Theatre kits in hospitals – reducing packaging

This case study focused on Royal Liverpool and Broadgreen University Hospitals NHS Trust (RLBUH), “one of the largest and busiest hospitals in the North of England. It has more than 5,600 staff and sees 600,000+ patients per annum. The Trust operates over two sites in Liverpool and carries out more than 13,000 procedures in 19 theatres every year. RLBUH wanted to reduce the amount of time medical teams took to prepare for each patient in order to improve turn-around times. One area highlighted was the number of items required per operation and the amount of time it took to unwrap them.”

The analysis considered these savings and scaled the results to calculate the net present value of the potential benefits over five years across the NHS in England. A decision was made to calculate social and environmental benefits only. This is based on the assumption that the staff time saved will be used to perform more operations, resulting in social benefits, rather than financial benefits from reducing the costs of staff time.

A further assumption was of a one-week reduction in waiting time for knee operations; while the potential for additional carbon emissions due to additional bed care for those with extra operations was ignored as this could potentially be offset by the ability of individuals to take care of themselves after the operations. The data was scaled up to show the potential benefits using the ratio of the number of theatres and Royal Liverpool and Broadgreen to the national number of theatres.

How can my Trust gain the described benefits?

The case study identified that reducing waste by packaging operation equipment together, through a reduction of the time required per operation, more operations can take place. It has also “reduced the volume of associated packaging waste by 90% (around 2.6 tonnes) helping the Trust to reduce its carbon footprint by five tonnes.”

Case study source

Waste – Royal Liverpool & Broadgreen University Hospitals

Healthy Returns – Production Reports

Financial Savings

The financial savings resulting from saving staff time have been calculated for the purpose of the case study as £175,000 per annum. This case study covers 19 surgical theatres, extrapolating the £175,000 saving across the 2,502 theatres in England (according to NHS England), the saving for the whole of England is £23,000,000 per annum.

Carbon Savings

The carbon savings resulting from the 90% reduction in volume of packaging waste resulted in a 5 tonne carbon saving.

Again extrapolating from the 19 surgical theatres considered in the case study to the 2,502 theatres in England the potential saving for England is 658 tCO2 an uptake factor of 50% has then been assumed to arrive at a 329 tCO2


  • Ignores additional carbon usage of beds and care for those with extra operations – though this may be offset by increased ability of individuals to care for themselves after operations
  • Assumes waiting time for knee operation reduced by 1 week