Cutting carbon
10% at a time
Cutting 
carbon in kidney care
A 10:10 crowdfunded project is helping hospitals make their kidney care more energy efficient. Here's their nine-month update.
Centre for Sustainable healthcare's energy-saving refit programme for dialysis machines was part-funded by 10:10ers as part of our Pitch Pledge Party project. Here's their nine-month update.
In 2010, renal technicians Fraser Campbell and Steve Milne found that adding heat exchangers to old Dialog+ dialysis machines could cut their carbon footprint by about 20%. Since then we've been working to promote this technique and help other renal units try it on their own machines.
Manufacturer BBraun has now started shipping all new machines with heat exchangers pre-installed, and has retrofitted the machines in their own dialysis units – a huge success for carbon reduction!
500 to go...
However, within the NHS there remain several hundred older machines in service without heat exchangers. The first task for our Pitch Pledge Party project has been to identify dialysis units who have previously purchased these machines and contact them to confirm how many remain in use, and whether heat exchangers have been fitted.
We've found 350-500 machines in use without heat exchangers within the NHS, spread across eight renal services. Many services now have heat exchangers on all machines, while others are planning to upgrade older machines to models incorporating heat exchangers in the next couple of years.
As a result of our contact, Guy's & St Thomas' are currently retrofitting their last 14 machines.
As a result of our contact, Guy's & St Thomas' are currently retrofitting their last 14 machines and the Newcastle renal service is beginning by retrofitting 21 home machines, with plans to retrofit the remaining 44 in-centre machines as funding allows. Meanwhile four other services around the country are now developing the business case for retrofitting their remaining machines.
A major barrier has been the way that budgets are divided up within NHS trusts. In many cases the capital cost of the upgrade comes from the renal equipment budget, while the financial savings from energy reduction accrue to the estates department.
To address this, we have also encouraged the estates people in the relevant trusts to work together with the renal department to arrange financing. Creating the connection between renal and estates has had knock-on benefits, with some trusts now exploring other carbon- and money-saving projects in the dialysis unit, such as water recycling.
More knock-on effects - more carbon cuts
Fiona Daly, Environmental Manager at Barts and The London NHS Trust reported back that it was great for her to link up with keen individuals within her organisation.
"One of our renal technicians has informed me that all of our dialysis machines already have heat exchangers on - great news! I spoke with him about a number of other initiatives he thought we could look into and I will work with him over the next year or so to see what we can achieve."
Contacts made through this project have also been using the Green Nephrology Network online to swap ideas and questions about carbon saving actions such as waste reduction and cycling to work.
What's next?
Over the next three months, we will continue to encourage and support to the four units trying to get investment funding through their trust, and to liaise with the suppliers to negotiate more affordable installation costs. And we'll be chasing up those last two renal services who still haven't recognised the carbon and money saving potential!
Coming up!
The Green Nephrology Summit on 26 September 2012 in London is an opportunity to meet staff, patients and suppliers working to improve the sustainability of kidney care, learn from their experiences and help create the vision for Green Nephrology in 2013 and beyond. You can register here.
To build on the successes achieved over the last year, and make sure people know about the great things going on in kidney units, we will be running Green Nephrology Awards. We've already got at least one entry from a local heat exchanger project…so watch this space!
P.S. A few of the best ways to stay in touch with us:
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