Wiser Carbon Neutral
We aim to develop an evidence base that can assist clinicians and policy makers to safely decarbonise healthcare, while maintaining high quality patient care.
This is an emerging area of research for Wiser Healthcare for which we are currently seeking funding
The problem
Healthcare accounts for 4-5% of global greenhouse gas emissions (7% in Australia). Around 40% of the footprint of healthcare comes from buildings (including energy, water and waste, catering and non-medical equipment). Greening hospitals by using renewable energy is vital, but alone will be insufficient as 60% of the footprint of healthcare is due to clinical care itself i.e. the tests and treatments that result from clinical decisions in relation to each individual patient. The UK leads the world in decarbonising healthcare; the NHS has cut its footprint by 26% compared to 1990 emissions. Almost all of that gain, however, has been achieved by less reliance on fossil fuels and decarbonising the UK electricity grid. Changing clinical care itself is the next, critically important challenge as further carbon footprint reductions will not be achieved without it.
Environmental sustainability is often described as a hierarchy of waste reduction: reduce (or recycle), reuse, and replace, with most attention to date being focused on reuse (or recycle) strategies. In some areas of healthcare, opportunities for reuse are limited (e.g. by infection control requirements) and replacement with lower carbon options is currently limited and will rely on future technical innovation. A major opportunity for reduction, therefore, lies in avoiding or reducing unnecessary or low value care.
Low value care confers little or no benefit and risks iatrogenic harm. As a result, it generates carbon emissions without improving health. CI Glasziou et al have shown that ~30% of healthcare is low value and 10% is harmful. CIs Barratt, Bell, Semsarian, Glasziou and AI Morton have shown low value care is widespread in cancer and heart disease. CI Buchbinder and AI Harris have found the same in the musculoskeletal (MSK) field. Research by CIs on this team is leading to practice change. Accelerating this change can significantly reduce healthcare’s carbon footprint without negatively impacting quality of care.
Recent publications
Methods to include environmental impacts in health economic evaluations and health technology assessments: a scoping review – Jake T.W. Williams et al.
The environmental impacts of healthcare are an important factor that should be considered during health technology assessments. This study aims to summarise the evidence that exists about methods to include environmental impacts in health economic evaluations and health technology assessments.
Cutting back on low-value healthcare practices supports sustainable kidney care – Scott McAlister et al.
July 2023 marked the hottest month on record, underscoring the urgent need for action on climate change. The imperative to reduce carbon emissions extends to all sectors, including health care, with it being responsible for 5.5% of global emissions. In decarbonizing health care, [...]
Integrating a climate lens into the design of education programmes for health professionals – Tara Tai-Wen Chen et al.
Climate change should be incorporated in to educational and training programmes for all health professionals to ensure they are able to urgently adapt and transition our health systems to low carbon and low waste models of care and to become climate resilient. However, [...]