Moorfields has successfully implemented key actions outlined in NHS England’s green plan guidance on medicines. We eliminated desflurane from anaesthetic use in 2022, followed by the complete discontinuation of nitrous oxide in anaesthetic procedures at our City Road site in 2025. Furthermore, we transitioned surgical cryotherapy from nitrous oxide to carbon dioxide, which has a nearly 300 times lower global warming potential.
Recognising our progress against national benchmarks, Moorfields has proactively moved beyond standard NHS guidance to explore innovative and specialty-specific sustainability practices in ophthalmic medicine. Our continued focus is on reducing the environmental impact of treatments while maintaining the highest standards of patient care.
The Moorfields medical retina service, with support from pharmacy and infection prevention and control, has led a pioneering sustainability project with the potential to significantly reduce the carbon footprint and plastic waste associated with eye care via eye drops.
Single-use eye-drop formulations, while convenient and sterile, generate substantial amounts of plastic waste and carbon emissions. As part of a green initiative, the medical retina service, with support from pharmacy, launched a project to trial the use of multi-use eye-drop bottles, following approval from the infection prevention and control team.
The three-week pilot involved transitioning 953 patients from single-use minims to multi-use bottles, alongside comprehensive training for technicians and nurses on proper handling and administration techniques. The results were promising and once implemented across all medical retina satellite sites, this is projected to result in the avoidance of 67.6 kg of plastic waste, 141.89 kg CO₂e, and savings of £86,953.93 annually.
Given that ophthalmology is the busiest outpatient specialty in the UK, even modest changes like this can yield major environmental and financial benefits. Our specialty doctor in medical retina shared the success of the project in an online presentation at the 2025 London Greener Celebration event series.
In 2025, our A&E nursing team worked with our pharmacy team to re-label and return mislabelled stock deposited in a designated box. The team also set up a designated box in A&E for staff to return mislabelled medication. As proof of concept, the pharmacy team relabelled and returned stock to A&E, helping to reduce both waste and cost. The pharmacy team is currently collecting mislabelled medications twice a week as part of business as usual.
| Action | KPIs |
| Reduce waste from medication | |
| Reduce plastic waste by transitioning to multi-dose eyedrops. |
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| Reduce waste and costs, and improve patient safety by relabelling and returning stock. |
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| Build on work done to date to rationalise procedure packs to inform general use of clinical consumables. |
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| Reduce drug wastage during high seasonal temperatures. |
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| Reduce plastic waste by recycling eyedrop bottles. |
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