P157 Care closer to home- better for the patient and the environment

<h3>Introduction</h3> The National Health Service (NHS) has been working to reduce its carbon footprint since 2008.¹ More recently a target has been made to achieve net zero by 2045 for emissions the NHS has the ability to influence.² It is estimated that 5% of NHS England’s carbon footprint is secondary to patient travel.^{1 2} In Northern Ireland, all Hepatology patients requiring care from a level 2 centre have been cared for at the Royal Victoria Hospital (RVH) in Belfast. For a cohort of these patients this requires significant travel for reviews. <h3>Methods</h3> In January 2025, following the appointment of a District General Hepatologist at Altnagelvin Area Hospital (AAH), Londonderry, an outreach clinic was set up. The aim was to provide care closer to home for patients requiring level 2 Hepatology input, with an added benefit of reducing CO2 emissions. A full day clinic was provided by a visiting Hepatologist from the Level 2 centre and local Hepatologist. A second clinic was held in April 2025, with an ongoing plan for 3 monthly clinics. To date, a total of 26 patients have been seen at the clinics, with a total 28 patient visits. The distance for return journeys to the RVH and AAH were recorded for each patient visit and the total distance saved was calculated. An estimate was then made of the CO2 emissions saved, based on the average CO2 emissions for a new petrol car in 2022 of 143.0 g/km.³ In reality the savings may be higher. <h3>Results</h3> The average distance saved per patient was 124.3 miles, with a median of 138.6 miles. The total number of miles saved for patients was 3481.6 miles. The estimated total CO2 emissions saved was 736.80kg, accounting for the visiting Consultant’s travel. On average each patient saved 28.62 kg in CO2 emissions, with a median of 31.90kg. The minimum average time saved per patient journey was over 2 hours, with a median of 138 minutes saved per visit. Feedback from patients on this change was overwhelmingly positive. There was only one patient who would have preferred to attend the RVH due to road quality and equidistant to both hospitals. <h3>Discussion</h3> The implementation of a Hepatology outreach clinic in AAH shows clear benefit to patients with reduced distance and travel time. The CO2 emission reductions from the provision of this service is notable and will only be multiplied over time. <h3>Reference</h3> Tennison, Imogen <i>et al</i>. Health care’s response to climate change: a carbon footprint assessment of the NHS in England. <i>The Lancet Planetary Health</i> 2021;5(2):e84–e92 DOI: 10.1016/S2542–5196(20)30271–0 NHS England. (2022) Delivering a ‘Net Zero’ National Health Service. London. (p4, p14.). Department for Transport &amp; Driver and Vehicle Licensing Agency (DVLA). (2023) Vehicle licensing statistics: 2022. Available at: https://www.gov.uk/government/statistics/vehicle-licensing-statistics-2022/vehicle-licensing-statistics-2022 (Accessed: 29 May 2025).).