Introduction There is strong emerging evidence on the devastating effect of anthropogenic climate change on lung health. In England, the NHS accounts for 30% of the public sector carbon footprint, with patient travel being accountable for 8% of overall travel (17%). The climate change act (2008) resulted in the government and NHS committing to an 80% reduction in carbon emissions by 2050.
Methods There are many studies detailed the benefit of telemonitoring in reducing carbon footprint within NHS services. Within the Lancashire and South Cumbria Long Term Ventilation Service (LSCLTVS) we have invested in a ventilator remote monitoring system (EncoreAnywhereTM). Over a 3 month time period we analysed the telephone consultations of all 138 patients under the care of the LSCLTVS (80 patients on remote monitoring systems). Patients or carers that called reporting deterioration in a clinical condition that could not be rectified over the telephone were identified. The normal intervention that would follow would be a visit from the GP or community respiratory team, hospital admission, clinic visit or home visit from the ventilation team. A ventilator review was indicated in 29 patients which would normally necessitate either a clinic visit to Royal Preston Hospital or a consultation at home. However as these patients had remote ventilator monitoring we were able to review data and make changes remotely.
Results In a 3 month time period 29 return journeys were prevented through the use of remote monitoring. This equated to 1029.3 km (623 miles), 249 kgCO2e (0.24 t CO2e)*saved over 28 hours in commuting time and £255 in mileage costs (40 p per mile). It also had a positive impact on patient experience and no hospital admissions or clinic visits were necessary after remote consultation. 62% (n = 18) patients required use of rescue packs including antibiotics and mucolytics as well as remote ventilator changes.
*Emission factors from DEFRA 2012 show for an average petrol car the value is 0.24234 kg CO2e per km
Discussion The use of remote monitoring within the LSCLTVS has reduced the carbon footprint of the service on average 6.6 kg CO2e per patient. Patients also reported improved satisfaction and compliance.