Surgery accounts for up to 70% of NHS waste. We can safely reduce that.

Surgical teams are the biggest producers of waste in the NHS but initiatives including the safe reuse of equipment can significantly reduce the amount of equipment that is considered single use only, a new report shows.

The National Institute for Health and Care Research (NIHR) Global Surgery Unit, based at the University of Birmingham, is hosting a major one-day conference on ‘green surgery’. During the conference, University of Birmingham academics are launching a new report on how operating rooms around the UK can reduce the estimated 156,000 tonnes of medical waste produced each year.

While most waste is a necessary part of performing life-saving and life-changing surgeries each day, the Unit’s report highlights how surgical teams in NHS trusts have used innovative, evidence-backed ways to safely reuse or reduce waste.

The report includes case studies of hospitals around the UK which have implemented sustainable practice in operating theatres and surgical practice. Examples include Leeds Teaching NHS Trust which rationalised surgical instrument trays for common procedures, saving the department £22,000 and cutting up to three tonnes of CO2 emissions each year.

Professor Aneel Bhangu, Professor of Global Surgery and Surgical Systems in the NIHR Global Surgery Unit at the University of Birmingham said: “Our report highlights the will, the need and the way forward to make surgery greener here in the UK. Examples from around the country show how innovation is leading to environmental and financial benefits for the NHS – all while maintaining the highest standards of safety and quality.”

The report also includes data from a representative survey of hospitals from around the UK, with 39 hospital trusts taking part. They found:

• There was considerable variation in waste segregation across different hospitals, with half (50%) of those surveyed using black, orange, and clear bags, which are sent directly to incineration or landfill. Only 30% were using yellow and black striped ‘tiger’ bags for non-hazardous hygiene waste, despite environmental and financial benefits,
• 30% of respondents were unsure of correct waste collection methods, leading to incorrect disposal and unnecessary environmental impact,
• 90% would like to see more sustainable measures for disposal of waste, with many respondents citing that they already segregate different kinds of waste at home for recycling purposes and would be open to doing so at work, and
• However, only 30% were aware of any waste management initiatives in their theatres and, less than half would know who to speak to about it.

The report also sets out policy recommendations, which include the publication of new guidance on the safe reuse of equipment in surgical settings, and support for Trusts and clinicians to understand new guidance on sustainable practices in surgical waste management.

The Green Surgery team based in the NIHR Global Surgery Unit produced the report. This team is delivering high impact, pragmatic research in environmentally sustainable surgery, as well as raising awareness on the urgent need for sustainability in healthcare with dissemination events and training courses. The work has been funded by the NIHR Programme Grant on Developing environmentally sustainable operating theatres.