Volume 51, Issue 2, February 2026, 103215Author links open overlay panel, AbstractBackground

Healthcare contributes approximately 4–5 % of the United Kingdom’s total greenhouse gas emissions, with patient and visitor travel responsible for up to 14 % of this footprint. Implementing telehealth in outpatient care offers potential to reduce travel-related emissions while maintaining high-quality care.

Objective

To evaluate the environmental impact and feasibility of replacing routine in-person cardiothoracic outpatient consultations with video appointments at a tertiary cardiothoracic center in Scotland.

Methods

This prospective quality improvement initiative converted 50 routine cardiothoracic outpatient appointments to virtual consultations using the NHS-endorsed Near Me video platform between January and April 2025. Round-trip distances from patient postcodes to hospital were estimated using standard geocoding tools. Carbon dioxide (CO₂) emissions avoided were calculated using the UK Government’s BEIS conversion factor of 211.2 g/mile for average petrol vehicles. Patient satisfaction and technical feasibility were evaluated through post-consultation surveys.

Results

Substituting 50 face-to-face appointments with Near Me video consultations avoided a total of 3,014.4 miles of patient travel, corresponding to approximately 636.7 kg of CO₂ emissions. No consultations required rescheduling due to technical difficulties. Patient satisfaction ratings were high, particularly for convenience and quality of interaction. Extrapolated to 1,000 patients annually, this model could prevent approximately 12.7 tones of CO₂ emissions.

Conclusions

Replacing in-person cardiothoracic consultations with telehealth is feasible, well accepted by patients, and environmentally beneficial. Scaling this approach across high-volume outpatient services supports the NHS’s commitment to net-zero emissions while preserving care quality and efficiency.

Introduction

Healthcare systems are increasingly recognized as significant contributors to global greenhouse gas emissions, responsible for approximately 4.4 % of global net output.1 In the United Kingdom, the National Health Service (NHS) contributes an estimated 4–5 % of national emissions, with patient and visitor travel accounting for 10–14 % of this total.2 Reducing emissions from travel has therefore become a strategic component of the NHS’s Greener NHS initiative and its legally binding commitment to achieve net-zero emissions under the Health and Care Act (2022).2

Telehealth has emerged as an effective intervention to reduce the carbon footprint of healthcare delivery.3, 4 Multiple studies demonstrate that virtual consultations significantly decrease travel-related emissions without compromising clinical outcomes or patient satisfaction.4, 5 However, evidence specific to cardiothoracic care—a specialty that often involves regional referral and long-distance travel—remains limited.

This study aimed to quantify the CO₂ emission savings achieved by converting routine cardiothoracic outpatient consultations to Near Me video appointments at the Golden Jubilee National Hospital, and to assess feasibility and patient experience.

Section snippetsDesign and setting

This prospective quality improvement initiative was conducted within the cardiothoracic department of the Golden Jubilee National Hospital (Clydebank, Scotland), a national tertiary referral center. The project was implemented between January and April 2025.

Participants

Fifty consecutive patients scheduled for routine non-urgent cardiothoracic outpatient reviews were invited to switch from face-to-face appointments to virtual consultations.

Inclusion criteria: Elective follow-up, clinical stability, and

Travel and emission savingsAll 50 patients successfully completed their virtual appointments.•

Total travel distance avoided: 3,014.4 miles

•

Estimated CO₂ emissions avoided: 636.7 kg

This equates to:•

The CO₂ absorption capacity of approximately 10 mature trees per year

•

The emissions from a petrol car driven 3,000 miles

•

Approximately 47 average-sized UK living rooms filled with equivalent CO₂ gas volume

Patient feedbackNo appointments required rescheduling due to technical difficulties. Survey feedback indicated:•

94 % rated convenience as

Discussion

This initiative demonstrates that replacing face-to-face cardiothoracic outpatient consultations with telehealth is both feasible and environmentally impactful. The project achieved measurable CO₂ savings while maintaining high patient satisfaction, consistent with findings from broader telemedicine research.3, 4

Conclusion

Transitioning routine cardiothoracic outpatient appointments to telehealth achieved substantial CO₂ emission reductions and excellent patient satisfaction. Scaling this digital model could meaningfully advance the NHS’s net-zero ambitions while maintaining care quality and efficiency.2, 3, 4, 5

Virtual care is not only patient-centred—it is planet-centred.

Ethics approval and consent to participate

This project was conducted as a service evaluation and quality improvement initiative within the NHS. According to local governance policy, formal ethical review was not required. Approval for implementation and data use was granted by the Golden Jubilee National Hospital Quality Improvement Committee. All participating patients provided verbal consent for teleconsultation and data inclusion.

Consent for publication

Not applicable — this study does not include any identifiable individual data.

Availability of data and materials

Anonymized data supporting the findings of this study are available from the corresponding author upon reasonable request and in accordance with NHS data governance policies.

Funding

This project received no external funding. The work was supported by departmental resources from the Golden Jubilee National Hospital.

Authors’ contributions

Dr Ibrahim Al-Shahwani conceived and designed the project, collected and analyzed the data, interpreted the findings, and drafted the manuscript. Dr Nawwar Al-Attar provided clinical supervision, methodological guidance, and critical review of the manuscript. Both authors read and approved the final version for submission.

Supervision

Conducted under supervision of Dr Nawwar Al-Attar.

Declaration of competing interest

The authors declare that they have no competing interests.

Acknowledgements

The authors thank the telehealth support team and administrative staff at the Golden Jubilee National Hospital for their assistance in implementing the Near Me consultations.

References (5)Global Healthcare Emissions and the Need to Decarbonize

BioMed Central

(2023)

Delivering a Net Zero NHS

(2022)

There are more references available in the full text version of this article.

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