ArticleJournal of the Royal Society of Medicine2022
How can we address the ever-pressing need to 'green up' surgical practice in the National Health Service?
Article in Journal of the Royal Society of Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Decarbonizing surgical care: a qualitative systematic review guided by the Congruence Model.BMC health services research · 2024Pooled it
- Strategies and tactics to reduce the impact of healthcare on climate change: systematic review.BMJ (Clinical research ed.) · 2024Pooled it
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- Green transplant: A scoping review of sustainability challenges and opportunities in transplantation.World journal of transplantation · 2026Review
- Cutting Costs and Carbon: Re-evaluating Routine Group and Save Testing for Appendicectomies.Cureus · 2025Article
- Green, Sustainable Nephrology: State of the Art Needs for Education and Implementation.Clinical journal of the American Society of Nephrology : CJASN · 2025Review
- Article
- Workforce, workforce, workforce: a wellbeing crisis without resolution.Journal of the Royal Society of Medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clinical practice has inadvertently changed after the COVID-19 pandemic and currently the need to provide sustainable surgical services is more pressing than ever. The National Health Service has committed to a long-term efficient plan to reduce carbon footprint but there is no detailed plan for surgical practice, the domain that contributes the most to hospital-derived pollution. A series of consecutive steps and measures ought to be taken, starting from a hybrid approach quantifying surgically attributed carbon footprint. Then, a variety of suggested measures can be widely discussed and accordingly applied on a wider or more local level. Appropriate training should always precede implementing new practices to ensure that staff is familiar with these. These measures cover a broad range and should be arranged on a patient-centred basis from preoperative preconditioning to an effective follow-up. The need for more intense research and implementation of enhanced recovery protocols is widely discussed. Also, the necessity of green research and reinvestment of materials and resources is highlighted. A change of philosophy from a cradle-to-grave approach to a repurposing approach is suggested. We are confident that a new era is dawning in surgical practice and teamwork is the key for providing greener surgical services.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.