Positively Green

The British Association of Urological Surgeons has put together a national snapshot audit for bladder cancer known as Environmental Lessons Learned and Applied (ELLA). This audit aims to assess current Bladder Cancer Pathways against a baseline and put forward recommendations on how the services could be decarbonised. UHP was one of the trusts who took part in this late 2024 audit which comprised of:

1. Unit level questionnaire

2. Audit of the management of consecutive patients undergoing  Transurethral Resection of Bladder Tumour

The units were judged on a number of factors including:

• Their use of advice & guidance to optimise secondary care referrals and reduce unwarranted referrals

• How carbon intensive their procedures are ie, are reusables used instead of disposable patient gowns, absorbent pads and drapes or are suction liners avoided.

• Whether the perioperative assessments were done virtually/on the same day as the procedure to reduce travel time

• Whether the units offer biopsy and ablation at check flexible cystoscopy

Upon assessment of the factors, UHP’s rank in this audit was 2, where 1 was the best performing int terms of lowest excess carbon emissions and 19 was the worst performing. This is a fabulous result as it indicates our Bladder Cancer Pathway as the second greenest pathway in the UK! The results demonstrate where UHP could reduce their carbon footprint of this service further, but in comparison to other units in the UK, UHP is emitting far less carbon for this service.

This audit is a great example of how small changes to practice results in a large reduction in CO₂ emissions. For example, the baseline report estimates that there would be a reduction of ~176 tonnes CO₂e across England annually [UK: 208 tonnes CO₂e] if: 

1. Items only opened when needed

2. Reusable gowns and drapes used instead of single-use

3. Suction liners avoided 

Similarly, the report estimates that there would a carbon emission reduction of  ~338 tonnes CO₂e across England annually [UK: 400 tonnes CO₂e] if all suitable recurrent tumours were ablated at check cystoscopy.

These kinds of audits are useful because they help units to understand what changes will yield the biggest reduction in CO₂ and what they are already doing to decarbonise. 

Well done team!