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Sustainability in Surgery

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Our Sustainability webinar series

Browse the webinars in our sustainability series, presented in partnership with RCS Edinburgh. Our webinars have focused on different aspects of the Intercollegiate Green Theatre Checklist that you can implement on a local level. Webinars are free to attend for RCS England members.  

Session one: Rub don't scrub - watch now

The first sessions' theme was 'Rub Don't Scrub' in a surgical setting, how to implement this and the possible impacts.

Session two: Power off - watch now

The second session in our series focused on 'Powering Off' in a surgical setting, how to implement this and the possible impacts.

Session three: Reusable resources – Register for 6pm on Tuesday 14 May

Join us for the third session in our three-part sustainability series focusing on different aspects of sustainability in surgery. This session will focus on reusable resources in a surgical setting, how to use reusable resources and the possible impacts.

The story so far

Climate change is the defining issue of this decade, and it is imperative that the role of individuals and organisations is understood. The NHS accounts for 4% of the UK's total carbon footprint, including travel, infrastructure and waste management. Operating theatres are responsible for a major part of this, producing 50-70% of total hospital waste.

Our commitment to sustainability

Recognising the severity of the situation, we made a climate emergency declaration in Summer 2023, together with the other UK surgical royal colleges. We have also pledged our support to the ten commitments set out by the UK Health Alliance on Climate Change (UKHACC), recognising the need for health organisations to show leadership and take steps to mitigate and adapt to climate change. 

Download the Green Theatre Checklist and Green Surgery report

To drive forward sustainable change in your own practice, read the new Intercollegiate Green Theatre Checklist and the supporting compendium of peer-reviewed evidence, guidelines and policies.

We have also endorsed a new landmark Green Surgery report that sets the groundwork for reducing the carbon footprint of surgical care. Find out more.

Setting a framework

Our Sustainability in Surgery Strategy, launched in 2021, outlining how we plan to embed financial, environmental and social sustainability with ethical purchasing into everything we do, this is now guided by our members through our Sustainability Champions. We are committed to supporting sustainability work and to help our industry to meet net zero carbon by 2045, in line with the Greener NHS strategy.

The Royal College of Surgeons of England is a member of the UK Health Alliance on Climate Change and we will align with relevant national and international initiatives aimed at mitigating further global temperature rise and climate change, including the UN Sustainable Development Goals.


Guidance and support

Every member of the surgical team has the power to reduce surgery’s carbon footprint. Our Good Practice Guide, Sustainability in the operating theatresupports you to make improvements in surgical care through small, sustainable practices that maintain patient care and support environmental health. You will learn about:
  • Solid waste reduction
  • Green purchasing
  • Water conservation
  • Care pathways
  • Cultural change and surgical leadership.

Working groups

Two working groups guide the development and implementation of our sustainability strategy.

Sustainability Staff Group

Our staff are passionate about a greener future for RCS England. This group lead on identifying areas to improve sustainability in day-to-day operational running, maximising opportunities in the College building in London. Details of members of this group and terms of reference are to follow.

Sustainability Champions  

Our Sustainability Champions were appointed to help guide, inform and implement our sustainability projects from September 2023 onwards. 

James Lind Alliance 

SiS Group Vice Chair Victoria Pegna, led The Royal College of Surgeons of England in supporting the James Lind Alliance, ‘Greener Operations’. In June 2022, the results identified the top ten research questions that should be addressed to help make operations (including surgery, anaesthesia, and healthcare provided around the time of an operation) more environmentally sustainable.

Green Surgery Challenge

RCS England are proud partners of The Centre for Sustainable Healthcare’s Green Surgery Challenge. The 2021 challenge involved five finalists devising and implementing a quality improvement project to make surgical practice more environmentally, socially and economically sustainable, whilst maintaining or improving standards of clinical care.

Congratulations to the team from Leeds Teaching Hospital NHS Trust for winning the Green Surgery Challenge with their holistic review of a laparoscopic appendicectomy. All five teams presented innovative projects to help make surgery greener, with initiatives ranging from reusable materials to examining preoperative care. If all of the projects were continued for one year they would save a combined 133.3 tonnes of CO2e.

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