Sustainable Care Pathways Method and Guidance
Method Document
This document presents the method for appraising models of care and allows users to understand the environmental impacts of new or existing care pathways and ultimately to improve the sustainability of health systems. By applying the method, a user will gain a greater understanding of the environmental impacts of health services, including both direct impacts and those expressed across the whole care pathway.
This method document should be used alongside the supporting guidance, below.
Guidance Documents
There are several guidance documents to assist you in the appraisal process. This includes a Summary overview for high-level appraisal, a comprehensive Main Document for detailed module analysis plus individual Module Guidance documents. In addition to supporting the information on this website, these documents provide:
• useful definitions, documentation and references to where data required may be sourced from in order to undertake a care pathway appraisal
• specific pathway appraisal information including what shall be included/excluded when undertaking an appraisal, example activity data, activity carbon emission factors, units of analysis and estimates of module performance against environmental metrics
This guidance is focused on a limited number of care pathway modules and environmental metrics. It is expected that further modules and sustainability metrics (social and environmental) will be added over time, particularly as more departments begin to conduct their own detailed pathway appraisal.
About the Sustainable Care Pathways Guidance
The principal objective of the information contained on this webpage and within the guidance documents is to enable more consistent quantification of the environmental sustainability of care pathways, both those that already exist and new and emerging pathways. It is envisaged that this information will be used to support decision-makers in their choices related to improving the performance of models of care.
Currently, this information is limited to appraising greenhouse gas (GHG) emissions, water use and waste generation. The guidance builds upon the requirements of the ISO14040 and ISO14044 Standards for Life Cycle Assessment, the Greenhouse Gas Protocol Product Life Cycle Accounting and Reporting Standard (Product Standard) and the Greenhouse Gas Accounting Sector Guidance for Pharmaceutical Products and Medical Devices (Sector Guidance).
Activity data, carbon emission factors and the associated environmental metrics are built into our pre-calculated modules and the carbon calculator tool. The data within this utilises a life cycle approach that includes: manufacture of consumables; manufacture of equipment; manufacture of medical gases; energy use; staff commuting; waste and water. The original information was collated in 2015 during the first launch of the guidance documents and associated methodology. The second edition (December 2023) includes updates to the surgical procedure module, reflecting current emission data with updated carbon emission factors. The healthcare activity data upon which the metrics are based, however, remains unchanged as does the content of the remaining guidance modules. The emission factors may therefore not capture all changes to the emissions intensity of activities over that time period.
As this is a relatively new area of research, (with few published studies assessing the carbon impact of healthcare) the data has been collected from a variety of sources utilising different research methodologies within healthcare systems across the globe. For additional information outlining the scope of the data including inclusion/exclusion criteria, assumptions and limitations, the original published sources can be reviewed in the environmental impact table or the guidance documentation.