Somerset Trust cuts carbon footprint in testing for UTI

Urinary tract infections (UTIs) are a significant cause of morbidity and mortality among patients and represent a considerable proportion of hospital admissions, with an increasing burden noted in high-income countries. UTIs can severely impact patient's quality of life and impose substantial costs on healthcare systems. Urine microscopy, culture and sensitivity (MC&S) testing is routinely performed for UTI management, antenatal care and preoperative screening for urological surgery. Despite the critical need for reliable testing, practices surrounding midstream urine (MSU) specimen collection vary greatly leading to potential inaccuracies and inefficient practices that generate unnecessary waste and expense.

There is marked variability in MSU collection processes, with a lack of standardisation across practice and consumable use. Processes are often unnecessarily complex and involve many single-use plastic items. Additionally non-compliant methods such as grey pulp and non-sterile specimen collection remain common. As most NHS and Independent Healthcare Providers outline objectives within their Green Plans to reduce single-use plastics, our aim was to address this issue by minimising the use of such items in this routine pathway, as identified by our consultant urologist and clinical sustainability lead.

Developing environmentally sustainable approaches to the delivery of routine clinical care is imperative, as healthcare transitions to net zero practices in response to the climate crisis. Single-use plastic products contribute significantly to healthcare's greenhouse gas emissions making reduction in their use a priority. Transitioning to lower carbon products should involve questioning the necessity of environmentally harmful practices that have evolved in the absence of evidence. Where evidence is lacking but there is a potential opportunity to introduce more sustainable alternatives in clinical care, we should investigate these possibilities. Excessive use of sterile plastic equipment stands out as an area warranting this type of enquiry.