Identifying and reducing waste from piped nitrous in the NHS 

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.  

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 a toolkit 

We are working with NHS England to create a comprehensive toolkit to support NHS organisations and teams to identify and address waste from piped nitrous oxide. The toolkit will include guidance to ensure nitrous oxide continues to be readily available for clinicians and patients when they need it.  

The toolkit, which builds on existing internal NHS England guidance, will 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 will work 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 will engage with a range of NHS organisations to inform the development of the toolkit.