The NHS is estimated to account for 4-5% of the UK’s greenhouse gas emissions, equivalent to approximately 20-25 million tonnes of carbon dioxide each year. Recognising the impact of climate change on population health, the NHS has committed to achieving net zero carbon emissions by 2045.
To support this ambition, GIRFT has developed a range of resources, including the Environmental Lessons Learned and Applied (ELLA) methodology. This provides a step-by-step approach to redesigning clinical pathways to reduce carbon emissions while maintaining or improving clinical outcomes.
Working collaboratively with patients, clinicians and scientific experts, GIRFT has already applied this methodology to develop guidance on decarbonising the bladder cancer pathway and upper urinary tract stones pathways.
Building on this work, a recently published study in the Journal of Clinical Urology highlights priority areas for the next phase of GIRFT’s net zero and sustainability programme within urology.
The authors reviewed existing literature to identify urological pathways with the greatest potential for decarbonisation. High-volume pathways, such as suspected cancer pathways and outpatient care, were highlighted alongside carbon-intensive processes, particularly those involving surgery. Robot-assisted surgery was identified as especially carbon intensive on a per-patient basis.
The findings will help shape GIRFT’s future work programme and are expected to support wider efforts, both nationally and internationally, to deliver high-quality, environmentally sustainable urological care.
GIRFT will continue to advance this work through its Greener Pathways programme, and as part of its role within the UKRI/NIHR-funded Sustainable Health Systems (SHS) Hub, based at the University of Exeter.
The study also reflects GIRFT’s ongoing commitment to developing future clinical leaders through its Clinical Fellowship Programme.
Study authors:
- Harriett Louden, GIRFT Clinical Fellow
- Tharani Nitkunan, Consultant Urologist, Epsom and St Helier NHS Foundation Trust
- John S. McGrath, former GIRFT National Clinical Lead
- Professor Tim Briggs, GIRFT Chair and NHS England National Director for Clinical Improvement and Elective Recovery
- William K Gray, GIRFT Academic Content Lead
- Joseph B. John, GIRFT Lead for Sustainable Care Pathway Development
