SP 5.12 Surgical Set Rationalisation at a District General Hospital: Improves Sustainability whilst Saving Time, Money, Space and Energy
Mary Claxton, Sophie Forster, Louise Skidmore, Christopher Hepworth, Andrew Stevenson, Marianne HollymanAbstract
Aims
Surgical instrument reprocessing is a major contributor to theatre-related carbon emissions. This project evaluated general surgery instrument sets at Musgrove Park Hospital to identify unnecessary instruments, streamline set design and quantify environmental and operational benefits.
Methods
Three core general surgery sets (Minor, Laparotomy and Basic General) were audited. Surgeons, scrub staff and instrument specialists performed visual inspection to identify rarely used items for removal. Reductions in reprocessing volume and associated carbon impact were estimated using instrument counts.
Results
Instrument volumes were reduced across all sets:
• Minor: from 41 to 31 instruments per set (−24%), removing 30 instruments overall.
• Laparotomy: from 88 to 77 instruments per set (−13%), removing 110 instruments overall.
• Basic General: from 81 to 56 instruments per set (−31%), removing 425 instruments overall.
565 instruments were removed, representing a 22% reduction across general surgery sets (from 2,380 to 1,815 instruments). This reduces reprocessing demand, energy use, water consumption and detergent requirements. Fewer instruments per set shortens assembly and checking times, improving workflow efficiency and reducing staff burden.
Combined with concurrent orthopaedic set rationalisation, time-and-motion analysis demonstrated reprocessing time savings equivalent to 221 twelve-hour shifts, delivering £119,000 labour savings. Annual carbon reductions were estimated at 69,346 kg CO₂—equivalent to removing 22 petrol cars from the road for one year.
Conclusions
Rationalising general surgery sets delivers meaningful environmental and operational gains. Removing rarely used instruments reduces reprocessing workload and carbon emissions while maintaining surgical capability. Even modest reductions across commonly used sets can generate substantial sustainability benefits.