OBJECTIVES: Healthcare’s supply chain contributes 62% of the 25 million tonnes of CO₂^e emissions generated by the UK National Health Services per annum. Changing from single use equipment to reusable equivalent can reduce CO₂^e up to 56%. The SHTG recognized the need to evaluate the environmental credentials of single use equipment through a parallel assessment alongside a health economic analysis. This novel research is the first UK parallel assessment published the Scottish Health Technologies Group (SHTG). An innovative hybrid approach utilized multidisciplinary methods to overcome data challenges. The findings of the report are in line with research and provides important methods for HTA sustainability globally.

METHODS: Applying environmental management frameworks, a carbon footprint of single use rhinolaryngoscopes was compared with a reusable equivalent. Data collection techniques included questionnaires, interviews and the use of guidance for technological representativeness were used to quantify national GHG emissions and waste volumes. The technologies were categorized using thresholds based on the functional unit, to strengthen support for the HTA decision making process. Sensitivity analyses were performed.

RESULTS: The carbon emissions of a single use flexible rhinolaryngoscope compared to its reusable equivalent was 6.03kgCO₂^e and 3.26kgCO₂^e respectively. Data extrapolation reveals the annual environmental impact of this technology, throughout NHS Scotland, to be 13,652kgCO₂^e and 7,381kgCO₂^e, for the single use and reusable devices, respectively. Raw material acquisition, the use of personal protective equipment and transportation were carbon hotspots. Use of the single use devices generates 12.58 tonnes of waste per year further burdening healthcare resources. This pilot study recommends the use a reusable equivalent in this setting.

CONCLUSIONS: Aligned with NHS net zero targets, these findings confirm the need to perform a parallel environmental assessment of technologies alongside a health economic analysis. Data constraints can be overcome using hybrid methodologies. This work support policy development in HTA sustainability framework development.