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Medicines

Moorfields has proactively moved beyond standard NHS guidance to explore innovative and specialty-specific sustainability practices in ophthalmic medicine.

Our progress so far

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. 

Moving from single use eye drops  

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.

Recycling pharmacy waste

In 2025, our A&E nursing and pharmacy teams collaborated to reduce medication waste by re-labelling and returning mislabelled stock. A designated box was introduced in A&E for staff to deposit such items, which the pharmacy team now collects twice weekly as part of routine operations. This initiative has successfully reduced both waste and cost.' 

Medicines plan

Action KPIs
Reduce waste from medication
Reduce plastic waste by transitioning to multi-dose eyedrops.  
  • Complete roll out of Tropicamide multi-dose eyedrops across medical retina by end of 2026. Potential to save 67.6 kg of plastic waste, 141.89 kg CO₂e annually. 
  • Increase usage and promotion of multidose preservative-free eyedrops throughout Ophthalmology (e.g. Latanoprost use by patients in the community during 2026: estimated potential to save up to 21,087 kgCO2e per year). 
Reduce waste and costs, and improve patient safety by relabelling and returning stock.  
  • Continue collecting and returning mislabelled medications from A&E twice a week.
Build on work done to date to rationalise procedure packs to inform general use of clinical consumables. 
  • Review high-use packs by 2028 – as an example, review of retinal therapy unit injection packs in 2026. 
Reduce drug wastage during high seasonal temperatures.
  • Review standard operating procedures (SOPs) in 2026.
Reduce plastic waste by recycling eyedrop bottles.
  • Initiate conversations nationally regarding recycling of medicinal packaging. involving conversations with vendors and national bodies.