Skip to main content

“Greener Operations” James Lind Alliance Priority Setting Partnership – Top Ten research priorities

The Society for Cardiothoracic Surgery (SCTS) is proud to have supported the “Greener Operations” - James Lind Alliance (JLA) – NIHR - Priority Setting Partnership (PSP) which has recently set research  priorities to help deliver more sustainable operations.  

The JLA uses an established and open process which brings together the public, patients, carers and healthcare professionals to set research priorities that are important to all. Operations including cardiothoracic surgery are a major contributor to the carbon footprint of healthcare and an evidence based change to more sustainable perioperative care is needed if we are to achieve a Net Zero NHS.

This national project was funded by Manchester Foundation Trust Charity and co-lead by consultant anaesthetist Dr Cliff Shelton and retired consultant colorectal surgeon and medical examiner Mr David Jones. An initial survey in 2021 attracted 1600 potential research questions about environmentally sustainable peri-operative care. These were distilled into 60 ‘indicative questions’ which were checked against existing evidence, and then prioritised in a second survey in 2022. Over 600 respondents participated in the surveys. The Greener Operations final priority setting workshop was held on 15th June 2022, when a group of patients, carers and health professionals worked together to agree the top ten priorities about environmentally sustainable peri-operative practice.

These are the top ten priorities.

  1. How can more sustainable reusable equipment safely be used during and around the time of an operation?
  2. How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation?
  3. How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice?
  4. Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations?
  5. How can the amount of waste generated during and around the time of an operation be minimised?
  6. How do we measure and compare the short- and long-term environmental impacts of surgical and non-surgical treatments for the same condition?
  7. What is the environmental impact of different anaesthetic techniques (e.g., different types of general, regional and local anaesthesia) used for the same operation?
  8. How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs?
  9. How can environmental sustainability be incorporated into the organisational management of operating theatres?
  10. What are the most sustainable forms of effective infection prevention and control used around the time of an operation (e.g., PPE, drapes, clean air ventilation)?

The priorities will help researchers and their funders to focus on what matters most to the ‘end users’ of research to deliver Greener Operations. This is an expanding field and the NIHR announced specific funding streams relating to sustainable healthcare at COP 26.

The priorities are very relevant to cardiothoracic surgery covering various aspects of care and they are applicable to research projects both small and large. The Greener Operations team are keen to publicise the priorities as widely as possible and stimulate research in this vital area. David Jones, Joint Lead for the Greener Operations PSP is happy to be contacted via e-mail ( if you require more information.


Website link to the Top Ten Priorities for Greener Operations:

Link to NIHR information about funding streams:

Twitter: @SusPeriOpPSP

View other News