The NHS faces a new challenge – it needs to continue providing world-class healthcare whilst striving to meet its net zero carbon goal1. New research has demonstrated that it is possible to reduce environmental impact by improving patient outcomes in two areas: reducing surgical site infections across the NHS2 and achieving first pass recanalization in mechanical thrombectomy3.
The research was presented at The International Society of Pharmaeconomic and Outcomes Research (ISPOR) European conference in December by Mesut Kocaman, EMEA Health & Economics Market Access Manager for Johnson & Johnson Medical Devices. Environmental impact models were used to analyse the influence treatment options can have on sustainability, keeping in mind the NHS’s objective to reach net zero carbon emissions by 20401.
The first study explored the impact of surgical site infections (SSIs) across NHS England – demonstrating SSIs were associated with 10 additional days in hospital, 4.1 additional outpatient appointments, and 22% more A&E visits compared with patients without SSIs2. Due to the additional resources required, the analysis demonstrated reducing one SSI could save 0.58 tonnes of CO2e (equivalent to two return flights from London to Rome), 5m³ of direct water use and 0.06 tonnes of waste2. The annual cost to NHS England of SSI-associated environmental impact was estimated to be £2.67million2.
Jennifer Nagy, UK General Manager for Ethicon, part of Johnson & Johnson Medical Devices Companies, says:
“Supporting our NHS to continue improving patient outcomes is our organization’s number one priority, but we also have a responsibility to promote a sustainable healthcare system. Our Plus Sutures were recognized by NICE in June 2021, the report highlighted their potential environmental benefits by preventing surgical site infections4, and it’s great that this study shows what the potential environmental impact of reducing SSIs could be.”
The second study focused on mechanical thrombectomy – a procedure which uses a mechanical thrombectomy device to remove a clot from the brain during acute ischemic stroke. Previous studies have demonstrated that achieving complete or near complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI) grade 2c-3) after a single pass can result in improved clinical outcomes5; the new research was to explore if there was also an environmental benefit. The study showed that the decrease in resource utilisation by achieving mTICI 2c-3 after a single pass (first pass recanalization) led to a 134 kg drop in CO2e and a reduction of 13 kg of waste compared to the patients who achieved the same result after multiple passes3. In the UK, it is estimated that there are approximately 10,000 patients eligible for mechanical thrombectomy due to acute ischemic stroke6. Achieving a 40% rate of first pass recanalization could save as much as 51 tonnes of waste each year and 536 tonnes of CO2e - equivalent to 2,500 round trip flights from London to Milan3.
Andrew Cleworth, who leads Cerenovus stroke solutions, part of the Johnson & Johnson Family of Companies, which makes products and technologies used during mechanical thrombectomy procedures, says:
“The NHS long term plan includes expanding access to mechanical thrombectomy from 1% to 10% of stroke patients7. At Cerenovus we want to change the trajectory of stroke together with the NHS and reach as many patients as possible. This research demonstrates that by removing clots from the brain successfully at the first pass, not only can we improve patient outcomes, we can also help the NHS meet its net zero goal.”
The full results can be found here for surgical site infections and here for mechanical thrombectomy.
References:
- NHS (2020). Delivering a ‘Net-Zero’ National Health Service. Available at: https://www.england.nhs.uk. Accessed: January 2022.
- Kocaman M, Galvain T. The Cost Analysis of the Environmental Impacts of Surgical Site Infection from the Perspective of NHS England. Value in Health, Volume 24, Issue 12, S2 (December 2021)
- Kocaman M, Taylor H. The Environmental Impact of the First Pass Effect in Mechanical Thrombectomy in the NHS. Value in Health, Volume 24, Issue 12, S2 (December 2021)
- © NICE 2021. MEDICAL TECHNOLOGY GUIDANCE: PLUS SUTURES FOR PREVENTING SURGICAL SITE INFECTION. Available from: nice.org.uk/guidance/MTG59. Accessed: January 2022. All rights reserved. Subject to Notice of rights. NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
- ZaidatOO, RiboM, MattleHP, SaverJL, Bozorgchami H et al. (2020) Health economic impact of first-pass success among patients with acute ischemic stroke treated with mechanical thrombectomy: a United States and European perspective. Journal of Neurointerventional Surgery.
- McMeekin P, White P, James MA, Price CI, Flynn D et al. (2017) Estimating the number of UK stroke patients eligible for mechanical thrombectomy. European Stroke Journal 2(4): 319-326.
- NHS. The NHS Long Term plan. Available from: https://www.longtermplan.nhs.uk Accessed: January 2022.
Notes to Editor:
About Ethicon
Ethicon, part of Johnson & Johnson Medical Devices Companies, has made significant contributions to surgery for more than 100 years from creating the first sutures, to revolutionizing surgery with minimally invasive procedures. Our continuing dedication to Shape the Future of Surgery is built on our commitment to help address the world's most pressing health care issues and improve and save more lives. Through Ethicon's surgical technologies and solutions including sutures, staplers, energy devices, trocars and adjunctive hemostats and our commitment to treat serious medical conditions like obesity and cancer worldwide, we deliver innovation to make a life-changing impact. For more information, visit https://www.jnjmedtech.com/en-GB/companies/ethicon
About CERENOVUS
CERENOVUS, part of Johnson & Johnson Medical Devices Companies, is an emerging leader in neurovascular care. Our commitment to changing the trajectory of stroke is inspired by our long heritage and dedication to helping physicians protect people from a lifetime of hardship. CERENOVUS offers a broad portfolio of devices used in the endovascular treatment of hemorrhagic and ischemic stroke. For more information, visit https://www.jnjmedtech.com/en-GB/companies/cerenovus
Johnson & Jonson Medical Devices bears no responsibility for the accuracy, legality or content of the external site.
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