Begum Hasina, Gray William K, Simpson Robin M, Ingleton Rose, Phull Manraj K
Greener NHS, NHS England, London, UK.
Getting It Right First Time Programme, NHS England, London, UK.
Lancet Reg Health Eur. 2025 Jun 2;54:101333. doi: 10.1016/j.lanepe.2025.101333. eCollection 2025 Jul.
The National Health Service (NHS) in England has committed to achieving net zero carbon emissions by 2045. A key early step in this journey is to understand where opportunities to decarbonise healthcare exist. The aim of this paper is to explore the potential to use available activity and emissions intensity data to investigate the carbon emissions of different specialty-level clinical activities in secondary and tertiary care in the NHS in England.
This was an exploratory, cross-sectional analysis of routine administrative data from secondary and tertiary care in the NHS in England. We included data for all patients admitted to hospital (including outpatient attendances, but excluding emergency attendances without subsequent admission) in England during the financial year 2022/23. The Hospital Episodes Statistics dataset and Theatre Productivity Data Collection were used. Carbon emissions factors were taken from published sources and linked to activity volumes to quantify the carbon emissions at a clinical activity level.
Data for 17,024,278 hospital admissions and 101,973,593 outpatient attendances were analysed. Outpatient attendances accounted for 45% of the measured carbon emissions. Of the remaining 55% relating to admitted patient care, emergency admissions accounted for 45% (82% of admitted patient care), in-patient elective activity 7% and day case activity 3%. The top 20 clinical specialties accounted for 79% of the carbon emissions, with general internal medicine, trauma and orthopaedics and general surgery the three highest carbon emitting specialties.
These data provide insight into the carbon emissions of specific elements of secondary and tertiary care activity in England. Such activity-level (and even more granular procedure-level and patient pathway-level) analysis is needed to inform carbon hotspot identification, intervention development and implementation to reduce the carbon emissions of care. As more granular data become available (e.g., on pharmaceutical use), such estimates will become more comprehensive.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
英国国家医疗服务体系（NHS）已承诺到2045年实现净零碳排放。这一进程的关键早期步骤是了解医疗保健领域的脱碳机会所在。本文旨在探讨利用现有活动和排放强度数据来调查英国NHS二级和三级医疗中不同专科级临床活动碳排放情况的潜力。
这是一项对英国NHS二级和三级医疗常规管理数据的探索性横断面分析。我们纳入了2022/23财政年度英格兰所有住院患者的数据（包括门诊就诊，但不包括随后未住院的急诊就诊）。使用了医院事件统计数据集和手术室生产率数据收集。碳排放因子取自已发表的资料，并与活动量相关联，以在临床活动层面量化碳排放。
分析了17,024,278例住院患者和101,973,593次门诊就诊的数据。门诊就诊占测量碳排放的45%。在与住院患者护理相关的其余55%中，急诊入院占45%（占住院患者护理的82%），住院择期活动占7%，日间手术活动占3%。前20个临床专科占碳排放的79%，普通内科、创伤与骨科以及普通外科是碳排放最高的三个专科。
这些数据为了解英格兰二级和三级医疗活动特定要素的碳排放提供了见解。需要进行这种活动层面（甚至更细化的程序层面和患者路径层面）的分析，以为识别碳排放热点、制定和实施干预措施以减少护理碳排放提供依据。随着更多细化数据的可得（例如关于药物使用的数据），此类估计将变得更加全面。
本研究未获得公共、商业或非营利部门任何资助机构的特定资助。
