A focus on environmental sustainability can often lead to the triple benefit of improved health outcomes, a lower carbon footprint, and decreased costs. Identifying environmental sustainability initiatives that can achieve all three benefits is highly desirable for the NHS.
An example of these potentially multiple benefits is within pathology services across NHS, where the hidden carbon footprint of single-use plastic bags is a big challenge.
Health Innovation East has worked in partnership with Abbott to use existing data, gather new data and generate insights to evaluate the effectiveness of an innovation from Abbott – AlinIQ pre-analytics powered by Indexor (Indexor)
The most common method of transporting samples to pathology laboratories involves packaging them in plastic bags and manually processing each sample at the point of delivery. These practices, and the prominence of single-use plastics, whilst effective at containing and preventing contamination, contribute significantly to the carbon footprint of pathology networks vital work across the NHS.
However, the carbon footprint created by pathology services is complex. It begins with the procurement of goods and services, extends to the transportation and analysis of samples, and ends with a clinical waste incineration process. The manufacture and long-distance shipping of specimen bags significantly contributes to the overall carbon footprint.
Our evaluation found that for every 100,000 standard sample bags (Midco’s Easy Open bags) used, 390kg of plastic and up to 1.475 tonnes of carbon dioxide equivalent is produced.
The NHS has a goal of becoming the world’s first carbon neutral public healthcare system – striving to reduce plastic usage and implement processes that are more carbon efficient.
The Indexor system is an advanced, expandable sample transport tracking system for pathology networks, designed to ensure compliance with the highest safety, quality, and traceability standards. It uses an RFID tag, which is scanned at different points in its journey to create a fully auditable trail from sample collection to analytical processing.
Most importantly, the system eliminates plastic bag use through the use of space-efficient racks which travel with the samples through the system, from GP surgeries to the laboratory.
The Indexor system’s check-in process involves scanning and sorting of up to 60 samples simultaneously, ensuring efficient management of a large number of samples. The rack scans the RFID tag in the samples to retrieve key information and check for any alerts, ensuring the sample’s integrity and quality. It also enables time-sensitive priority samples to be identified on receipt in the laboratory to aid processing of priority samples.
Such thorough verification also guarantees that the sample has been transported under proper conditions and is ready for accurate and reliable processing and analysis.
Working alongside Abbott and NHS partners, Health Innovation East collected data and conducted interviews with four different healthcare sites to evaluate the effectiveness of Indexor within their setting. The sites highlighted efficiency savings as one of the primary benefits of implementing the system.
The Royal Wolverhampton Hospital Black Country Pathology Services (BCPS) network saw a two-hour reduction in throughput time from booking to results for the majority of samples, resulting in faster turnaround of test results to patients and clinicians.
Eastern Pathology Alliance (EPA) at Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH), experienced a notable 65% decrease in processing time.
Royal Cornwall Hospitals NHS Trust (RCHT) recorded a 52% reduction in missing samples.
NHS Grampian reduced the processing time for 5,000 daily samples from 46.9 to 9.4 hours.
Philip Shelton, Head of Industry Partnerships, Health Innovation East
“Indexor is a good example of an innovation that has multiple benefits. Our evaluation has shown that it can provide a win-win solution for patients and staff, improving sustainability and reducing costs.
2Evaluations like these are vital in providing the evidence for innovations that have potential to be scaled and spread further. This is one of our core activities at Health Innovation East and we’re delighted to have supported Abbott and the four pathology laboratory services with this evaluation.”
The implementation of Indexor also resulted in financial savings of approximately £121,680 per year, per site by freeing up an average of five full-time equivalent positions, allowing laboratory staff to focus on other tasks or projects. This was especially impressive given there was an average year-on-year increase in samples observed of 5-10% across all the sites.
By eliminating the need for single use plastic bags, the sites also saved on procurement costs and reduced their carbon footprint. NHS Providers alone could save up to £1,744 in direct costs for 100,000 bags and an additional £240.63 per 100,000 bags in incineration costs.
If Indexor were adopted across all pathology networks in the NHS across England, the net zero benefits could be significant. During 2022-2023, the National Health Service (NHS) received more than 160 million blood sciences requests (from Chemistry, Haematology and Immunology departments), with each request typically contained in one plastic bag.
The evaluation suggests the NHS could potentially save around 624.9 tons of plastic by using Indexor, delivering on the triple aim of improved health outcomes, a lower carbon footprint and decreased costs.