P083 GIRFT Greener guideline: a practical guide to decarbonise the skin lesion pathway

Abstract

The NHS contributes substantially to the UK’s carbon footprint, producing approximately 4–5% of national greenhouse gas emissions. NHS England’s commitment to net zero carbon emissions must prioritize environmentally sustainable models of care. NHS England’s GIRFT (Getting It Right First Time) national programme introduced the environmental lessons learned and applied (ELLA) approach to produce greener patient pathways. This study applied the ELLA approach to skin cancer services to produce our guideline. Pathway mapping, estimating activity volumes and a review of relevant literature identified potential decarbonization strategies. Emissions modelling was performed on longlisted interventions by combining approximate carbon savings by number of applicable cases to demonstrate the potential annual greenhouse gas (GHG) reductions if implemented system wide. This materiality assessment highlighted the most impactful recommendations. These were prioritized for discussion with a wide group of relevant stakeholders to consider clinical and implementation feasibility. More detailed GHG emissions modelling on shortlisted interventions will be performed with the input of an expert scientific reference group and adaptation of existing life cycle assessments. The results were synthesized into ‘A practical guide to decarbonise the skin lesion pathway’, with potential CO2 savings of 1214 tonnes per year (Table). Joint benefits of sustainable care, prevention and future directions for decarbonizing skin cancer care are also considered. This national guidance has the potential to drive system-wide transformation of dermatology lesion pathways, delivering patient, environmental and financial benefits. It provides a foundation for decarbonizing other areas of care, with recommendations refined as new evidence and innovations emerge.TableDecarbonization strategies with initial emissions modellingInterventionEstimated annual savings in England (tCO2e)aInterface with primary care432Treating low-risk lesions46Direct-to-surgery booking103One-stop clinics152Appropriate treatment settings105Avoiding unnecessary procedures62‘Action set’ for skin procedures155Management of surgical waste33Personalized follow-up126aTonnes of carbon dioxide equivalent GHG emissions.