The Mid Yorkshire Teaching NHS Trust’s transition to using reusable tourniquets has resulted in a noteworthy decrease in both carbon emissions and expenses.

Tourniquets are utilised throughout the NHS to identify suitable veins in patients for blood collection by applying pressure to a limb to restrict blood flow.

Within the Trust, teams are continuously exploring ways to incorporate more sustainable and cost-efficient solutions, particularly in high-volume clinical items like tourniquets. Annual statistics revealed that the Trust was using 330,000 disposable tourniquets each year, significantly impacting the procurement budget and waste disposal.

At the beginning of 2022, a comprehensive review of tourniquet use within the Trust commenced. Our Procurement team collaborated with NHS Supply Chain to identify a reusable alternative that met the Trust’s criteria for cost-effectiveness, sustainability, and clinical necessity. As part of the assessment, the Procurement and Sustainability teams recorded each department’s tourniquet usage, while also seeking input from various internal and external stakeholders.

After evaluating various samples, the Daisygrip reusable tourniquet was chosen for a trial in high-usage areas, beginning with the Phlebotomy department. Following positive feedback, the trials were expanded to the Emergency Department and Computerised Tomography.

The trials proved successful in all departments, and the Procurement team could demonstrate the waste reduction advantages of switching from multiple disposable alternatives previously in use. The results indicated that after the Daisygrip tourniquet had been used eight or nine times, sustainability benefits would become evident. Standardising to a single tourniquet brand across the Trust would also facilitate inventory management and a more efficient user training process.

In the year since the introduction of reusable tourniquets, the Trust has observed:

A 75% reduction in plastic waste, equivalent to 2.3 tonnes of CO2e, due to decreased use of single-use tourniquets.

Savings of £20,000 in procurement costs, achieved after approximately 250 uses, depending on the type of disposable alternative and usage within each department.

A significant decrease in the number of single-use tourniquets employed. For instance, during a six-month trial period, the Phlebotomy services alone used 6,375 fewer single-use tourniquets, resulting in 127kg less plastic waste.

Peter Leighton-Jones, Head of Sustainability, said: “It’s clear that there has been a gravitation towards disposable, single-use items in the NHS over recent years, driven largely by the response to the pandemic, which caused seismic changes to how we conducted healthcare activities, with the intention of reducing infection risks. Whilst the logic for taking these steps was sound at the time, the environmental impacts have been extremely pronounced, with waste volumes having increased markedly during the COVID affected period.

“The time has now come to redress the balance and move towards a more circular style of healthcare, where items can be reused depending on the products in question, where it’s safe to do so from a health provision and infection risk perspective. Whilst it may be challenging to move back to reusable items, it’s incumbent on the healthcare system to invest the requisite time and effort in overturning the status quo.

“All purchasing decisions should be based on whole-life costing analysis, where the overall costs of ownership might well be lower for more robust, reusable products. Likewise, lifecycle carbon assessment is critical. All of this is necessary if the Trust is to achieve both its carbon reduction commitments and its broader sustainability aspirations.

“It’s extremely positive that this latest initiative is moving us back in the direction of resource circularity and, in doing so, is saving money, reducing carbon emissions and avoiding needless waste.”

Ian Noble, Clinical Procurement Specialist at Mid Yorkshire, said; “Sustainability and standardisation are very important to the Trust. The opportunity to implement reusable tourniquets ticked a lot of boxes. There will always be the need for disposable versions in infectious patient cases, however, a move towards a reusable alternative with viable reprocessing options is a really positive move.”