The main nitrous oxide manifold at University Hospital of Wales has been successfully decommissioned, marking a huge step in the Health Board’s commitment to reducing carbon dioxide (CO2) emissions.
Nitrous oxide is commonly used in healthcare for anaesthetics but despite being a critical part of healthcare delivery, it is considered a harmful greenhouse gas. Studies show nitrous oxide has more than 265 times the global warming potential than CO2.
There are currently four nitrous oxide manifolds across the Health Board’s sites which are the typical method of storage. Findings by a Cardiff and Vale University Health Board multi-disciplinary project team have identified wastage from this type of system can be high due to leaks and loss of gas from the supply.
The Health Board has trialled portable nitrous oxide cylinders at the Children’s Hospital for Wales as part of an individual pilot which has increased efficiency considerably, from 2.5% to 74%. This demonstrates that significant gains are to be made from moving from a piped supply to a portable cylinder supply.
Following the successful pilot, the team scaled the pilot study across the organisation through The Spread and Scale Academy, with ambitions to share insights and encourage change across Wales.
Earlier this year, the manifold at the University Hospital Llandough site was fully decommissioned. Now, only two of the four manifolds remain in use, the dental manifold at University Hospital of Wales and a manifold at St David’s Hospital. There is a project underway to explore decommissioning these remaining manifolds.
The Healthcare Without Harm Report says 5.6% of UK emissions are from healthcare settings and the NHS Wales Decarbonisation plan highlights anaesthetic gases reduction. The Health Board has projected savings of 1.15 million litres of nitrous oxide or 679 tonnes of CO2e each year which will play a huge part in making healthcare more sustainable in Cardiff and the Vale of Glamorgan and beyond.
The project group are working with Welsh Government and other Health Boards to provide support and advice to clinicians looking to implement this change – helping to reduce the use of nitrous oxide across Wales.
The next part of this project will review the use of Entonox and engage the Emergency Unit to explore using smaller cylinders. Within maternity services, the team are reviewing the effectiveness of the Entonox Carbon Reduction Units implemented earlier this year, and sharing the results across Wales.
The project team have been successful in securing Welsh Government SBRI (Small Business Research Initiative) funding and will be working across Wales with other Health Board’s and industry to develop technology to breakdown the gas ensuring it is not released into the atmosphere. Health Boards and Trusts across NHS Wales could potentially adopt this solution.
Dr Charlotte Oliver, Consultant Anaesthetist and member of the Spread and Scale Academy team for this project said, “As a team, and also personally, we found Spread and Scale incredibly valuable. It enabled our team to spend 3 days together, time we would not otherwise have found to dedicate to our project. The quality of the course was excellent and Becky was an inspiration. By the end of the three days our team had a shared vision of where our project was going and a clear work plan to follow. We felt energised and that we would be able to achieve our aims.
“We have achieved our original aims at Cardiff and Vale and we have been able to reach all the health boards across Wales to spread our success. All the health boards are now working on this project, although are at different stages with it. So, I would say that the scale up from one anaesthetic room in the Children’s Hospital to national implementation is well underway!”
Elaine Lewis, General Manager for Pharmacy & Medicines Management and EPMA Programme Lead, said, “I found Spread and Scale Academy excellent and provided an opportunity to upscale projects with a different approach and thinking. This is one of the best projects I have been part of and I think the attendance at the Spread and Scale Academy facilitated this.”
The next Spread and Scale Academy will take place in Cardiff on the 8th, 9th and 10th March. The application period is currently open and will close at midnight on 13th January 2023. Apply here.
