A recently published study in the British Journal of Urology International sets out the ‘STEPS to low carbon care framework’ and details how it can be used to support clinical teams to increase the environmental sustainability of urological care in England.
The STEPS (Settings and Treatments, Efficiency, Prevention and System change) framework has been developed by Greener NHS to help clinicians and health service managers implement decarbonisation actions within clinical care. It integrates what is known about the carbon footprint of healthcare with known enablers for delivering transformational change in healthcare systems
For the study – entitled All STEPS count: an integrated framework for net zero urological care – authors from Greener NHS and GIRFT conducted a narrative review of the evidence base for a range of decarbonisation actions in urology. The STEPS framework was then used to categorise the actions, using the NHS in England as a case study.
The authors identified tangible actions and areas where further research was required. Evidence-based actions that support greater environmental sustainability included tackling known carbon hotspots in operating theatres (e.g. anaesthetic gases, consumables, unnecessary electricity use), one-stop clinics, day case surgery and appropriate use of virtual appointments. If implemented, such changes also have the potential to yield co-benefits in terms of financial cost, efficiencies, and patient experience and outcomes.
Key climate mitigation actions related to disease prevention were also identified. However, there was limited evidence demonstrating the implementation of climate change action as part of routine service delivery.
The authors concluded that the STEPS framework can function as a useful tool to guide further low-carbon research, innovation, and implementation within urology and across healthcare, and that translating the evidence base into low carbon care at scale and pace is essential if the NHS is going to meet its target of net zero by 2045.
The study was carried out by:
- Jamie Hyde: Greener NHS
- Eleanor King: Greener NHS
- Joseph John: GIRFT clinical fellow
- Kieran O’Flynn: GIRFT joint clinical lead for urology
- Ian Pearce: British Association of Urological Surgeons
- John McGrath: GIRFT joint clinical lead for urology
- William Gray: GIRFT’s academic content lead
- Manraj Phull: Greener NHS
