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Green at Barts Health

Barts Health's sustainability group

What is Sustainable Quality Improvement (SusQI)?

This video from The Centre for Sustainable Healthcare breaks it down:

Get Involved!

Do you have an idea for a SuSQI poject? Get in touch! Email us at


Our SusQI Projects

Keeping Patients Awake & Safe for Cataract Surgery:


"[This project] emerged from the simple observation by the theatre team that at least 1-2 cataract surgery cases per week were being converted from GA to LA on the day of surgery. In addition to the use of environmentally harmful anaesthetic gases, GA patients require more hospital visits, additional investigations & longer hospital stays. General anaesthesia is also associated with higher risks than local. It was felt that the decision for type of anaesthetic should be made earlier on in the pathway and with a greater focus on improved patient engagement.

The project was an awe-inspiring team effort which involved the whole ophthalmology team including clinicians, pre-op assessment nurses, theatre nurses, operating department practitioners (ODPs), anaesthetists and of course the patients. The team also had support from CSH to help calculate the impact of the project.

The impact the project had on the triple bottom line and the opportunity to introduce the principles of SusQI were possibly what gave us the winning edge in the Green ward competition. Rates of GA in cataract surgery are low but they can be reduced further and deliver wider benefits, as was demonstrated by the project. There was a significant reduction in CO2 emissions as a result of less waste and not using harmful anaesthetic gases and a substantial financial saving of £162K per annum due to the reduced cost of equipment, workforce & investigations.

Looking at social sustainability, patients benefitted from improved engagement and shared decision making, fewer disruptive visits to hospital for pre-operative assessments, and leaving hospital earlier – as less time was needed in recovery after an LA.

Staff benefitted from working together as a team towards a common goal and from the empowerment of being able to lead the transformation. Clinical outcomes were not measured, but there were perceived benefits relating to reduced risks from GA, reduced waiting time due to the streamlined pathway and a reduced risk of Covid transmission as GA is an aerosol generating procedure.

A key take home message is that there are plenty of opportunities for sustainable healthcare solutions and by empowering the people on the ground you can be very successful in making a difference."

Read the full article on this project, "Keeping an Eye on Sustainability" on the Barts Health Website.



  • More on CoVOG: Green at Barts Health played an advisory role on sustainability during the post-COVID reconfiguration of Outpatient services...
  • More on our reuseable sharps bins...


Other SusQI Projects We Love

GOSH's "Gloves Are Off"

"1.4 billion gloves are used across the NHS each year. To combat this, Lead Infection Prevention Control Nurse Helen Dunn, and Practice Educators Amy Leonard and Nicola Wilson at Great Ormond Street Hospital (GOSH) are on a mission to encourage healthcare professionals to reduce unnecessary use of non-sterile gloves..."

Read the full report on the GOSH website.



"A programme developed for members of the multidisciplinary team to teach children and young people how to swallow pills. It was set up at the Great North Children’s Hospital, Newcastle, and has won the NHS Sustainability Award, the HSJ Value Award for Pharmacy and Optimisation and the Bright Ideas in Health Award for Demonstrating an Impact upon Quality Improvement. The 15-minute e-learning session is for all health and care professionals who want to teach children and young people how to swallow pills using an evidence-based, six-step technique..."

Learn more on the e-Learning for Healthcare website.


Case Studies from Greener NHS

A collection that highlights the important work happening at all levels across the NHS...

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Banner image: "Warming Stripes for England from 1884-2020" from