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Reducing nitrous oxide at the NOC

04/03/2025
The Nuffield Orthopaedic Centre (NOC) is the second hospital run by Oxford University Hospitals NHS Foundation Trust (OUH) to cut its greenhouse gas emissions after changing the way it delivers nitrous oxide (N2O).

The Oxford hospital, like the Horton General Hospital in Banbury, has switched from delivering N2O via a manifold, a system delivering it to pipelines throughout the hospital, to using portable supplies of the gas delivered in small cylinders.

It is expected that more than 30 tonnes of carbon dioxide equivalent (CO2e) will be saved every year as a result – that is the equivalent of driving a petrol car more than 4 times around the world, or nearly 16 times around if driving an electric car.

N2O, a harmful greenhouse gas, is on occasion used by anaesthetists as part of general anaesthesia.

Using N2O cylinders that attach directly to the anaesthetic machines instead of via long pipes improves efficiency and removes the risk of leaks. Audits across UK hospitals found that using a manifold system to be wasteful.

Emma Walduck, an Anaesthetic Sister based in the NOC Theatres, said: "Switching to portable nitrous oxide cylinders has been a positive and straightforward process to rollout. Since they were implemented in April 2024, we have used only a few cylinders.

"We are proud to deliver this initiative, which is helping us to reduce our environmental impact."

The decommissioning of the NOC manifold follows a similar move at the Horton General Hospital in Banbury in February 2024, saving more than 500 tonnes of CO2e every year.

Mark Holloway, Chief Estates and Facilities Officer with responsibility for sustainability at OUH at OUH, said: "A key action outlined in our Green Plan, Building a Greener OUH 2022-2027, was to review our transportation, use, and explore the disposal of nitrous oxide across the Trust.

"I am therefore delighted that the NOC has become our second hospital to transition to using a portable supply of nitrous oxide, helping us reduce the amount of the gas being wasted.

"Although there is still work to be done to reduce nitrous oxide across the wider organisation, I am grateful to my colleagues for their hard work and dedication in delivering this important project."

Stuart Kinton, Chair of the OUH Sustainability Network, said: "This is a great example of a project in which simple changes can have a significant impact on the carbon footprint of the Trust without any impact on patient care or staff ability to deliver that care.

"Saving 30 tonnes of carbon dioxide equivalent each year is a really positive step in the right direction towards the national target for a net zero NHS carbon footprint by 2040 and is one that should be truly celebrated."

Pictured: Lawrence Eadle (Medical Equipment/Orderly Manager, Theatres) and Emma Walduck (Anaesthetic Sister)
 

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