The SHC care pathway assessment framework
The framework
The care pathway assessment framework consists of the method, guidance and care pathway carbon calculator. Taken together, the framework helps to measure the environmental impact of healthcare pathways – both those already in use and new ones being developed – in a consistent way. This information can help decision-makers choose ways to make care delivery more sustainable.
The framework currently measures three things: greenhouse gas emissions, water use, and waste. It’s based on internationally recognised standards for measuring environmental impact, including ISO 14040 and ISO 14044 (the standards for life cycle assessment), the Greenhouse Gas Protocol’s Product Standard, and its sector-specific guidance for pharmaceutical products and medical devices.
Emission factors
The calculator and pre-built modules draw on data covering the full lifecycle of care – from manufacturing consumables, equipment and medical gases, through to energy use, staff travel, waste and water. This data was first gathered in 2015. In December 2023, the surgical procedure module was updated with newer emissions data. The remaining healthcare data will be updated, expanded and internationalised through the work of the PCP consortium.
Because this is still a developing area of research, the data has come from a range of studies using different methods across healthcare systems worldwide. If you’d like more detail on where the data comes from, what it does and doesn’t include, and its limitations, you can find this in the environmental impact table or the full guidance documents.
The method
The method outlines how to appraise models of care, allowing users to understand the environmental impacts of new or existing care pathways and ultimately to improve the sustainability of health systems. By applying the method, a user will gain a greater understanding of the environmental impacts of health services, including both direct impacts and those expressed across the whole care pathway.
The method document should be used alongside the supporting guidance.
The guidance
There are several guidance documents to assist with the appraisal process. This includes a Summary overview for high-level appraisal, a comprehensive main document for detailed module analysis, plus individual module guidance documents. In addition, these documents provide:
• useful definitions
• support to identify to where to source relevant data from
• specific pathway appraisal information
The guidance is currently focused on a limited number of care pathway modules and environmental metrics. There is work underway to include further modules and sustainability metrics (social and environmental), as part of our work with the PCP Consortium.
The carbon calculator
The care pathways carbon calculator is a simple, entry-level tool that lets anyone assess a care pathway and estimate its environmental impact. It uses pre-built modules based on common healthcare activities, so you don’t need specialist data or expertise to get a high-level estimate. It’s best suited to quick, indicative assessments – for a more detailed or rigorous analysis, other tools aligned with the SHC method are available.
The emissions database
The emissions database is an open-access repository of emission factors for care pathway activities. Sources are provided at the highest level of detail possible, so you can see exactly where each figure comes from and how it was calculated. Where underlying data is proprietary and cannot be published in full, we provide as much detail as possible, alongside a description of the source.
Next steps
Once you have assessed the care pathway, the next step is to take action. Take a look at some ways you can decarbonise a care pathway, to help get you started, or start up a conversation in our community of practice to learn from peers who have faced similar challenges.
