Zoë Halfacree is a small animal veterinary surgeon who has specialised in Small Animal Surgery.  Zoë is passionate about environmental sustainability in the veterinary profession and has completed a Business Sustainability course at the Cambridge Institute of Sustainable Leadership. She is chair of the Greener Veterinary Practice working group, Vet Sustain, a group of veterinary professionals championing sustainability in the veterinary profession.

The environmental impact of healthcare

Our planet is facing crisis: climate change, with drought, heat waves, flooding and sea level rise, loss of biodiversity and resource scarcity. Healthcare has a significant environmental impact: it is very energy intensive, has a significant carbon footprint through the procurement of equipment, pharmaceuticals and travel and also generates large volumes of waste. If global healthcare were a country, it would be the fifth largest carbon emitter in the world (Healthcare without Harm, 2020).  The reality of our environmental impact as healthcare professionals is alarming, but this also means we have a real opportunity to make a difference every day, by making changes in our practice.  We must also make change to ensure resilience of veterinary healthcare in a changing planet.

The Intergovernmental Panel for Climate change suggest that a ’safe’ limit for global warming is 1.5 degrees (above pre-industrial levels).  In order to remain within this limit, carbon neutrality by the middle of the 21st Century is essential (IPCC, 2015).  Carbon neutrality means achieving a balance between the carbon emitted and the carbon absorbed from the atmosphere.

The main natural carbon sinks are forests, soil and oceans and, so far, there are no artificial carbon sinks able to remove carbon from the atmosphere at an adequate rate to abate climate change (EU News, 2020). It is therefore essential that we reduce what we produce and protect and restore the natural resources that are essential for equilibrium of our ecosystem. The United Nations warns that we only have the next 12 years to limit a climate change catastrophe (Watts, 2018).  Last week (1 October 2020), the NHS became the world’s first national health service to commit to becoming ‘carbon net-zero’; its target is 2040 and it has planned clear milestones (NHS, 2020).

Making Changes

The daily pressure on the veterinary team is great and COVID-19 has multiplied this, but there will never be a good time to think about making changes, it needs to begin now. Starting with a small step is still a start and if we all do that within our practices it will add up to a big difference.

  • This may be as simple as putting a food waste container in your tearoom (food waste that is not segregated reduces recycling and also results in methane from anaerobic digestion; methane is 84 times more potent that carbon dioxide as a greenhouse gas) or producing electronic client invoices rather than paper. A lot of what we can achieve to make our veterinary clinic greener is the same as what we may do at home, but as a medical facility there are many other impacts we can improve upon.
  • Inhalant anaesthetic agents are potent greenhouse gases and using low-flow anaesthesia techniques can reduce their emission into the atmosphere; certain gases such as nitrous oxide and desflurane should be avoided (Jones & West, 2019).
  • Changing from single-use plastic sharps containers to re-usable sharps containers reduces carbon emissions (up to 95%), costs and sharps injuries (Veterinary Record, 2019).
  • As a purchaser of pharmaceuticals, consumables and equipment you have the power to make changes by asking your supplier about their environmental credentials. Even just requesting a switch to plastic-free packaging or rationalising the number of weekly deliveries you receive makes a difference (West & Gough, 2020).

There are so many changes that can be made, and several UK leading practices are sharing the initiatives they have used. Please visit www.vetsustain.org to view resources.

This blog was created to support a session that VN Futures provided at the BVNA This Is Us 2020 online event. The session on Environmental Sustainability, chaired by the blog author, Zoe Halfacree, was held on Saturday 10th October at 2.05pm, and asked the question: “What ideas and approaches have your practices utilised to reduce environmental impact and increase sustainability, and what changes do you think could be embraced for the future?”

We welcome your thoughts on this topic below.


Health care without harm (2020), Health care climate footprint report
viewed October 3 2020

International Panel for Climate Change (2015), Paris Agreement

Watts J (2018), We have 12 years to limit climate catastrophe, warns UN, The Guardian

European parliament, (2020), News, European parliament
viewed October 3 2020

NHS, (2020) NHS becomes the world’s first national health system to commit to become ‘carbon net zero’, backed by clear deliverables and milestones, nhs.uk

Veterinary Record, (2019), Green Practice adopts reusable sharps containers. Veterinary Record, 184, 370. https://veterinaryrecord.bmj.com/content/vetrec/184/12/370.3.full.pdf

West, E. & Gough, S., (2020), 10 tips for sustainable procurement. Veterinary Record on line https://veterinaryrecord.bmj.com/content/vetrec/187/3/96.full.pdf

Jones, R.S., West, E. (2019). Environmental sustainability in veterinary anaesthesia.
Vet Anaesth Analg., No 46 (4): 409-420.

Zoë Halfacree