Greener Operations: Sustainable Perioperative Practice

About this PSP

The Greener Operations: Sustainable Peri-Operative Practice PSP worked with patients, carers, healthcare professionals and the broader public to identify uncertainties about environmentally sustainable practice within peri-operative care.

Peri-operative practice is defined as care provided from or in the secondary care setting to patients who may benefit from surgical management. For full details of the PSP scope, please see the protocol.

The results of the PSP establish the priorities for research in environmentally sustainable operating theatre practice, providing a focus for future research efforts.

The Greener Operations PSP Top 10 was published in June 2022.


PSP website
Articles and publications

Key documents

Greener Operations: Sustainable Peri-Operative Practice PSP protocol

Greener Operations: Sustainable Peri-Operative Practice PSP Steering Group terms of reference

Greener Operations: Sustainable Peri-Operative Practice PSP question verification form

Greener Operations: Sustainable Peri-Operative Practice PSP engagement summary

Greener Operations: Sustainable Peri-Operative Practice PSP Priority Setting Workshop video (2 minutes)

Greener Operations: Sustainable Peri-Operative Practice PSP Priority Setting Workshop video (Extended version)

Greener-Operations-PSP-Plain-English-Summary-of-the-PSP.pdf

Greener-Operations-PSP-Final-Sheet-of-Data.xlsx

Top 10 priorities

    1. How can more sustainable reusable equipment safely be used during and around the time of an operation?
    2. How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation?
    3. How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice?
    4. Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations?
    5. How can the amount of waste generated during and around the time of an operation be minimised?
    6. How do we measure and compare the short- and long-term environmental impacts of surgical and non-surgical treatments for the same condition?
    7. What is the environmental impact of different anaesthetic techniques (e.g., different types of general, regional and local anaesthesia) used for the same operation?
    8. How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs?
    9. How can environmental sustainability be incorporated into the organisational management of operating theatres?
    10. What are the most sustainable forms of effective infection prevention and control used around the time of an operation (e.g., PPE, drapes, clean air ventilation)?

The following questions were also discussed and put in order of priority at the workshop:

    1. How do we measure the carbon footprint of an operation?
    2. What are the best ways to educate healthcare professionals who provide care before, during and after operations, about sustainable healthcare?
    3. Can equipment be recycled or repaired, instead of being disposed of, to reduce its environmental impact?
    4. How can the waste of drugs be avoided during and around the time of an operation?
    5. What alternative, more sustainable, materials can replace plastic packaging and equipment used during and around the time of an operation?
    6. How do we define and avoid low-benefit or unnecessary operations?
    7. How can energy usage within an operating theatre be safely reduced?
    8. What are the barriers to using more sustainable anaesthetic practices?
    9. How can we increase the reuse and recycling of equipment used for rehabilitation in the recovery period after an operation?
    10. Can alternative, more environmentally sustainable, methods of disposal be used for waste that is generated during and around the time of an operation?
    11. What is the most sustainable way of providing equipment packs for an operation?
    12. How can we compare the environmental impacts of reusable and single-use equipment used during and around the time of an operation?
    13. How much recyclable waste generated during an operation is being appropriately recycled?
    14. What is the most sustainable way to sterilise equipment used during an operation?
    15. How can drug syringes be used better to reduce their environmental impact?

Document downloads

For full details of all of the questions identified by this PSP, please see the document below.

Greener-Operations-PSP-Final-Sheet-of-Data.xlsx