Nitrous oxide project | Association of Anaesthetists

Nitrous oxide project

Nitrous oxide project

The NHS has committed to achieving net-zero direct emissions by 2040, this specifically includes anaesthetic gases. Nitrous oxide confers the largest carbon footprint of the anaesthetic gases within the acute sector, accounting for at least 80% of the total anaesthetic gas footprint in 2019/20.

The Nitrous Oxide Project was founded in NHS Lothian by Alifia Chakera, who took this nationally and globally with the help of Centre for Sustainable Health care fellows Amarantha Fennell Wells and Chris Allen in January 2021. The Project is committed to flattening anaesthetic nitrous oxide emissions by: minimising system waste; educating and promoting green practice; and assessing and applying nitrous oxide catalytic cracking technologies where appropriate.

This is a multidisciplinary project, requiring significant engagement with estate and pharmacy teams ideally via your site’s medical gases committee. Our environmental champions will form a key part of this national project, and we will look to them to galvanise and promote the project in their own hospitals. We encourage local nitrous oxide project teams to report on their findings so we can quickly assess and share lessons from different site experiences. This can be done by completing and returning the nitrous oxide assessment sheet provided in the ‘how to guide’.

In summary, in order for our environmental champions to support this project, we provide:

  • National educative webinars on nitrous oxide mitigation
  • A simplified ‘How to guide’ –to help run the project – assessing manifold usage, clinical usage, and waste etc.
  • Ensure meaningful site-level nitrous oxide consumption data is available from the following national contacts.

Scotland: [email protected]

Wales: [email protected]

Northern Ireland: [email protected]; [email protected]

Republic of Ireland: [email protected]

England: The Greener NHS team are presently working on making English data available on a national platform. English sites should secure their gas supplier nitrous oxide data via their pharmacy department.

Medical Gas supplier contacts are:

BOC [email protected] or [email protected]

AirLiquid [email protected]

Piped Nitrous Oxide Waste Reduction Strategy

Recent efforts within NHS Lothian to reduce the total contribution of theatre nitrous oxide has revealed that wastage from piped manifold systems is a far more significant problem than that of persistent clinical usage. NHS Lothian’s lean approach can be adopted to address piped nitrous wastage oxide at any acute site. The project lead for NHS Lothian advises that once a nitrous oxide mitigation project team is established at an acute site, they should first discuss their investigative approach and draw on the Lothian methodology as an exemplar and not an absolute standard. An audit and analytics sheet has been included at the end of this document to facilitate investigation.

Download the document

Environmental champions meeting 27 January 2021

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