Horton hospital improvements save equivalent of 260,000 Banbury - Oxford train journeys

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Improvements to the way anaesthetic gas is delivered at the Horton General Hospital are saving the equivalent of 260,000 Banbury - Oxford train journeys.

The changes are set to save over 500 tonnes of carbon dioxide equivalent (CO2e) every year following the decommissioning of its nitrous oxide (N2O) manifold.

Since February 2024, the Banbury hospital has used a portable supply of N2O in small cylinders which are wheeled into theatres when required, helping Oxford University Hospitals NHS Foundation Trust (OUH) reduce its carbon footprint.

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Despite being part of healthcare delivery, N2O is a harmful greenhouse gas.

From left: Aaron Fleming (Anaesthetic Registrar), James Boyd-Horton (Horton Operating Department Practitioner), Karen Wentworth-Foster (Horton Theatre Manager) and Marta Astraverkhava (Anaesthetic Consultant)From left: Aaron Fleming (Anaesthetic Registrar), James Boyd-Horton (Horton Operating Department Practitioner), Karen Wentworth-Foster (Horton Theatre Manager) and Marta Astraverkhava (Anaesthetic Consultant)
From left: Aaron Fleming (Anaesthetic Registrar), James Boyd-Horton (Horton Operating Department Practitioner), Karen Wentworth-Foster (Horton Theatre Manager) and Marta Astraverkhava (Anaesthetic Consultant)

The gas, used by anaesthetists for sedation and pain relief among other things, was previously distributed via a manifold, a system that delivers N2O to the pipelines around the hospital. Audits across UK hospitals found this wasteful.

Instead, it is now delivered to patients on an individual basis and now much smaller amounts of the gas are kept on site.

An OUH-wide audit suggested the Horton was only using approximately 5% of the N2O ordered and that 95% could be saved. The 587 tonnes CO2e saving is estimated to be the equivalent of approximately 261,586 return train journeys between Banbury and Oxford per year, 345 tonnes of plastic (1kg plastic = 1.7kg CO2e) or leaving a low-energy light bulb on for 39,133 years.

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It is also expected to save approximately £8,000 annually from 2025 onwards.

The Horton General Hospital where changes to anaesthetic gas supply are making important environmental savingsThe Horton General Hospital where changes to anaesthetic gas supply are making important environmental savings
The Horton General Hospital where changes to anaesthetic gas supply are making important environmental savings

Speaking on the Sustainability Day of Action today (Monday), consultant anaesthetist Dr Marta Astraverkhava said: “As a team we were determined to identify nitrous oxide wastage so we could reduce its environmental impact and support the Trust - and NHS-wide pledge to be net zero by 2040.

“We are proud to be able to change our approach at the Horton and vastly reduce the amount of nitrous oxide being wasted.”

Using nitrous oxide cylinders that attach directly to the anaesthetic machines instead of via long pipes improves efficiency and removes risks of leaks.

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The Horton accounted for about half the pure nitrous oxide footprint across the four OUH hospitals and is the first to move from a wall supply to a portable supply of gas. The Nuffield Orthopaedic Centre, Churchill and John Radcliffe hospitals are preparing to make the switch in due course.

Mark Holloway, Chief Estates and Facilities Officer with responsibility for sustainability at OUH, said: “Exploring the disposal of nitrous oxide across the Trust was an action included in the OUH Green Plan, so we are pleased to make such a big step forward in our efforts to reduce the Trust’s carbon footprint in this way.

“While we still have work to do to reduce nitrous oxide across the wider organisation, I am thankful to my colleagues whose hard work and dedication to delivering sustainable improvement has delivered this important project.”

Stuart Kinton, Chair of the OUH Sustainability Network, said: “The OUH Sustainability Network would like to congratulate and celebrate the multidisciplinary team who identified the need for this project and who have invested a lot of time and effort in making it a reality alongside their regular duties.

“This project will help OUH on its journey towards the national target for a net zero NHS carbon footprint by 2040.”

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