Nitrous oxide toolkit: Reducing waste in NHS trusts

Nitrous oxide and nitrous oxide/oxygen mixture, also known as ‘gas and air’ are used in a variety of settings across the NHS. Recent work has shown that the way these gases are supplied, through medical gas pipeline systems, can cause significant waste. Evidence shows leaks in these supply systems, alongside other issues, cause around 75% – 99% of the gases to be wasted. 

This interactive toolkit has been developed to help NHS trusts to reduce nitrous oxide waste safely and efficiently. Through doing this work, there is an opportunity for NHS trusts to save time and money, improve operational efficiency and to reduce carbon emissions from nitrous oxide, a potent greenhouse gas. 

The toolkit offers clear step-by-step guidance on how to reduce waste. This includes practical tools, case studies and advice from trusts to support implementation of simpler, smaller supply systems. 

The toolkit has four main sections: 

1. Understanding nitrous oxide systems: this covers the basics of how the gases are used and supplied in clinical settings, helping staff understand where waste commonly occurs in their supply.
2. Getting started: this provides practical guidance on setting-up waste reduction efforts, creating governance structures, engaging stakeholders and building effective project teams.
3. Aligning supply with clinical use: this offers a framework for assessing usage of the gases and making informed decisions about transitioning to smaller, simpler supply systems.
4. Optimising systems: this details multiple ways NHS staff can continue to reduce waste and increase efficiency in the supply of the gases, no matter the system being used.