Aims and Objectives The NHS is responsible for 40% of the public sector carbon footprint. Emergency departments are both resource intense and under significant pressures. In this context, prioritising sustainability is challenging.

Our aim was to improve sustainability in our ED, in line with NHS Scotland’s net zero targets. Objectives included carbon reduction, financial savings and improved patient and staff experience.

Method and Design A multi-disciplinary team created ‘Fife Green ED’. We identified carbon intensive practices, informed by RCEM’s Green ED framework, including glove use, walking aids, waste management and patient information leaflets.

Results and Conclusion Gloves Off: Staff were surveyed to gauge hand hygiene practices and an education campaign launched to reduce glove use. 67.7% of staff admitted to using gloves when not clinically indicated. Post intervention, procurement of gloves was reduced by 58 boxes over 2 months, equating to 0.3 tonnes CO₂ and £427 saved.

Walking aid reuse: Last year, our ED purchased 1280 crutches. Reusing 40% (the national target) would save £4347 and 9728kg CO2, equivalent to 42,053 car miles. We have created walking aid labels informing patients of a new process whereby aids deposited at recycling centres are cleaned, refurbished and returned.

Better Bins: Waste bag numbers and types (recycling, clinical, general) were recorded over 4 days. A random selection was examined to assess appropriateness of contents, finding incorrect segregation costs an estimated £8393/year in our ED. Ongoing work includes improving signage, bin positioning, and staff education.

Electronic Leaflets: Digitalising patient information alongside paper versions reduces use of paper, ink, toner and printers. A webpage has been developed allowed access to patient information, with QI work underway to implement its use.

Barriers to implementation of sustainable projects within healthcare include time, funding, departmental cooperation, motivation, and need for leadership. Formation of a multi-disciplinary sustainability group can drive change, providing a source of motivation and teamwork.