Cardiff and Vale University Health Board (UHB) has helped to pioneer ground-breaking technology that makes the use of ‘gas and air’, given as pain relief to women in labour, safe for the environment.
It says the development has the potential to slash harmful emissions in Cardiff and the Vale and beyond.
The new nitrous-oxide ‘cracker’ machine has been installed in the maternity unit at the University Hospital of Wales, and has been met with positive responses from both healthcare professionals and patients.
‘Gas and air’, or Entonox, is a mix of nitrous oxide and oxygen and is widely used to provide pain relief to women in labour. When exhaled, this greenhouse gas contributes significantly to climate change. It represents about 75% of all the carbon dioxide equivalent (CO2e) from anaesthetics used across Cardiff and Vale UHB.
The newly installed machine, called a nitrous oxide “cracker”, breaks up the nitrous oxide into harmless nitrogen and oxygen, the main components of normal air, after the gas has been used. This slashes the harmful emissions while ensuring patient care is not compromised.
A diverse team of clinicians, pharmacists, estate managers, and engineers came together to tackle the problem encouraged by the Health Board’s Spread and Scale Academy, a programme designed to bolster innovation across various sectors.
Dr Charlotte Oliver, a Consultant Anaesthetist at Cardiff and Vale UHB who has been a driving force in this initiative, said: “Our aim has consistently been to diminish waste and emissions. The cracker is not just a machine; it symbolises our commitment to sustainable practice and represents a crucial leap forward in reducing harmful emissions.”
The project was initiated as part of a broader effort by Cardiff and Vale UHB and the wider NHS Wales system to make healthcare practices more environmentally sustainable. The project was supported by funding from Welsh Government’s Small Business Research Initiative (SBRI) and an initial competitive selection process chose, e-breathe, a Northern Irish MedTech company to develop the prototype. The focus on UK manufacturing was not just about economic benefit but underscored a commitment to sustainable practice.
Its success is anticipated to lay the groundwork for wider commercial rollouts and collaborations beyond Cardiff, aligning with the NHS's and Welsh Government’s overarching sustainability ambitions.
Charlotte said:
“This project is more than just about reducing emissions; it's about a new way of thinking in healthcare sustainability. The success of this initiative could inspire countless other organisations to take proactive steps in combating climate change.”
Faye Williams, SBRI Project Manager said:
“I am really proud to have been able to deliver this project on behalf of the SBRI Centre of Excellence. Charlotte and her team at Cardiff have been wonderful to work with and the unique collaboration with Cardiff and Vale UHB along with colleagues from NWSSP, Betsi Cadwaladr University Health Board and of course David at e-breathe has seen this idea go from concept to reality.
“To see the final prototype in use at Cardiff is great as it shows what we have been able to achieve, and I hope this can have a wider impact across Wales and beyond.”
David McLaughlin, CEO of e-breathe, said:
“This innovative product provides a sustainable way for mums to get the pain relief they require during childbirth and provide a more comfortable work environment for midwives – as such it ticks a lot of boxes for us at e-breathe as an integral part of our vision to provide more sustainable healthcare.
“Working with the SBRI and clinical teams at UHB has provided immensely valuable access to real-life users who could help shape the product and also a route to trial the product. The collaboration has been a pleasure.”
Suzanne Rankin, Chief Executive of Cardiff and Vale UHB, said:
“I extend my heartfelt gratitude to all our colleagues for their tireless efforts in advancing sustainable healthcare. Your dedication to innovation and sustainability exemplifies what we can achieve together. Through the spread and scale of ground-breaking innovations like the nitrous oxide cracker, we are taking significant steps towards minimising our environmental impact while maintaining high standards of patient care. This commitment to sustainability not only benefits our community today but also ensures a healthier tomorrow for future generations.”
