Where you can make a positive impact towards net zero
Front-line AHPS should improve public health and reduce carbon impact by:
- Using remote consultation and monitoring where appropriate so that people make only essential trips to give and receive care.
AHPs in leadership or management roles should:
- Consider sustainability in the business case, approvals or design process for digital or technology designs/projects
- Play a leadership role in introducing electronic records and low/zero paper solutions to reduce waste
- Understand the carbon impact of choices on data storage, for example hosting data in low carbon efficient data centres (typically cloud or colocation) and how long data is stored for (particularly imagery and video)
- Support sustainable choices when guiding decisions about technology purchases for AHPs, for example low energy devices and promoting reuse at end of life to minimise waste.
All AHPs should:
- Embed good digital practice learned during the COVID-19 period and exploit digital capabilities to support more carbon efficient ways of working, ensuring that digital methods of communication are used where possible
- Reduce the carbon impact of digital methods of communication, for example by only sending necessary emails and keeping the size of attachments and copy lists as small as possible
- Consider remote, digital or tele-healthcare interventions in terms of improved environmental sustainability as well as access and patient experience
- Explore ways of extending the lifespan of digital technology or ensuring its appropriate recycling/reuse.
The NHS Long Term Plan sought to mainstream digitally-enabled care across all areas of the NHS. The transformations possible with technology will play a key role in the delivery of the wider net zero agenda, for example by reducing travel. The NHS must ensure that sustainability is embedded within this digital transformation agenda, and working to reduce emissions from and through digital services is also key.
Digital: “Digital” refers to a wide range of technologies that support the delivery of care, including wearable devices and remote monitoring, video consultations, electronic health records, and clinical decision support tools.
Delivering a Net Zero NHS highlights the importance of digital interventions to reduce carbon. Implementing digitally-enabled care models will significantly reduce travel and journeys to physical healthcare locations. This contributes to care closer to home, where suitable and appropriate for the patient.
Virtual treatment pathways can facilitate many sustainability benefits, including:
- Reduction or repurposing of estate footprint
- Reduced local air pollution
- Increased patient wellbeing / choice
- Time savings for the workforce.
The COVID-19 pandemic has created a rapid acceleration in virtual treatment and consultation pathways meaning that continued growth here can be expected. Important considerations remain, for example the need for pathways to be as inclusive as possible. Digital pathways can help some people, who find traditional models of care challenging, to access the services that they need, and active consideration should be given to how communities can be identified.
The net zero agenda will be supported by frontline digitisation of clinical records, clinical and operational workflow and communications aided by digital messaging, and electronic health and care record systems. Consideration should also be given to how digitisation can be done in the most carbon efficient way possible, for example through carbon efficient cloud hosting, or data and information storage approaches that share access to the same files, rather than creating duplicate records.
Greener NHS, NHS Digital and NHSX are working to ensure that the carbon footprint associated with producing, maintaining and operating digital infrastructure is as low as possible
Telemedicine: Telemedicine, defined as the use of technology to provide health services across distance, time, or other barriers.
Telemedicine has the potential to eradicate travel mileage for patients needing to attend hospital or primary care appointments. Remote consultation can also reduce the need for staff to travel into either their home base or out to satellite locations. They can choose to deliver the service from their base hospital, health centre, or increasingly from home, thus avoiding commuting related emissions.
As travel emissions account for as much as 18% of the total carbon footprint of the UK health sector, research has been undertaken to quantify the emissions reduction relating to travel. However, it is important not to disregard negative impacts of the technology used to facilitate telemedicine in terms of the cost of manufacturing, using and recycling the equipment 
Studies often focus on one specific site and calculated a CO2eq reduction depending on the geographical distribution of patients and choice of transportation  . Holmner et al. (2014) showed that replacing physical visits with telemedicine appointments resulted in a significant 40–70 times decrease in carbon emissions. They also showed that remote consultations are a greener choice at a distance of only a few kilometres when the alternative is transport by car.