Net zero and sustainability

In Sheffield Teaching Hospitals, Royal Hallamshire Hospital, it is the responsibility of our orthoptists to provide an efficient low vision service. We provide LVA services to all ages, with the majority of patients finding a good improvement in their abilities when using magnification. However, could we be doing better for our environment as well as our patients?

The NHS Net Zero campaign has encouraged me to look at our service and see where we could make changes that would reduce our carbon emissions. As with any hospital environment, there is going to be waste, but we need to see where we can prevent this.

When we issue aids to patients, we need to be aware of their effect on the environment and also what is best and beneficial for the patient. What tends to occur in low vision assessments is that the patient is issued with a handheld pocket magnifier and a stand magnifier. These are two plastic aids, both of which will eventually need replacing. However, now we stock handheld magnifiers that come with a stand to adapt the magnifier itself, therefore reducing the number of aids a patient requires, saving costs along with the added benefit of reducing the amount of non-recyclable plastic we are giving out. Patients also benefit as they do not need to switch between two magnifiers. The handhelds with detachable bases are also lightweight and easy to use, providing patient satisfaction.

If patients require it, we will provide them with a carrier bag to take their magnifying aids home. These bags come from our own homes, so are already being reused, which is better for the environment. However we could still improve upon this. As a service, we need to consider all aspects, and by simply changing to using paper carrier bags, we could avoid yet more plastic going into landfill. This is something we shall seek to change as soon as possible.

Lighting is very important in low vision, and we always advise the use of daylight bulbs and white LEDs. We encourage our patients to use LED as they are more environmentally friendly, requiring less energy to run and reducing carbon emissions, but they are also best at producing bright and clear light. We also advise patients to change the lighting around their homes to LED bulbs.

Throughout ophthalmology, we could also change our lighting to LED light fittings and also ensure we switch off any lighting and electrical equipment we are not using, which would be a further step towards reducing our energy consumption and emissions as a whole department.

In low vision, we heavily rely on external stock being ordered in. We need to ensure that our suppliers are aware of their effect on the environment and produce products and packaging that is sustainable. This would lower our indirect effect on the environment and raise awareness among other companies.

During the COVID-19 pandemic, we used telephone consultations as a way of assessing and keeping in touch with our low vision patients. In most cases, a low vision face-to-face assessment is required to find out which is the most appropriate magnifier for the patient. However, where suitable, it would help our indirect carbon footprint to bring fewer people into the hospital setting and continue with telephone consults and reviews.

In the best interest of our patients and public health, it is important to see patients as early as possible in low vision. Appropriate referrals and earlier intervention enable patients to get used to using magnifiers while their level of vision is at a better stage in their condition, especially those who will deteriorate over time. Patients then get better use from their magnifiers and find they do not need to return to swap and change their magnifiers as often, which creates more plastic waste, as magnifiers cannot be reused or recycled. Early intervention in younger patients can also help to keep them in work, providing a better quality of life for our patients. Appropriate referrals also mean that patients do not travel to appointments that are not necessary, increasing their and the NHS’s carbon footprint. Working together with orthoptists and consultants, we aim to promote effective low vision referrals within our ophthalmology department and wider public, such as high-street optometrists.

As a team, we are keen to change what we can to ensure that our low vision service runs in the most effective, efficient and sustainable way. Our small steps will help the NHS become net zero.