A new GIRFT study published in British Journal of Urology International could help urology teams identify ways to improve the lifetime of their flexible cystoscopes.
The exploratory study – entitled Factors associated with flexible cystoscope longevity: an analysis of supplier and health service datasets – supports GIRFT work to reduce the carbon footprint of clinical care and adds to understanding about how to manage valuable healthcare resources.
GIRFT’s first greener pathway A practical guide to decarbonising the bladder cancer care pathway was published in 2024 and included recommendations for decarbonising the flexible cystoscopy procedure for patients with bladder cancer.
Around 300,000 procedures that involve a flexible cystoscope are conducted in the NHS each year. The study looked at data for around 1,900 flexible cystoscopes produced by KARL STORZ Endoscopy (UK) Ltd which were used in hospitals in the UK between March 2019 and July 2024.
It found that the median number of uses before failure was 58. Where a higher number of uses before failure was shown, the following factors were associated:
- more recent year of use
- same-site, same-complex decontamination
- an on-site endoscopic specialist available on site
- decontamination in a dedicated endoscopy unit
- using a drying cabinet or bowl storage rather than vacuum packaging
The NHS has a significant carbon footprint, producing 4-5% of the UK’s greenhouse gas emissions, and NHS England is committed to reaching net zero carbon emissions by 2045. Developing environmentally sustainable models of clinical care is one of the key priorities to help achieve this ambition. GIRFT is working in collaboration with Greener NHS to develop greener pathways, helping to increase the efficiency and reduce the negative environmental impact of healthcare delivery in the NHS.
This study and wider work are part funded by the UKRI/NIHR funded Sustainable Health Systems Hub at University of Exeter, of which GIRFT is a key partner.
The GIRFT colleagues who authored the study are:
- Joseph John – Lead for sustainable care pathway development
- William Gray – Academic content lead
- John McGrath – Joint clinical lead for urology
- Professor Tim Briggs – GIRFT programme lead and NHS England National Director for Clinical Improvement, Elective Recovery and UEC
