P127 One cost, many savings – the benefit on patient experience and carbon footprint of the introduction of a portable fibroscan machine to NHS Tayside

<h3>Background and Aims</h3> Fibroscan machines have become an integral part of Hepatology services with portable scanners offering the opportunity to bring services closer to patients. In large geographic areas we hypothesised that portable scanners improve patient experiences and mitigate some of the significant impact of healthcare on carbon emissions. NHS Tayside (NHST) is a Scottish Health Board serving over 400,000 patients with Hepatology out-patient clinics in Perth Royal Infirmary (PRI) and Ninewells Hospital, Dundee (NW). These hospitals are 30km apart and prior to the acquisition of a portable Fibroscan machine all patients needed to attend NW for a Fibroscan. We evaluated the impact of introducing a portable Fibroscan to the NHST Hepatology service by assessing the impact on patient travel distance; CO₂ emissions; and direct costs to NHST. <h3>Methods</h3> Fibroscans performed at PRI (n=260) were identified between 08/03/2023 and 21/02/2024. Distance and time travelled were calculated using patient postcodes and Microsoft Bing maps (08:00 on a weekday). CO₂ emissions were set at 165.47g CO₂/km for an average sized car of unknown fuel type.¹ The cost of an outpatient appointment in NHST was £151.² <h3>Results</h3> Patients attending for a PRI consultant clinic with Fibroscan (n=102) avoided an additional trip to NW for a nurse led Fibroscan. Whilst patients attending a PRI nurse led clinic (n=158) would previously have attended NW and therefore avoided the added journey time and distance between NW and Perth. The mean distance (range) travelled to PRI was 18.85 (0.5–85) km and to NW was 47.06 (16.1–117) km. The mean (range) journey time to PRI was 20.51 (2–78) minutes and to NW was 35.22 (14–93) minutes. The mean (range) CO₂ produced to PRI was 3.12 (0.08–14.06) kg and to NW was 7.79 (2.66–19.36) kg. The total travel distance saved by patients receiving Fibroscans at PRI was 18,748.20km. This saving equated to 200 hours of patient time and a CO₂ saving of 3102.26kg. The direct clinic cost saving to NHST of consultant performed Fibroscans was £15,402. <h3>Conclusion</h3> In just under a year, the introduction of a portable Fibroscan has saved substantial travel time and reduced the CO₂ footprint for patients by allowing them to receive their Fibroscan closer to home. Furthermore, the cost saving from consultant performed Fibroscans is appreciable. The introduction of portable Fibroscan machines should be considered in NHS trusts covering large geographic areas, to save patient time, unnecessary CO₂ emissions and extra clinic attendances. <h3>References</h3> Department for Energy Security and Net Zero. Greenhouse gas reporting: Conversion factors. 2023. GOV.uk (Accessed 15/05/2024) Available at: https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2023 Kate Barlow. Learning together: Improving access and experience. The health Literacy Place. (Accessed 19/05/2024) Available at: https://www.healthliteracyplace.org.uk/learning-together-improving-access-and-experience/