The carbon agenda

The joint editorial published on 6 September 2021, by Annals and 232 other international scientific journals, on climate change further brings this further into focus.2 Plastics products (including gloves, tubing & blood sample tubes) are among the greatest contributions to carbon emissions in the NHS, and the UK is committed to reducing the use of plastics within healthcare.1,3 Of note, it is estimated that there are nearly two million tons of plastic waste generated by the US healthcare industry.4 As the largest employer in Britain, the NHS is responsible for approximately 4-5% of the nation’s carbon emissions - equivalent to the entire carbon emission of Croatia.5 In April 2021, the Royal College of Surgeons of England launched the “Sustainability in Surgery Strategy” group to ‘embed financial, environmental and social sustainability with ethical purchasing’ into surgical practice.6 Prof Mahmood Bhutta is a key figure leading these changes and provides a thoughtful and insightful editorial to this edition of Annals. Call for emergency action to limit global temperature increases, restore biodiversity, and protect health. Health care’s response to climate change: a carbon footprint assessment of the NHS in England.