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Identifying and reducing waste from piped nitrous in the NHS 

We have worked with NHS England to create a comprehensive toolkit to support NHS organisations and teams to identify and address waste from piped nitrous oxide and nitrous oxide/oxygen mixture gases.

Nitrous oxide is a commonly used medical gas and is responsible for the largest overall volume of emissions from anaesthetic and medical gases (at least 80% in 2019/20). Tackling these emissions is essential to achieving NHS England’s commitment to reaching net zero. The biggest opportunity to reduce emissions from nitrous oxide is to reduce waste from piped nitrous oxide and nitrous oxide/oxygen mixture gases.  

What has happened so far? 

NHS trusts have achieved sizable emissions reductions already, reducing nitrous oxide waste through: 

  • audits and system pressure tests to identify leaks; 
  • repairs to pipework and improved stock management; 
  • where appropriate, decommissioning of the medical gas pipeline system (MGPS) and moving to portable nitrous oxide cylinder supply.  

However, there is the opportunity for more trusts to come on board and to go further to reduce waste and address concerns around exposure to leaks. There is also an opportunity to reduce financial costs related to piped nitrous oxide systems. 

Creating the Nitrous oxide toolkit: Reducing waste in NHS trusts

We have worked with NHS England to create a comprehensive toolkit to support NHS organisations and teams to identify and address waste from piped nitrous oxide and nitrous oxide/oxygen mixture gases. The toolkit includes guidance to ensure nitrous oxide continues to be readily available for clinicians and patients when they need it.  

The toolkit builds on existing internal NHS England guidance to address the practical barriers to reducing waste from piped nitrous oxide and share best practice from NHS organisations who have already undertaken this work.  

We have worked closely with NHS staff and other stakeholders to ensure that the toolkit meets the needs of varied NHS organisations that use a medical gas pipeline system for nitrous oxide. With consideration of their different operating environments and levels of progress already made towards waste reduction, we have engaged with a range of NHS organisations to inform the development of the toolkit.  

Looking ahead  

We are now working with NHS Elect to implement the toolkit during 2024/25. This will include utilising the experience of those who have successfully implemented waste reduction projects. It is will also include hosting webinars, providing forums and creating opportunities to connect with others doing similar work.  

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