Manchester researchers aim to make surgical operations greener

Healthcare staff at Wythenshawe Hospital – part of Manchester University NHS Foundation Trust (MFT) – have launched a collaborative research project into how surgical care can be made more environmentally sustainable.

Supported by the Manchester University NHS Foundation Trust (MFT) Charity and run in collaboration with The James Lind Alliance (JLA), the Greener Operations Priority Setting Partnership (PSP) aims to gather views from patients, carers, healthcare professionals and the public to guide future research areas to make peri-operative practice ’greener’.

Peri-operative practice refers to healthcare before, during and after an operation – including the procedure itself – as well as consultations before an operation, and hospital care afterwards.

The project is jointly led by Wythenshawe Hospital’s Dr Cliff Shelton, Consultant Anaesthetist, and Mr David Jones, Medical Examiner and retired Consultant Surgeon.

Dr Shelton said: “While the NHS has had to respond to the immediate threat of COVID-19, climate change and environmental pollution remain very real and pressing threats to health, both in the UK and around the world. We need to take urgent action to make this better.

Healthcare itself makes a significant contribution to global warming and pollution, with the NHS alone responsible for almost four per cent of the UK’s carbon footprint. It’s estimated that each operating theatre creates around two tonnes of waste each year, and a single operation can generate greenhouse gas emissions equivalent to driving an average car for 2,000 miles.

Mr Jones added: “Last year NHS England and NHS Improvement set out a vision for the NHS to become the first national health system in the world to reach ‘carbon net zero’, where emissions are reduced as more sustainable patterns of care are developed and implemented. We hope this project will make a significant contribution to understanding how we can achieve this during and around the time of surgery, while maintaining excellent standards of care.”

Environmental sustainability is a key priority for MFT, with a strategy in place to embed sustainability across the Trust’s 10 hospital sites.

In 2020, MFT was also named Investors in the Environment ‘Natural Environment Champion’ for its work in promoting biodiversity through its green spaces and rooftop beehives.

Jennifer Strong, Senior Sustainability Officer at MFT and a member of the PSP steering group, said: “The scale and pace of the changes required to drive out carbon emissions are significant.

“We’ve led a number of green projects over the past few years. Some, such as our current £7 million energy upgrades funded via the Public Sector Decarbonisation Scheme (PSDS) are focussing on energy and efficiency improvements, while others are supporting staff learning and engagement – such as our staff Green Impact scheme, or our latest travel campaign ‘MFT Cycling Club’, which rewards staff for active travel.

Historically, there has been a lot of focus on the estate, however the challenge ahead for sustainability is how we green the way we deliver care, and we hope this project will help us to understand this further.

The JLA is a non-profit organisation which brings together Priority Setting Partnerships (PSPs) – made up of patients, carers, and healthcare professionals – on a range of areas within health and care. PSPs collectively identify unanswered questions or evidence uncertainties, to help guide future research priorities.

The Greener Operations project steering group is made up of people who represent all areas affected by peri-operative practice – including both patients and healthcare staff. It is also supported by a range of professional and charitable partners interested in sustainable healthcare, including patient groups, UK Royal Colleges, and professional associations.

Jonathan Gower, James Lind Alliance Advisor and chair of the PSP steering group, said: “Priority Setting Partnerships aim to gather a wide range of views and experiences from across different groups of people, to help decide the most pressing issues for research to look at.

With the Greener Operations PSP we’re looking to gather as many ideas as possible from people who have undergone surgery or are involved in surgical care, or even those interested in making healthcare greener, to help researchers focus their efforts into making surgical care more environmentally sustainable.

The team has launched an online survey for people to share their views, with responses forming an initial ‘long list’ of ideas. These will be prioritised in subsequent surveys, before going to a collaborative workshop to decide a final ‘Top 10’ research priorities.

Bob Evans, a public representative on the steering group, added: “In all walks of life, we are urged to have less impact on the environment. In the same way, we want your help to identify the priority issues for making operations more environmentally friendly. Taking a few minutes to respond to our survey could really help make an impact.”

Another member of the steering group, Becky Knagg, is chairperson of the Bay-Wide Maternity Voices Partnership. She added: “As an advocate for women who use maternity services and their families, I am really pleased to be involved in this priority setting partnership. I look forward to seeing the impact this project will have on the sustainability of surgery in the future.”

John Hitchman, a public representative member, added: “I commend the team for their ground-breaking work in sustainable healthcare. There are so many pressing environmental issues to pursue, but by making ‘greener operations‘ a priority, they fulfil both patient and public aspirations. I am proud to play a small part in this valuable research.”

The survey will remain open until August 2021, with the team looking to finish the project by the beginning of 2022.

For more information on the project, visit the Greener Operations webpage, or follow latest updates on Twitter at @SusPeriopPSP.