Consultant anaesthetist Dr Rebecca Sutton, at the Royal Manchester Children’s Hospital
Consultant anaesthetist Dr Rebecca Sutton, at the Royal Manchester Children’s Hospital

Manchester University NHS Foundation Trust is helping to tackle climate change, throwing the gauntlet down to its staff, asking them to think about and implement ways to reduce their carbon footprint.

The trust runs a programme known as Green Impact, it encourages teams across the organisation to change the way they do things, lessening the impact on the environment. Teams are then graded on a scale of bronze to platinum – reflecting the level of impact their change in behaviour is making.

Consultant anaesthetist Dr Rebecca Sutton, at the Royal Manchester Children’s Hospital, has helped her own team achieve Green Impact platinum status – acting as a catalyst for changes related to anaesthesia and operating theatres in her department.

Rebecca has been at the forefront of a drive to increase awareness of the environmental cost of volatile anaesthetic agents, as well as helping reduce both her department’s energy use and the amount of waste it sends to landfill.

Rebecca said: “Like a lot of people environmental issues were on my radar in my personal life, but I kept it separate from work.

“The Green Impact programme was my route in, the principles were all there, but I wanted to take them further by applying them to the operating theatre, which is a really resource intensive area in any hospital.

“It can be daunting to try and make changes in a huge organisation like an NHS trust, but if you turn that around it means there’s an opportunity to have a huge impact, especially if replicated across the organisation – small change can make a big difference.”

As an anaesthetist Rebecca has been able to question how anaesthetic gases are used. Volatile anaesthetic gases trap heat in the atmosphere, in a similar way to carbon dioxide, contributing to the greenhouse effect. Therefore, it is better to use the least amount possible, in part by using lower flows of the carrier gases.

Rebecca explained: “The environmental impact of volatile anaesthetic gases should be considered when thinking about which agent to use and how to use it – there are ways of using less without impacting on the patient.

“A simple analogy would be to say, ‘it’s like turning off a tap to save water when you’re brushing your teeth.’ It’s not about compromising patient safety but being mindful of what we’re using.”

Finding ways to reduce waste and energy have also been introduced by Rebecca and her colleagues. Some of the moves may seem simple but a change in culture can reap big rewards.

Rebecca said: “Operating theatres use lots of energy for lighting and air changing but they don’t need to be on when the theatre isn’t being used, which has been the case in the past.

“And there’s lots of waste, many things are double packed as they have to be sterile. We’ve not always been great a separating waste, though much of it can be recycled which prevents it from going to landfill – that’s better for the environment and it saves cash.”

All theatres in the department now have clearly identified domestic waste bags and staff are informed about how to properly dispose of rubbish. This move followed a pilot that resulted in the amount of rubbish going into clinical waste bags being halved – this would otherwise have found its way to landfill.

Rebecca thinks often it’s a cultural change that is needed, asking people to think more about the effect their choices have on the environment.

She said: “People sometimes view this as being restrictive but it’s more about being informed and so able to make better choices.”

Rebecca is now working to produce The Green Theatre Workbook – A Resource for Improving the Sustainability of Operating Theatres. It is hoped the document will help others across the NHS learn from Rebecca’s experience and apply the same principles to the way they work.



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