Specialist patient care pathways
Alongside its core Patient Care Pathways (PCP) methodology work, SHC has partnered with specialist clinical communities to apply this approach in depth to specific areas of care. Maternity and kidney care are two examples: both are high-volume, resource-intensive specialties where mapping the care pathway has helped identify carbon hotspots, build sector-specific guidance and tools, and support clinical teams to take practical action toward more sustainable, equitable care.
Green Maternity Care
SHC partnered with the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of Midwives (RCM), and the Centre for Sustainable Healthcare (CSH) on Green Maternity Care, a year-long, SBRI Healthcare-funded project (launched April 2024) to make maternity services more sustainable and more equitable at the same time. The project mapped maternity care pathways to pinpoint where carbon impact and health inequity overlap, recognising that outcomes such as maternal mortality and stillbirth vary sharply by ethnicity and deprivation, and that climate change disproportionately harms the communities already facing the worst care.
Building on those pathway insights, the partners ran the Green Maternity Challenge, training and mentoring clinical teams from selected UK maternity units to design and deliver sustainable quality improvement projects addressing the hotspots identified. The work culminated in a Green Maternity Report setting out priorities and evidence-based recommendations, alongside practical guidance for producing a maternity service carbon footprint — bringing the wider maternity community together to discuss how the findings should shape future care.
Sustainable Kidney Care
Kidney care is disproportionately carbon-intensive: globally, the roughly 2 million people receiving renal replacement therapy account for 2–3% of healthcare budgets and an estimated 14 million tonnes of CO2e annually, while UK studies have found dialysis care to be around 18 times more carbon-intensive per patient than average NHS care. With ESKD incidence rising and not all patients who need RRT currently able to access it, SHC frames this as an urgent priority for renal services trying to meet NHS Net Zero and international 1.5°C goals.
SHC’s work in this space builds on the Green Nephrology programme it helped set up in 2009 with the Renal Association, British Renal Society and NHS Sustainable Development Unit (now consolidated into the UK Kidney Association and Greener NHS respectively), which grew into a network covering over 80% of UK renal units. From 2019, SHC partnered with Newcastle upon Tyne Hospitals NHS Foundation Trust to carbon-footprint in-centre haemodialysis using SHC’s Care Pathway Guidance – life-cycle-assessing the service from manufacture through to disposal – producing a detailed picture of one part of the renal pathway and an online haemodialysis carbon calculator, while flagging that other components of kidney care still need the same treatment. More recently, SHC has supported the UK Kidney Association’s Sustainable Kidney Care Committee in developing a net-zero framework for UK renal services, collaborated with the International Society of Nephrology’s GREEN-K initiative on the “12 Steps to a Greener Kidney Unit” guidance, and produced a discussion paper on the burden of chronic kidney disease in the UAE with Pure Health, Maverex and AstraZeneca ahead of COP28.
