1200 Making miles matter – reducing the carbon footprint and improving integrated care in down syndrome. (17th August 2022) - Bower, Rachel
Abstract : Aims: The Cambridge Community Paediatric team provide a clinic for children with Down syndrome. This has been developed into a multidisciplinary format (MDT) where children see the paediatrician, audiologist and orthoptist on a single visit. This has reduced the need for families to travel to and attend multiple different appointments. This service evaluation considered the environmental impact of reducing patient appointments and travel. Methods: 29 children attended the MDT clinic over 3 months from September to November 2021. The electronic patient record was used to calculate the distance travelled by each family attending the clinic. The appointments for the same cohort of patients in 2019 (precovid) were compared and distance travelled to attend appointments in paediatric, vision and audiology clinics was calculated. Kilometres travelled allowed us to calculate the carbon footprint of journeys based on the government published conversion factors for an average size car using unknown fuel. (Department for Business, Energy and Industrial Strategy, 2021) Results: Of the 29 children who attended the clinic 19 were included in the analysis. Of those excluded 4 moved into the area after 2019 and 6 were not born in 2019 meaning there was no valid comparison data for them. Families travelled from across Cambridge city, south and east Cambridgeshire ( figure 2 ). The total carbon emissions generated from attending appointments in 2019 was 409.5kg CO2e with a reduction to 90kg CO2e in 2021 ( figure 1 ). Data was collected retrospectively and we made an assumption that all families travelled by car and to and from home address. Conclusion: Globally health systems are responsible for 4-5% of global greenhouse gas emissions. In 2019, the NHS emissions totalled 25 megatonnes of carbon dioxide equivalent. (Imogen Tennison, February 2021). 5% of this is due to patient travel (Watts, 2020). Travel is an area of significant potential change and that 'health systems can have a considerable degree of influence through innovations in models of care.' (Imogen Tennison, February 2021). The clinic is in the centre of Cambridge but serves a large geographical area with limited public transport and most patient journeys are currently by car. Our clinic was developed with the aim of improving patient care through reduced numbers of appointments, reduced time out of educational settings, less time out of work for families and better co-ordination in assessing health needs working as an MDT. It received excellent patient feedback and anecdotal staff feedback suggested they felt they were delivering a much better service. A happy 'side effect' was that the clinic was associated with a reduction in the carbon footprint of the clinic by 88% through reduced patient travel.