A clinically-led programme to reduce the impact of hospital theatres on the environment has resulted in a volatile anaesthetic gas being removed from the NHS Scotland supply chain this month.
Used to put patients ‘to sleep’ during surgery, desflurane has a 14-year atmospheric ‘lifetime’ and a global warming potential 2,500 times greater than carbon dioxide.
Alert to its environmental harms, clinicians across NHS Scotland have already commenced a sustained move away from Desflurane to clinically appropriate and safe alternatives that are also better for the environment.
Stopping the use of Desflurane across NHS Scotland, with use allowed only in exceptional clinical circumstances, has already reduced harmful emissions by around 6.17 kilotonnes of carbon a year – the same as powering 1,700 homes every year.
Over the course of a year, emissions saved through the elimination of Desflurane would be equivalent to driving around the earth 740 times or driving between Glasgow and London 42,500 times.
Cabinet Secretary for Health and Social Care, Humza Yousaf said:
“Programmes like this are key to our transition to become a net-zero health service, whilst ensuring patient safety remains at the heart of every clinical decision.”
Stopping the purchase and use of desflurane is the first action for the soon to be launched National Green Theatres Programme.
The Centre for Sustainable Delivery at NHS Golden Jubilee has been commissioned to lead the programme and support clinical involvement in environmental matters at Board level.
Kenneth Barker, Clinical Lead for the National Green Theatres Programme, said:
“Theatres are high carbon and energy intensive areas that produce high volumes of waste, so reducing the environmental impact of theatres will make a positive difference toward achieving Scotland's net zero targets.
“NHS Scotland has assigned an ambitious target to be net-zero for anaesthetic gases by 2027, and removal of Desflurane is just the first step towards this. While some hospitals and hospital networks around the world have stopped using desflurane, this is the first time it has been removed from a national supply chain.
“We are delighted to work with clinical teams across Scotland and specialists in National Procurement to make this happen before the green theatres programme fully gets under way.
“Our patients always comes first but it’s great that we are now making clinically safe patient care decisions with sustainability in mind.”
Launching in the coming weeks, the 3-year National Green Theatres Programme will provide advice and guidance to support Boards to deliver a range of actions that will reduce the carbon footprint. In addition to the environmental benefits it is hoped the programme will reduce costs that can be repurposed to improve patient experience.
The Golden Jubilee University National Hospital stopped using Desflurane in June 2022.
Roddy Chapman, Consultant Anaesthetist and Deputy Clinical Director for Anaesthetics at the Golden Jubilee University National Hospital, commented:
“Desflurane was traditionally used for long cases as it has a rapid recovery, meaning patients would ‘wake up’ faster at the end of the operation, compared to previous inhaled agents like Isoflurane.
“Most general anaesthesia at the Golden Jubilee University National Hospital is done exclusively with intravenous drugs, with low fresh gas flow used to minimise the amount of anaesthetic gases used.
“Our priority continues to be providing the highest quality care using the right drugs at the right time and it is right that we do this whilst also considering our impact on the environment.”