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Net-zero clinical transformation

We've chosen our operating theatres as the flagship clinical area for sustainable transformation. We will take a holistic approach to greening our theatres, ensuring each facet is suitably accounted for from an environmental perspective.

Our progress so far

As part of our commitment to a net-zero future, we've chosen our operating theatres as the flagship clinical area for sustainable transformation—building on our success in eliminating the use of desflurane and nitrous oxide in anaesthetic procedures.  

Empowered by capacity from the On Purpose placement, we launched a vibrant, multidisciplinary Green Theatres Working Group. Our mission is to reimagine theatre practice through the lens of reuse, resilience, and responsibility. We’ve already made tangible strides in transitioning to reuseable surgical equipment—phasing out single-use cryoprobes, phacospeculums, and various types of forceps across the trust. We are also making good progress with transitioning to reuseable theatre clothing, having recently stopped all orders of single-use gowns at our City Road site, and are exploring options for reusable theatre hats. We have also eliminated desflurane and nitrous oxide from our anaesthetic procedures.
 
Our plan going forward is to take a holistic approach to greening our theatres by ensuring each facet is suitably accounted for from an environmental perspective: theatre staff, procurement of equipment and clothing, perioperative care, waste reduction, and energy use. As such, the group brings together voices from across the theatre ecosystem—surgeons, anaesthetists, theatre practitioners, medical equipment and logistics leads, soft services, and procurement partners. 

Meeting every three weeks, this coalition is co-chaired by our OCSS Director and Transformation Programme Manager, with clinical leadership from a Consultant Anaesthetist dedicated to sustainable practice. In March 2025, the group held two lively, in-person workshops at our City Road theatres, connecting directly with staff to inspire action and spark ideas for change. 

Net-zero clinical transformation plan

Action KPIs
Net-zero clinical leadership
Formalise net-zero clinical lead position. 
  • For consideration post new medical leadership structure to be implemented in the second half of 2025. 
Progress with general green theatre projects 
Complete quality improvement projects in theatres that focus on a measurable reduction in emissions, with co-benefits for outcomes and quality of care, efficiency and reducing healthcare inequalities. 
  • Develop a Moorfields-specific green theatres checklist (based on Royal College of Surgeons template) by 2026.
  • Continue to conduct regular productivity drives within the trust to ensure good utilisation of our theatre space and resources and to improve our carbon impact by reducing downtime.  
Share learnings and outcomes through clinical networks. 
  • Publish success stories on Future NHS – Greener NHS Hub during the life of the green plan. 
  • Explore opportunities for international collaboration on green theatre projects with eye centres around the world.  
Promote green theatres e-learning for all staff working in theatres. 
  • Review ‘Green Operating Theatres’ e-learning and explore opportunities to incorporate into our training plan in 2026.
Optimise digital pathway management for perioperative care. 
  • Move away from face-to-face pre-assessment and follow-up post-surgery, where clinically appropriate, to reduce patient travel by 2027.
Build on relationships with our suppliers to transition from single-use to re-useable items in theatres
Transition to reusable theatre equipment. 
  • Transition to reusable or more sustainable versions of theatre equipment products and measure the resultant reduction of carbon emissions. Develop a pipeline for implementation in 2025. 
Transition to reusable theatre clothing. 
  • Replace single-use hats with reusable hats in 2026. 
  • Transition to reusable gowns in 2025. 
Improve theatres waste management and reduction rates 
Reduce theatre waste via bin installations.
  • Roll out reusable sharps bins in theatres by the end of 2025. 
  • Roll out green recycling bins in theatres by the end of 2025. 
Reduce use of paper in theatres and measure the resultant reduction of carbon emissions. 
  • Paper usage eliminated by June 2026 in line with Electronic Patient Record (EPR) go-live. 
Use of Genesis inventory management software to improve management of stock. 
  • Set targets for percentage reduction in expired consumables by end of March 2026.
Optimise energy use in theatres
Optimise airflow management prior to move.
  • Measure and monitor air change rates continuously.
Ensure maximum value from theatre sessions by improving theatre efficiency / reducing HVAC (heating, ventilation, and air conditioning) wastage. 
  • Increase theatre utilisation / reduce average unused minutes per theatre session in 2025.  
  • Reduce variation in cataract cases per operating list / standardise to 8 cases per list where possible in 2025. 
  • Consider measuring electricity and carbon savings from theatre HVAC downtime as a positive byproduct of the above two KPIs in 2026.