Presentation (CTI)

OBJECTIVES: Healthcare systems face mounting pressure to reduce their environmental footprint, yet patient travel remains an overlooked contributor to care pathway emissions. Despite patient travel being a commonly identified emission hotspot, environmental sustainability assessments (ESAs) frequently omit travel-related impacts due to limited data on journey frequency, transport mode, and distance. This gap is especially pronounced in chronic diseases requiring high-frequency monitoring, and in conditions where geographic concentration of specialist services creates a substantial per-patient travel burden. This study demonstrates a scalable, transparent methodology for estimating patient travel-related environmental impacts in ESAs, applied across two contrasting UK settings: heart failure and cystic fibrosis.
METHODS: Four inputs were required: journey frequency, transport distance, mode of transport, and emissions per kilometre by mode. For heart failure, reported travel distances and transport modes for all-cause general practitioner (GP) and hospital visits were combined with ecoinvent emissions factors to derive per-patient and national estimates. For cystic fibrosis, where direct distance data were unavailable, distances were estimated by mapping patients to national population density distributions and converting published travel-time bands to average road distances in the UK.
RESULTS: For heart failure, average annual emissions were estimated at 12.7 kg CO₂e for GP visits and 8.0 kg CO₂e for hospital visits, corresponding to a national total of approximately 27,400,000 kg CO₂e (prevalence 2.4%; average 22.2 GP and 1.65 hospital visits per patient annually). For cystic fibrosis, average emissions per specialist visit were 47.9 kg CO₂e, equating to a national total of approximately 2,200,000 kg CO₂e based on 11,381 patients attending four times annually.
CONCLUSIONS: Patient travel generates substantial emissions varying meaningfully across care pathways. Transparent estimation approaches enable inclusion of travel in ESAs, supporting more complete environmental comparisons across treatment options. These findings highlight the value of standardising patient travel data collection to support future ESAs.