Reducing the number of instruments on surgical trays and why this matters

Reducing the environmental impact of operating theatres is one way the NHS can reach its "Net Zero Supply Chain by 2045" ambition.

Health Innovation NWC has been key in an interesting project on the benefits of reducing the number of items in surgical trays, how to make this reduction and how to replicate this process. This work has now been pulled together in a detailed report.

Often instruments are added to surgical trays over time without ongoing reflection on their actual use or whether functionally similar items are also available. One related study found that 75 per cent of instruments were unused in each surgery, meaning that trusts were routinely washing and sterilising equipment that was never used.

Health Innovation NWC's evaluation looked at gallbladder removal surgeries in two sites in Yorkshire between January and March 2023. Data was presented to a surgical group and a number of methodical steps were followed to reach a consensus on what instruments would be included in trays for these surgeries going forward. Proposals were also reviewed by other stakeholders, such as the local sterilisation services to agree the optimal configuration of the new green surgical instrument trays.

The benefits this audit and data analysis of one procedure alone revealed was that costs could be reduced by 30-50 per cent, and prevent 2-3 tonnes of CO2 per year from being generated. Survey results also uncovered the additional benefit of easier and faster surgery preparation.

Laura Boland, Head of Innovation Pipeline, Evaluation and Insights, at Health Innovation NWC, said, “This project has captured the benefits of surgical instrument rationalisation, which include cost savings, carbon reduction and time saved during surgery preparation. The two surgery teams involved were overwhelmingly positive about the process and their role in making the NHS more sustainable. Our report summarises practical steps other sites can take to replicate the process, and it's backed up by an NHS England 'How to' guide, making it easier for other Trusts to achieve their net zero goals."

Health Innovation NWC was commissioned by NHS England’s Sustainable Procurement team to capture the benefits of the tray rationalisation process. This included meeting with local teams, site visits, data verification and the creation of the overall report. Read the report's full findings and recommendations. Email england.ccf@nhs.net for access to the NHS's how-to guide and audit tool.

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Laura Boland and the collaboration team produced a webinar on 12 October 2023 called "Surgical procedure set rationalisation for net zero". This was hosted by the Centre for Sustainable Health Care. View the slide deck and watch the recording.