University Hospitals Plymouth NHS Trust – sustainable changes and innovation
Summary
University Hospitals Plymouth NHS Trust have been working to introduce several sustainable initiatives to improve patient experience whilst saving money and reducing the trust’s environmental impact, including recycling old X-ray film and selling extracted silver, increasing use of telephone appointments and reducing plastic packaging for lab samples.
Organisation
University Hospitals Plymouth NHS Trust (UHP) provides secondary care to around 475,000 patients, serving a diverse population of rural and urban communities with wide variance in health and life expectancy.
What was the aim/problem?
Multiple departments at UHP have been working to introduce sustainable initiatives to improve patient experience whilst saving money and reducing the trust’s impact on the environment.
What was the solution?
In UHP’s Health Records department, colleagues recognised the need to make the disposal of old X-rays, which are usually sent to landfill, more environmentally friendly. UHP’s Health Records team worked with metal company Betts, who offer a service to fully recycle old X-ray film after X-rays reach their required retention period and no longer need to be kept. X-ray film is usually made up of a silver halide crystal emulsion with a base layer of polyethylene terephthalate (PET) plastic. First, Betts collect the film from hospital sites and remove any confidential data. They then remove and refine the silver from the X-ray film and sell it on to jewellers. The PET plastic is also fully recycled. Betts pay UHP £500 per tonne net weight of X-ray film, so this partnership not only helps to reduce the trust’s carbon footprint and cut down the storage space taken up by old X-ray records, but also generates extra income.
In UHP’s skin cancer service, increases in the number of referrals were causing appointment delays. Skin cancer specialist nurses trialled nurse-led telephone clinics to reduce waiting and travel times, improve patient experience and cut transport pollution. Each patient’s suitability for telephone clinics was assessed after they had had a histology review with a consultant, and patients were given the option to have in-person appointments instead if they preferred.
In UHP’s Emergency Department, colleagues from the trust’s sustainability team worked closely with clinical and non-clinical staff to identify areas where environmental impact and waste could be reduced. The team realised that approximately one third of cannulas that were inserted were not being used. The trust introduced a cannulation education programme to make sure staff only insert cannulas in patients when it’s clinically necessary, improving patient comfort, creating cost savings and reducing wastage. The team also persuaded their canulation record booklet supplier to switch to recycled paper.
Across the whole trust, GP practices and labs have also switched from transporting samples for lab analysis in single use plastic bags, which were incinerated after use, to a sustainable racking system.
What were the results?
Since UHP’s Health Records team began working with Betts to recycle old X-ray film in 2018, approximately ten tonnes of film have been sent for recycling, generating £4000 of extra income for the trust to spend on patient care.
After six months of using telephone appointments in their skin cancer service, UHP have saved around 3.6 tonnes of CO2 emissions. Consultant time was freed up and patients were seen more quickly: waiting times for benign histological diagnoses decreased from six months to two months, whilst waiting times for malignant diagnoses dropped from three months to one. When surveyed, patients who switched to phone appointments found their consultation less stressful and more convenient. Phone appointments were also estimated to have saved around £5900 in patient fuel costs.
Before UHP’s lab packaging project, around 7-8000 samples were transported to the trust’s labs in single use plastic bags each day. By procuring a space-efficient, sustainable racking system named Indexor, the team could stop using plastic bags for samples. The racking system logs the details of each sample, speeding up sample booking-in when they arrive at the labs. The system also keeps track of sample temperature and how long samples have been in transit. Once rolled out across the whole trust, the new system is expected to save over 300,000 plastic bags, 6000kg of plastic and 43,600 kg of carbon.
Want to know more?
Contact Kirsty Wavish, Sustainability Manager at University Hospitals Plymouth kirsty.wavish1@nhs.net