Environment and sustainability
The College is committed to embedding sustainability in everything we do.
It is widely accepted that current use of global resources is not sustainable without compromising the wellbeing of current and future generations. Therefore, the College and anaesthetists must minimise the environmental impact of our lives and work.
The Lancet Report 2015 suggested that addressing climate change is the greatest opportunity to improve global health. Man-anthropomorphic CO2 and other greenhouse gas emissions are significant drivers of climate change. The NHS contributes significantly to the UK’s CO2 production, with estimates suggesting as much as five per cent of CO2e based on estimates for NHS procurement, staff and patient travel, infrastructure and waste management.
Modern anaesthetic gases are expelled into the atmosphere and contribute to climate change. They also represent five per cent of the carbon footprint for all acute NHS organisations, with the carbon footprint of anaesthetic gases estimated to be 0.47 MtCO2e. Less than one-quarter of this carbon impact is from use of volatile agents (desflurane, sevoflurane and isoflurane) and more than three-quarters from nitrous oxide (N2O). A third of the N2O use comes from theatres, with the remaining two-thirds from use in obstetrics and emergency care. The global warming effect of volatile agents differs by a factor of 20. At one litre FGF a MAC-hour of the more potent sevoflurane has a CO2e of 1.1kg CO2e compared with 73kg for desflurane, the equivalent car travel being eight vs 487km.
The Trustee Lead and the Environmental Advisors, ensure that the College aligns itself with relevant national and international climate change initiatives related to anaesthesia and the wider NHS, including being a member of the UK Health Alliance on Climate Change.
The College is already committed to promotion of sustainability through our Strategic Plan 2022–2027, our Sustainability Strategy 2019–2022, and the Joint Environmental Policy Statement with the Association of Anaesthetists. We support implementation of initiatives which align with our College strategy of perioperative care, and promote efficient and cost-effective use of healthcare resources whilst reducing variability of care and improving patient outcomes.
Guidance
- NHS England guidance: desflurane decommissioning and clinical use
- NICE desflurane evidence summary
- Consensus statement on the removal of pipeline nitrous oxide in the UK and Ireland
e-learning
Blogs, articles and webinars
- A new role for anaesthetists in environmentally-sustainable healthcare
- Anaesthetic gases, climate change, and sustainable practice
- NHS looks to anaesthetists to reduce carbon emissions
- Sustainable practice – everybody’s business?
- A more sustainable NHS
- The Climate Change Act 2008 (RCoA Bulletin 2019;113:34-35)
- Plastic recycling in the operating theatre, working towards a circular economy (RCoA Bulletin 2015;92:32-34)
- Polyvinylchloride, phthalates and packaging (RCoA Bulletin 2014;86:29-31)
- The environment, the gas bill and the route to sustainable anaesthesia (RCoA Bulletin 2013;82:39-41).
Other resources and organisations
- The Lancet Countdown on Health and Climate Change - Policy brief for the UK
- Sustainable Development Unit
- UK Health Alliance on Climate Change
- Centre for Sustainable Healthcare
- Association of Anaesthetists’ Environment and Sustainability Committee.
Dr Helgi Johannsson, RCoA Vice-President and Sustainability Lead
Lucy Brooks, RCoA Environmental Advisor
Li Fang, RCoA Environmental Advisor
Mary Slingo, RCoA Environmental Advisor
Paul Southall, RCoA Environmental Advisor
The College will align itself with relevant national and international initiatives aimed at mitigating further global temperature rise and climate change. We will aim to minimise the environmental impact of our work as an organisation and move towards achieving the ISO 14001 standard.
