Practical tips for making healthcare systems more sustainable

Reviewed by Lily Ramsey, LLMNov 6 2023

Cutting nitrous oxide waste in hospitals, switching to reusable vaginal speculums for cervical screening, and prescribing tablets over intravenous drugs are just some of the tangible actions doctors can take to reduce the carbon footprint of healthcare.

If global healthcare were a country it would rank fifth in the world for greenhouse gas emissions. A new series launched by The BMJ today offers a range of ideas, with practical tips on making healthcare systems more sustainable.

Each article details one action or project that frontline clinicians can implement, backed by a rapidly growing evidence base, to reduce the carbon footprint of their work.

Readers can also use a linked interactive tool to find actions relevant to their own role and workplace.

"The climate crisis is a health crisis, and healthcare professionals are on the frontline," write Florence Wedmore and colleagues in an editorial to launch the series. "Clinicians want to know how they can help slow this crisis and we aim to showcase solutions that are within the power of individuals."

Previous studies show that carbon can be saved by switching asthma patients to dry powder inhalers, replacing single-use face masks with reusable options of equivalent protection, and changing prescribing habits, which also saves money and reduces harm to patients.

Other achievable actions linked to lower greenhouse gas emissions include:

• Using smaller or fewer pre-packed surgical trays during operations to avoid re-sterilising unused instruments

• Switching from single use plastic speculums for cervical screening to reusable stainless steel versions

• Choosing oral over intravenous medications to reduce the impact of manufacturing, using, and disposing of equipment and packaging

• Changing the dose and frequency of iron supplements in line with the latest recommendations to benefit patients and help mitigate environmental harms

• Reviewing nitrous oxide loss and waste to help cut consumption in hospitals

"The BMJ has long recognized the seriousness of the climate emergency, and campaigned to cut carbon emissions within healthcare and beyond," say Wedmore and colleagues. "That campaign is now shifting towards concrete actions that healthcare professionals can and must take in response to this emergency.

"We hope the new series will help many more clinicians realise the benefits of more sustainable healthcare for patients and the planet."