Celebrating Sustainable Health and Social Care Week

When solving one problem can also resolve another


When Ultramed founders, Dr Paul Upton and Alan Sanders, met travelling back to Cornwall a few years ago, thoughts of creating a business that would have a significant impact on environmental impact of healthcare was not at the forefront of their minds.

Their conversation began over a yachting magazine, where they discovered their mutual interest in boats and sailing.  Somewhere in southern England, Paul shared his vision of an online assessment tool that would reduce the need for patients waiting for operations to visit the hospital for a face to face health review.  Alan, owner of a highly successful graphic design business, could see the potential for this idea, so they kept in touch, further explored and developed an online preop assessment.

Positive outcomes

Some three years on, the programmes have been developed, tested and are now being trialled in 5 hospitals throughout the UK.  Feedback is positive, with patients appreciating the option of carrying out their assessment at a time and place to suit themselves.  Clinicians report they’re able to make better use of their clinic time and space to focus on more complex patients.  In addition, this system is improving patient flow through pre-op assessment, thereby helping to fill theatre lists and reducing breaches of Referral to Treatment time.

As the trials have progressed however, some additional benefits have arisen that make the process more attractive not only to the healthcare community but to the wider population. 

Unexpected benefits

Each Trust has been able to implement MyPreOp in a way to suit their workflow which has resulted in some providing a ‘one-stop shop’ so that patients visit their Consultant and are pre-assessed at the same visit.  Others prefer to send out a link to the programme by post or email, so the assessment can be undertaken remotely and submitted electronically.

Early feedback indicates that this has led to a reduction in patient journeys to hospital, resulting in less traffic on the roads and thus lower pollution levels.  There is also decreased pressure on car parking which is frequently an issue on hospital sites.

One Trust alone estimates a reduction in patient journeys of around 70%, which equates to 832 fewer journeys over a three-month period.  This is the equivalent of 19,968kg CO2, or the amount of carbon 190 mature trees could absorb in a year!

In addition, anecdotal evidence indicates that Pre-Op assessment units are being used more effectively with space optimised to review more complex patients.  Thus, it’s possible that in due course, less space may be needed to run the service whilst also allowing for more patients to be reviewed.  With space often at a premium on hospital sites, incurring charges for cleaning, heating, lighting and maintenance, this could offer options to reduce the footprint of pre-op assessment clinics, providing much needed clinical space for other uses or for disposal.

So, an idea that was born out of a clinical need to resolve bottlenecks in the pre-assessment process has had the unexpected outcome that it supports a more sustainable and environmentally friendly healthcare system.  At a time when the NHS is being tasked with reducing overheads and carbon emissions, opportunities to reduce patient travel and improve flow through pre-assessment would seem to offer an easy solution for healthcare providers.

As the NHS Sustainable Development Unit ‘Fit for the Future – Scenarios for the low-carbon healthcare 2030’ states: ‘This report argues that a low-carbon NHS is a more efficient NHS, and that if the service is to provide the best possible quality of healthcare in the future, it must build both its efforts to mitigate climate change and its resilience to that change.’

It looks like Ultramed have tapped into a previously unexploited means of tackling climate change and environmental pollution.

- Gill Pipkin