8 A new way of supplying acid concentrate to dialysis machines at the RFL is saving carbon emissions equivalent to driving a petrol car over eight-and-ahalf times round the equator. Gareth Murcutt, renal technical manager at the RFH, was asked by his clinical director to look at sustainability and at first thought any gains would be marginal, given there could be no compromise in patient care. Gareth investigated how acid concentrate – an essential component in the preparation of dialysis fluid – was being delivered to the dialysis machines. Staff loaded a new five litre cannister of acid concentrate onto each machine for every treatment and the technical team then did an audit of how much was left in the containers at the end of each session. “The results really shocked me; I couldn’t believe it at first,” said Gareth. “It turns out, on average, we were throwing away around one third of every single cannister that we bought.” Kidney dialysis gets drastic about plastic Staff with the new tanks at Tottenham Hale Kidney and Diabetes Centre We were throwing away one third of every single cannister “ “ Gareth realised that by switching to a bulk central acid delivery system, where dialysis fluid is pumped directly to the dialysis machines, this would eliminate this wastage – saving over £55,000 a year. The reduction in emissions of over 77,000 kg CO2e per year was as a result of reducing dialysis fluid wastage and over half of the carbon savings come from no longer using the cannisters. Edgware Kidney Care Centre and Tottenham Hale Kidney and Diabetes Centre, who between them have 78 dialysis stations, were chosen to trial the new system and the hardware was successfully installed. As well as financial savings the switch has realised additional benefits. Annually more than 1,000 tonnes of lifting by staff has been eliminated as well as 1,750 hours of staff time managing the cannisters, enabling healthcare teams to spend more time with patients. The cost of the installation will be recouped by the trust in just one year. Not content to stop there, the dialysis service has been inspired to investigate other changes, such as removing one unnecessary disinfection cycle on the trust’s dialysis machines. This is now saving a further £21,000 and emissions of 13,000 kg CO2e per year. Gareth, who has completed a scholar’s course in kidney care sustainability, said: “Removing even small amounts of plastic or waste from the supply chain quickly adds up to significant emissions savings when you consider the scale involved in modern healthcare.”
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