Philips believes the collaboration represents a first in a multinational company working with an NHS Trust in this way, using its clinical and ‘environmental expertise in sustainability’ to identify efficiency improvements with the potential to reduce the carbon footprint of a critical care department. Working with the Trust over a six-month period, a team of nine Philips clinical and environmental specialists analysed data, interviewed clinical staff including physicians and nurses, and undertook shadowing and observation sessions on clinical workflow, supply chain and procurement, medical technology, and staff and patient experience. Philips explained: “The results have formed a blueprint to drive further change and improvement across the Trust, in line with the NHS’s overall target of being the world’s first Net Zero national health service by 2040.”
The analysis has been developed as part of an existing 14-year strategic agreement between Philips and the Trust, initially focused on support for its radiology services. Critical care was chosen as a focus area because it represents a significant portion of the NHS carbon footprint, and among the most expensive types of care.
Key areas highlighted by the team to enhance sustainable care included::
ICU discharge optimisation: optimising ICU capacity, with earlier discharge of patients no longer requiring critical care, ‘freeing up staff and equipment resource, improving health outcomes, and substantially reducing the carbon footprint associated with patient care and reducing costs’.
Reducing waste in the supply chain – including reducing the high CO2 impact of single-use items such as arterial lines –by using less, re-using, or finding alternatives.
Staff experience: driving cultural change by staff training on the latest sustainability requirements, identifying sustainability ambassadors, enabling staff to share ideas, measuring success, and recognising staff for their efforts.
Medical technology: reducing use of power, and effective management of medical equipment, switching it off when not in use, reducing waste and making savings; and reducing excessive noise – including from patient alarms which can be distracting for staff and patients;
Strategic refurbishment: reducing costs and CO2 emissions through extending the lifespan of existing buildings.
Following the analysis, the Trust has implemented a number of recommended initiatives – including staff reminders on sustainability requirements and environmental impact from activities; prevention of unnecessary waste; ensuring Personal Protective Equipment (PPE) use is appropriate to each patient, and not ‘a blanket policy’, and actively no longer treating patients as a medical issue – ‘de-medicalisation’ – as their health improves.
Dr Richard Hixson, Consultant in Anaesthesia and Critical Care Medicine at CDDFT, said: “The quality of care we provide on the unit has gone up because of the work, as well as through the direct way we serve certain groups of patients. For example, by looking at patient flow and de-medicalisation of patients, we are helping to ease demand on critical care by adjusting medication, removing monitoring no longer required, and moving patients onto new pathways, in a positive way.”