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The Carbon Emissions of Clinical Activities by Speciality in Secondary and Tertiary Care in England
Background: The National Health Service (NHS) in England was the first healthcare system in the world to commit to achieving net zero carbon emissions. A key early step in this journey is to understand where opportunities to decarbonise healthcare exist. The aim of this paper is to use available activity and emissions intensity data to investigate the carbon emissions of different specialty-level clinical activities in secondary and tertiary care in the NHS in England.
Methods: This was a carbon quantification analysis using administrative data from secondary and tertiary care in the NHS in England. We included data for all patients attending hospital in England during the financial year 2022/23. The Hospital Episodes Statistics (admitted patient care and out-patients) dataset and Theatre Productivity Data Collection were used. Carbon factors were taken from published sources and linked to activity volumes to quantify the carbon emissions at a clinical activity level.
Findings: Data for 17,024,278 hospital admissions and 101,973,593 out-patient attendances were analysed. Out-patient activity accounted for 45% of the measured carbon emissions. Of the remaining 55% relating to admitted patient care, emergency admissions accounted for 45% (82% of admitted patient care), in-patient elective activity 7% and day case activity 3%. The top 20 clinical specialties accounted for 79% of the carbon emissions, with general internal medicine, trauma and orthopaedics and general surgery the three highest carbon emitting specialties.
Interpretation: These data provide insight of the carbon emissions of specific elements of secondary and tertiary care activity in England. Such activity-level (and even more granular procedure-level and patient pathway-level) analysis is needed to inform carbon hotspot identification, intervention development and implementation to reduce the carbon emissions of care. As more granular data becomes available (e.g. on pharmaceutical use), such estimates will become more comprehensive.
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Declaration of Interest: The authors declare that there is no conflict of interest.
Ethical Approval: Ethical approval was not sought for the present study because it did not directly involve human participants.
Keywords: Environmental sustainability, carbon footprint, sustainable healthcare, planetary health
Begum, Hasina and Gray, William Keith and Simpson, Robin M. and Ingleton, Rose and Phull, Manraj K., The Carbon Emissions of Clinical Activities by Speciality in Secondary and Tertiary Care in England. Available at SSRN: https://ssrn.com/abstract=4978427 or http://dx.doi.org/10.2139/ssrn.4978427
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