Presentation (CTI)

OBJECTIVES: To estimate potential water, energy, carbon, and cost savings from introducing a novel detergent that enables omission of the final rinse step after the manual cleaning of flexible endoscopes in NHS hospitals when used with validated Endoscope Washer Disinfectors (EWDs).
METHODS: Data on endoscope reprocessing volumes and practices were collected from nine NHS decontamination units, including endoscopes processed per day, rinse water volume and temperature. This informed a model of annual water and energy consumption with and without the final rinse step. Carbon emissions were estimated using 2024 UK government greenhouse gas conversion factors for water supply, wastewater treatment, and electricity. Energy costs were calculated using Ofgem’s 2025 electricity prices. Sensitivity analyses varied rinse volume (15-25 L) and temperature (27-40 °C) around a base case (23 L, 31.3 °C).
RESULTS: Units reprocessed an average of 48 scopes/day, 6 days/week. Eliminating final rinses could save approximately 3.16 million litres of water annually, reducing emissions by 1,073 kg CO₂e. Energy savings from reduced hot water use (~78,100 kWh/year) could lower emissions by 16,170 kg CO₂e and save around £20,100 annually. Energy use per rinse ranged from 0.17 to 0.87 kWh, with water temperature having twice the impact on energy and emissions compared to rinse volume. These savings represent a measurable contribution toward NHS Net Zero goals, particularly when scaled across national services.
CONCLUSIONS: Implementing this novel detergent with validated EWDs can reduce water and energy consumption, carbon emissions, and operational costs. While per-unit savings are moderate, they are scalable with broader adoption. These findings support integration into NHS green procurement and decontamination protocols, with longitudinal studies recommended to confirm long-term impacts.