Driving Round in Circles

Andy Connor's picture

Between March 31st 2008 and April 1st 2009, the renal team in a DGH not too far from me requested that their patients attend the hospital's radiology department as outpatients on 534 occasions (although sometimes, of course, the patients had more than one test done on the same day).

With the help of GoogleMaps and the patients' postcodes, and assuming that they travelled to and from their homes, I reckon that these patients clocked up around 25401 kilometres in attending these appointments.

The average distance for a one-way journey was 24 km. The National Travel Survey tells us that journeys of this length, within the UK, are undertaken by car (88% of the time), bus (3%), train (8%) and other (1%).

If we combine those figures with the DEFRA conversion factors of 0.20487 kgCO2eq/km for an average car, 0.10462 kgCO2eq/km for a bus, and 0.06113 kgCO2eq/km for a train, we find that carbon cost of all this travel was 4783.5 kgC02eq - ie nearly 5 tonnes of CO2 per year.

So just the travel, by just the outpatients, from just the renal team, in just one hospital, to just their radiology appointments, produces enough CO2 to fill up 5 large detached houses each year. In the same way that clinicians shouldn't have to think about the financial cost of a treatment on an individual patient basis, I don't think we should be thinking about the carbon cost of the interventions we organise as we book them. But you can see that if we want to reduce the emissions related to kidney care, we must find ways to integrate these considerations into the policies and patient pathways that determine how we provide kidney care nationally.



And the answer?

Anonymous's picture
This seems to me to prompt a few questions - and possible 'solutions'. I'm sure the questions are obvious to anyone reading this, but does anybody know the answers? - In how many of these cases would it have been possible, in theory, for the patient to go immediately from the consultation where a radiology referral was made, to have whatever scan/X-ray was needed? ie - was there any preparation (eg fasting) that would preclude this? - Every hospital must have the capability to perform 'urgent' scans on demand. What would be the implication if all referrals that could be, were treated as urgent and done on the spot? My guess is that it must be possible to predict roughly how many referrals are likely to come from each clinic, and to plan for corresponding radiology facilities to be manned and ready at these times. If this were to happen, it wouldn't just be transport time/cost/Co2 that is saved, but also from reduced letter writing, reduced DNA, as the patient would already be on the spot, reduced admin time in planning. booking, then rebooking appointments. Does anything like this happen anywhere already? Has the comparison been carried out? Andy Williamson Vice Chair - Guy's and St Thomas' Kidney Patients' Association

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