Key questions for green surgery

The intention of project and report is that the recommendations be distributed to all surgical teams in the UK (and internationally) with a plan for implementation. The project has support from national and international surgical bodies and organisations.

The scope of the Green Surgery Project involves collaboration from an Oversight Committee, made up of a multidisciplinary team of stakeholders including representation from the surgical colleges, surgical specialties, hospital department representatives, patient and industry representation. The Project Team and Oversight Committee meet quarterly to agree on the scope of the Green Surgery Project. The aim of the Oversight Committee is to provide health care professionals with the tools required to change the impact of surgical care pathways through the recognition, understanding and development of the relationship between climate breakdown and delivery of surgical care. Further, the Green Surgery Project Team also meet monthly to steer development of the report and consists of the UK Health Alliance on Climate Change, Brighton and Sussex Medical School, the Centre for Sustainable Healthcare, Professor Jennie Wilson, Infection Prevention and Control, and Dr Jasmine Winter-Beatty, Royal College of Surgeons of Edinburgh.

Phase 1 of the Green Surgery Project is complete including a report update to the Health Foundation. This phase involved development of the Project Team, Oversight Committee, and the project aim and scope. The structure of the report has also been agreed by the Oversight Committee. These papers can be viewed here. Phase 2 is underway and involves exploring literature, gathering evidence, identifying knowledge gaps and key questions.

As anticipated, many knowledge gaps for greening surgery have been identified including facilitators and barrier to behavioural change in greening surgery; quantification of effects on cost associated with environmental savings in surgery and associated hospital departments, and evidence to support the rationalising of diagnostic care in a surgical care pathway, e.g., perioperative blood testing.

Bearing in mind the scope of the report, four key questions have been carefully identified following feedback from the Oversight Committee. These key questions support and align with Net Zero NHS, Greener NHS and the NHS Long Term Plan objectives, aiming to drive action in reducing carbon footprint.

The first key question aims to contextualise, frame and approximate the carbon emissions attributed to NHS surgical care and its proportion to the NHS carbon emissions. The second key question aims to identify how alternative models of surgical care affect carbon footprint and clinical outcomes, for example, the management of abbesses with antibiotics. The third key question will aim to identify what role digital care plays within the surgical care pathway. And last but by no means least, the fourth key question aims to identify what the opportunity is for reducing diagnostic testing within surgical care e.g. histology specimens.

If you have any queries regarding the Green Surgery Project and Report, please contact Melissa Pegg, Fellow in Sustainable Surgery for the UK Health Alliance on Climate Change: melissa.pegg@ukhealthalliance.org.

By Melissa Pegg, Fellow in Sustainable Surgery

The Green Surgery Project, supported by the Health Foundation involves key stakeholders from national institutions, aiming to produce an evidence-based guide and recommendations on how to mitigate the carbon footprint associated with surgical practice. The intention of project and report is that the recommendations be distributed to all surgical teams in the UK (and internationally) with a plan for implementation. The project has support from national and international surgical bodies and organisations.

The scope of the Green Surgery Project involves collaboration from an Oversight Committee, made up of a multidisciplinary team of stakeholders including representation from the surgical colleges, surgical specialties, hospital department representatives, patient and industry representation. The Project Team and Oversight Committee meet quarterly to agree on the scope of the Green Surgery Project. The aim of the Oversight Committee is to provide health care professionals with the tools required to change the impact of surgical care pathways through the recognition, understanding and development of the relationship between climate breakdown and delivery of surgical care. Further, the Green Surgery Project Team also meet monthly to steer development of the report and consists of the UK Health Alliance on Climate Change, Brighton and Sussex Medical School, the Centre for Sustainable Healthcare, Professor Jennie Wilson, Infection Prevention and Control, and Dr Jasmine Winter-Beatty, Royal College of Surgeons of Edinburgh.

Phase 1 of the Green Surgery Project is complete including a report update to the Health Foundation. This phase involved development of the Project Team, Oversight Committee, and the project aim and scope. The structure of the report has also been agreed by the Oversight Committee. These papers can be viewed here. Phase 2 is underway and involves exploring literature, gathering evidence, identifying knowledge gaps and key questions.

As anticipated, many knowledge gaps for greening surgery have been identified including facilitators and barrier to behavioural change in greening surgery; quantification of effects on cost associated with environmental savings in surgery and associated hospital departments, and evidence to support the rationalising of diagnostic care in a surgical care pathway, e.g., perioperative blood testing.

Bearing in mind the scope of the report, four key questions have been carefully identified following feedback from the Oversight Committee. These key questions support and align with Net Zero NHS, Greener NHS and the NHS Long Term Plan objectives, aiming to drive action in reducing carbon footprint.

The first key question aims to contextualise, frame and approximate the carbon emissions attributed to NHS surgical care and its proportion to the NHS carbon emissions. The second key question aims to identify how alternative models of surgical care affect carbon footprint and clinical outcomes, for example, the management of abbesses with antibiotics. The third key question will aim to identify what role digital care plays within the surgical care pathway. And last but by no means least, the fourth key question aims to identify what the opportunity is for reducing diagnostic testing within surgical care e.g. histology specimens.

If you have any queries regarding the Green Surgery Project and Report, please contact Melissa Pegg, Fellow in Sustainable Surgery for the UK Health Alliance on Climate Change: melissa.pegg@ukhealthalliance.org.