Specialist patient care pathways
Alongside our core Patient Care Pathways (PCP) method work, we partner 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 towards more sustainable, equitable care.
Green Maternity Care
We 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 project funded by SBRI Healthcare and launched in April 2024. Its aim was 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. Outcomes such as maternal mortality and stillbirth vary sharply by ethnicity and deprivation, and climate change disproportionately harms the communities already facing the worst care.
Building on these insights, we ran the Green Maternity Challenge with our partners, training and mentoring clinical teams from selected UK maternity units to design and deliver sustainable quality improvement projects targeting the hotspots identified. The work culminated in the Green Maternity Report, which sets out priorities and evidence-based recommendations, alongside practical guidance for producing a maternity service carbon footprint.
Sustainable Kidney Care
Kidney care is disproportionately carbon-intensive. Globally, around 2 million people receiving renal replacement therapy (RRT) account for 2–3% of healthcare budgets and an estimated 14 million tonnes of CO2e each year. UK studies have found dialysis to be around 18 times more carbon-intensive per patient than average NHS care. With end-stage kidney disease (ESKD) on the rise, and not everyone who needs RRT currently able to access it, this is an urgent priority for renal services working towards NHS net zero and international 1.5°C goals.
Our work in this area began in 2009, when we helped set up the Green Nephrology programme with the Renal Association, the British Renal Society and the NHS Sustainable Development Unit (now the UK Kidney Association and Greener NHS). It grew into a network covering more than 80% of UK renal units.
From 2019, we partnered with Newcastle upon Tyne Hospitals NHS Foundation Trust to carbon footprint in-centre haemodialysis using our care pathway guidance, assessing the service’s full life cycle from manufacture to disposal. This produced a detailed picture of one part of the renal pathway and an online haemodialysis carbon calculator, and highlighted other parts of kidney care that still need assessing.
More recently, we have:
- 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
- produced a discussion paper on the burden of chronic kidney disease in the UAE with Pure Health, Maverex and AstraZeneca ahead of COP28
Next steps
Interested in applying the care pathway approach to your specialty? Find out how to assess a care pathway, or get in touch to explore working with us.
