van-Hove Maria, Begum Hasina, Phull Manraj, Bhargava Jonathan, Chang Lydia, Briggs Tim W R, Gray William K
Getting It Right First Time programme, NHS England, London, UK.
Department of Public Health and Sport Sciences, University of Exeter, Exeter, UK.
Eye (Lond). 2024 Dec;38(18):3525-3531. doi: 10.1038/s41433-024-03356-y. Epub 2024 Sep 19.
The National Health Service (NHS) in England has set a target to be net zero for carbon emissions by 2045. The aim of this study was to investigate the estimated difference between the carbon footprint of the Getting It Right First Time (GIRFT) High Volume Low Complexity (HVLC) pathway for cataract surgery and current practice.
Retrospective analysis of administrative data. Data were extracted from the Hospital Episode Statistics database for all elective cataract surgery procedures conducted in England from 1st April 2021 to 31st March 2022.
The England average carbon footprint was 100.0 kgCOe (ranging from 74.8 kgCOe - 128.0 kgCOe depending on Integrated Care Board). Had all Integrated Care Boards adhered to the GIRFT HVLC pathway, then 17.5 kilotonsCOe would have been saved in 2021-22. The main limitation of our study is that only key elements of the cataract surgery pathway were included in the analysis.
Even in a standardised healthcare pathway such as cataract surgery and within a publicly funded national healthcare system, significant differences in practice exist. With this paper we have demonstrated that tackling this unwarranted variation and adhering to the GIRFT HVLC pathway where possible has the potential to reduce the carbon footprint of cataract surgery.
英国国家医疗服务体系(NHS)设定了到2045年实现碳排放净零的目标。本研究的目的是调查白内障手术“一次做对”(GIRFT)高容量低复杂性(HVLC)路径的碳足迹与当前做法之间的估计差异。
对管理数据进行回顾性分析。数据从医院事件统计数据库中提取,涵盖2021年4月1日至2022年3月31日在英格兰进行的所有择期白内障手术。
英格兰的平均碳足迹为100.0千克二氧化碳当量(根据综合护理委员会的不同,范围在74.8千克二氧化碳当量至128.0千克二氧化碳当量之间)。如果所有综合护理委员会都遵循GIRFT的HVLC路径,那么在2021 - 22年期间将节省17.5千吨二氧化碳当量。我们研究的主要局限性在于分析中仅纳入了白内障手术路径的关键要素。
即使在诸如白内障手术这样的标准化医疗路径以及公共资助的国家医疗体系内,实践中也存在显著差异。通过本文我们证明,解决这种不必要的差异并尽可能遵循GIRFT的HVLC路径,有可能减少白内障手术的碳足迹。