NHS looks to anaesthetists to reduce carbon emissions

In January 2019, NHS England published its Long Term Plan, setting out its commitments for the next ten years - including how it will deliver on the carbon reduction targets from the 2008 UK Climate Change Act.

To date, the health and social care system has kept on track, carbon-wise, achieving a 19% reduction in annual emissions since 2007 despite a 27% increase in activity. However, we are now hitting the steep part of the carbon reduction curve: the NHS 2030 target is 57% reduction from the 2007 baseline. That is a further 10.36 million tonnes/year carbon saving - from 21.54 MtCO2e in 2017 to just 11.18 MtCO2e by 2030. 

The NHS Long Term Plan states that, of this 10.36 MtCO2e saving, 2% (i.e. 0.21 MtCO2e) will be delivered through “transforming anaesthetic practices”.

So what does that mean for anaesthetics?

The NHS Natural Resources Footprint 2018 gives the carbon footprint of anaesthetic gases as 0.47 MtCO2e, in 2017. A previous report indicates that less than one quarter of this carbon impact is from use of volatile agents (desflurane, sevoflurane and isoflurane) and more than three quarters from nitrous oxide (N2O). But only one-third of N2O use is in theatres; the rest is in emergency care and obstetrics, where it will arguably be more difficult to reduce or replace.

The implication to me is that anaesthetists will need to lead on carbon reduction, and that this may require an almost total avoidance of both desflurane and N2O in theatres, as well as an increase in regional and IV anaesthesia and, in due course, volatile capture and recycling.

This is fantastic timing with the recent appointment of the first Environmentally Sustainable Anaesthesia Fellow, Dr Cathy Lawson, through a partnership between the Association of Anaesthetists, Newcastle Hospitals and CSH. Part of Cathy’s role will now be to support a “2%” task group for delivering on the LTP carbon reduction commitment from anaesthetic practice. The task group is co-chaired by the Association and SDU, and includes representation from CSH and Healthcare Coalitions. 

All help in meeting these ambitious targets will be very gratefully received!