables In addition to specialised equipment, many generic disposable items are now more common than their reusable alternatives, such as gowns, drapes, and table covers. These have been rationalised through arguments around cost, convenience, and infection prevention. Increasingly, these rationale don’t stand up to


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