I am Jason Lie, one of the consultant anaesthetists and also the Sustainability Lead for ELHT. It is an honour to tell you more about my role in this guest blog and highlight the importance of sustainability in our organisation.
I suppose I always have a passion for minimising waste as I grew up. I recall that as a child, I always ensured that I used the other side of any papers before throwing them away, as well as not wasting any food, electricity and water.
My ambition is for ELHT to become the greenest trust in the North West of England and build a reputation nationally.
In terms of how I got involved in sustainable healthcare, it all began in 2019 when I started getting involved in the use of different anaesthetic gases and nitrous oxide in anaesthetic practice and our waste streams.
Anaesthetic gases and metered dose inhalers contribute to 5% of the entire NHS carbon footprint. As a consultant anaesthetist myself, it creates an immediate link for me to contribute to improving our sustainability! Ultimately everyone has a role to play and every little helps.
Anaesthetic gases (such as desflurane and sevoflurane for maintenance of anaesthesia) and nitrous oxide (including gas and air such as entonox for labour) are all greenhouse gases and contribute to global warming. They stay in our ozone layer for a long time – 14 years for desflurane, 1.1 years for sevoflurane and 110 years for nitrous oxide.
My first quality improvement project, “Nitrous Oxide Mitigation Project”, in 2021 looked at slowing down factors contributing to global warming and climate change.
It identified that at Royal Blackburn Hospital more than 98% of the nitrous oxide from our nitrous oxide manifold was leaked to the environment (that’s over 5,000 tonnes of carbon dioxide equivalent (CO2e) a year) and at Burnley General Hospital it was more than 75% (or over 99 tonnes of CO2e).
These findings led to the decommissioning of our piped nitrous oxide on both sites by 2022, which will save the Trust over £130,000 (and reduce the CO2e by 51k tonnes) over the next 10 years! We were the first trust in the North West of England to succeed with this.
We were also ahead of the game with the use of desflurane, which was decommissioned nationally by the NHS in 2024. Through the change of culture and perseverance, we managed to reduce our use of desflurane from 26.1% of all our general anaesthesia in 2019 to almost 0% in 2025. Again, this is not just supporting our sustainability efforts as this was accountable for 700,000 kg CO2e in 2019 but it is making a financial saving of £179,000 a year.
Thanks to these two hugely successful stories, I have been involved in more and more sustainable healthcare projects, ranging from recycling, food wastage, packaging at our canteen, electric vehicles and innovative technology just to name a few.
I love being involved in these kind of things as I feel that I am in the best position to witness from the shop floor level things that can influence changes for the Trust.
I am also lucky enough to have a supportive department and division who support me getting involved in all these projects.
“For a Greener NHS” programme was officially launched in January 2020 with a key target for the NHS to commit to net-zero carbon emission by 2040. To support this, ELHT now has a clear Green Plan for our sustainability journey.
The biggest challenge has always been the change of culture (especially in clinical practice) and it is known to take a long time for a big organisation like ELHT and the NHS as a whole, although the pandemic has certainly sped up this process.
However, in general, everyone wants to play a part in being more sustainable, which is fantastic. For example, on recycling, colleagues were trying to take home their plastic bottles to recycle, until reassurance from our waste manager that we recycle through our waste management company. That really shows the mentality of ELHT!
Without a doubt, the challenge to reach net-zero is absolutely enormous. We can all play a part in it by doing what we can instead of thinking it is somebody else’s responsibility.
ELHT has already made huge strides in reducing our emissions like the installation of LED lights, solar panels, introduction of electronic patient records, conversion to electric vehicles for patient transport and many, many more projects.
Here are some other success stories:
- Coolsticks - a reusable device introduced to all operating theatres, Critical Care and the Central Birth Suite as a first line option to ethyl chloride vapo-coolant spray to assess nerve blocks. Ethyl chloride releases chloroethane into the environment, which remains in the atmosphere for around 1-2 months, and costs £19.80 per can (ELHT uses 10 cans per week), with a significant carbon footprint from manufacture and transportation. So the change is helping the environment beyond the Trust and our finance.
- Theatre hats - ELHT spent between £30-40k per year on disposable theatre hats! We have managed to procure some reusable theatre hats for staff to help reduce this cost and therefore carbon footprint. The North West Schools of Anaesthesia and Obstetric and Gynaecology have also provided residents with their own theatre hats and many theatre staff, anaesthetists and surgeons have also bought their own theatre hats to aid this cause.
- Greener by default - ELHT have just signed up to the ‘Sustainable & Inclusive Nutrition for All: Testing Healthy, Low-Carbon Menus in Hospitals Research Project’. Run by researchers from UCL & the London School of Hygiene and Tropical Medicine, this is due to start in November. The study is focussed on the impact of healthy, sustainable menus on patient meal choice, with the goal of improving nutrition, reducing cost and carbon footprint all without reducing patient satisfaction. The study will involve designing and piloting new menus with free consultation and guidance by the study organisers with a focus on plant based, low carbon options becoming standardised.
- Physio - ELHT have set up an initiative to reuse and recycle walking aids given to patients. The NHS spends millions of pounds every year on walking aids, many of which are not returned. With this scheme, we could reduce the NHS’s carbon emissions by 7.4 kilotonnes over the next three years.
- Green endoscopy - introduction of reusable, sturdy and wipeable bags to replace single-use patient bags for their belongings.
- Introduction of seven points of procurement of all our new products - companies need to provide data on their product’s energy consumption, greenhouse gas emissions, reduction in waste, use of recycled products, reduction in hazardous substances, packaging and end-of-life recycling.
- Green ED - ELHT has been registered on to the waiting list for the Green ED initiative run by the Royal College of Emergency Medicine. For more information including some helpful infographics of the various frameworks, please visit their website https://greened.rcem.ac.uk
- Solar panels - ELHT has secured just short of £2 million of the above funding to support solar panel installation. The panels will be installed this year at Burnley and Pendle hospitals where they are expected to generate over 1 million kilowatt hours of energy over the course of a year. This will potentially save the Trust over £250,000 annually.
There has been some great work done to support sustainability and there are plenty of things coming up that colleagues can get involved with.
Even simple things like turning off computers and lights when not in use, recycling wherever possible or getting involved with our ‘gloves off’ initiative that is reducing single use non-sterile gloves – it can all add up and make a difference.
If you want to know more, please look out for our ‘green newsletter’ or why not become an ELHT Green Champion? Email me jason.lie@elht.nhs.uk directly if you want to know more.
I’d love to hear from you – the more people who support our activity, the sooner we can reach our target of becoming net zero.