SusQI Case Study - Lean Pathway and Low Carbon Alternatives in Curette and Cautery Skin Surgery

Caroline Lloyd
Caroline Lloyd • 16 October 2023

This project was part of the 2023 Green Team Competition at South Warwickshire University NHS Foundation Trust, implemented by colleagues from our dermatology team.

Team Members:

  • Simon Tso, Consultant Dermatologist
  • Tracey Williamson, Staff Nurse
  • Mi Joo Choi, IMT1
  • Becky Seeley, GP ST3
  • Enenche Edache, GP ST3

Project Aims:

Develop a consensus on a lean pathway for curette and cautery skin surgery procedures and evaluate the outcomes of this lean pathway clinically and across the triple bottom line.

Educate dermatology staff who undertake and assist with minor skin surgery at South Warwickshire University NHS Foundation Trust about the BSDS sustainability guidance 2022 for skin surgery.



Increased awareness of the BSDS sustainability guidance 2022 and its evidence base, as well as infection control and sustainability

No impact on infection rate, indicating no increased risk of infection using the lean pathway


The switch to a lean pathway resulted in a reduction of 1.24kgCO2e per procedure. The dermatology department at South Warwickshire University NHS Foundation Trust is estimated to conduct up to 1,000 curette and cautery procedures per year, which could result in savings of up to 1,240kgCO2e each year, equivalent to driving 3,662.14 miles in an average car.


The lean pathway results in savings of £4.08 (excluding VAT) per procedure, which could lead to savings of £4,075.45 (excl. VAT) per year.


Click here for more information on the Green Team Competition (including organisation impact reports).

Resource author(s)
Tso, S; Williamson, T; Choi, MJ; Seeley, B; Edache, E
Resource publishing organisation(s) or journal
South Warwickshire University NHS Foundation Trust
Resource publication date
July 2023

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