100 MOVING TOWARDS “NET ZERO” HEALTHCARE: THE CARBON FOOTPRINT OF A MIXED FACE-TO-FACE AND TELEHEALTH MOVEMENT DISORDER CLINIC

Abstract

Abstract Background The climate emergency disproportionately impacts older people. Providing low carbon-emitting care now is important for current and future healthcare. In “For a Greener NHS”, the NHS (National Health Service) set a target to reduce Carbon emissions for which it is directly responsible by 80% by 2028, 100% by 2040; and for emissions over which the NHS has influence by 100% by 2045. A low carbon model of care includes telehealth clinics. 3.5% of all UK road traffic is NHS travel and transport. Methods A sample was used to estimate modes of transport to clinics. One calendar year of telehealth clinics were reviewed to estimate distances not travelled by patients. Personal protective equipment (PPE) use was estimated. Carbon Dioxide equivalents emissions were calculated to compare face-to-face attenders with telehealth reviews. Results Clinician commute emitted 26.84kgCO2e. A sample of 57 face-to-face attendees indicates 89.48% travel by private vehicle, 7.02% by taxi, 1.75% by ambulance and 1.75% by bus. For the sample, this equates to 246.94kgCO2e if petrol cars used and 238.61kgCO2e if diesel cars used; 1.53kgCOe for taxi transfers; 1.92kgCOe for bus transfer. Reliable data on ambulance transport related CO2e was not found. For telehealth clinics over calendar year 2021, the total distance not travelled by patients was 14,749.8km, mean 25.51km, median 21.6km and range 1-276km. The estimated CO2e savings were: 2.30tonnes CO2e if petrol cars; 2.22tonnes CO2e if diesel cars; 215.65kgCO2e for taxis; 26.4kgCO2e for buses. The PPE related emission-savings were 128.48kgCO2e. Estimating from median travel distance 21.6km for the year: face-to-face attendances resulted in 75.17kgCO2e from taxis; 9.21kgCO2e for bus use; 801.81kgCO2e if petrol private car, 774.78kgCO2e if diesel car. 56kgCO2e in PPE related emissions. Conclusion Telehealth clinics can assist in reaching net zero healthcare. Sustainable and active transport needs facilitation. A specific organisational “Green Plan” is required to equitably and effectively deliver sustainable healthcare.