Reusable tourniquets apply pressure to reducing waste at Mid Yorkshire

A switch to the use of reusable tourniquets by the Mid Yorkshire Teaching NHS Trust has seen a reduction achieved in both carbon emissions and costs.

Tourniquets are used across the NHS to assess and determine the location of a suitable vein on a patient for drawing blood by applying pressure to a limb to limit the flow of blood.

Across the Trust, teams are constantly looking for ways to incorporate more sustainable and cost-effective solutions, especially in high-volume clinical products such as tourniquets. Annual figures showed 330,000 disposable tourniquets were used each year within the Trust, which had a large impact on the budget allocated for purchasing and waste disposal.

At the start of 2022, a review of tourniquet usage across the Trust began. Our Procurement team worked in liaison with NHS Supply Chain to identify a reusable alternative which could meet the Trust’s requirements around cost, sustainability and clinical need. As part of the review, each departments’ tourniquet usage was captured by the Procurement and Sustainability team. A wide range of internal and external stakeholders were also consulted.

Following the assessment of a variety of samples, the Daisygrip reusable tourniquet was approved for trial within high usage areas, starting with the Phlebotomy department. After receiving positive feedback, trials were then extended to the Emergency Department and Computerised Tomography.

The trials were successful across all departments, and the Procurement team were able to evidence the waste disposal benefit of switching from a variety of disposable alternatives previously in use. The results showed that when the Daisygrip tourniquet had been used eight or nine times, sustainability benefits would start to be realised. The standardisation from several brands to one tourniquet across the Trust would also enable easier inventory management and allow a more streamlined user training rollout.

In 12 months since the introduction of reusable tourniquets, the Trust has seen:

A reduction in plastic waste of three-quarters of a metric tonne² (attributable to the reduction of single use tourniquets), which equates to 2.3 tonnes CO₂e.
Procurement savings of £20,000. These were realised once the tourniquet had been used approximately 250 times, dependant on what the disposable alternative was and the number of uses within each department.
A substantial reduction in the number of single use tourniquets used¹, e.g., in a six-month period of the trial, Phlebotomy services alone used 6,375 fewer single use tourniquets, producing 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.”

¹ Each reusable tourniquet has a useable life of two years or 10,000 uses, tested and verified by the manufacturer.
² Three-quarters of a tonne of avoided plastic waste = 2.3 tonnes of CO₂e (using conversion factors for material use; Average Plastic. https://www.gov.uk/government/publications/greenhouse-gas-reporting-conversion-factors-2023 )