Climate change is a very real threat to the world as we know it.
Therefore, it is important we all make changes to become more sustainable and reduce our carbon footprint. Here at the Functional Gut Clinic, we have incorporated many of these changes into how we operate on a day-to-day basis to minimise our impact on the environment and lower our carbon footprint whilst improving our patient services.
Reducing patient footfall and unnecessary in clinic testing:
The COVID pandemic provided the biggest challenge to healthcare the world has seen in recent history. Every aspect of how healthcare is delivered in order to be safe and effective has been looked at an ushered in a new era of innovation. At Functional Gut, even before the pandemic back in 2018, we recognised that by developing highly effective home testing kits and implementing remote support via telephone consultations, online videos and using video conferencing platforms we could drastically reduce the need for patient travel.
Home Testing Kits – The Evidence
Our hydrogen-methane breath tests (HMBTs) for SIBO and malabsorption testing can be performed at home as a postal kit, meaning patients no longer have to make the journey to the clinic. Since the introduction of our postal kits, we have seen a yearly increase in the proportion of patients opting to use them. In 2019, 74% of private patients used postal kits instead of clinic appointments, which jumped to 94% and 99% in 2020 and 2021, respectively. The remaining 1% of in clinic appointments are usually those who require additional assistance or international patients visiting the country for only a short period of time. A recent review of patient compliance in over 1500 home testing kit patients showed only 0.1% of tests were considered invalid and these were quickly repeated in-clinic to obtain results.
Following the pandemic, similar systems were put in place for the gastric emptying studies (GES) and H. Pylori tests, which followed a similar rise in uptake. In 2020, 70% of patients received GES postal kits and 65% of patients received H. pylori home kits, which both increased to 100% in 2021. The kits support our continuing high level of patient care (as per CQC requirements) and best practices within GI physiology. Additionally, there is a financial benefit for patients as they no longer have to pay travelling costs.
24h ambulatory pH monitoring
One further test which has seen progression is the 24hr pH monitoring for gastro-oesophageal reflux assessment. Even before 2020, FGC encouraged patients to remove their nasogastric probes themselves at home where safe and if the patient felt confident with the process at the end of the 24-hour pH monitoring period. Support is provided by the clinical team on how to do this safely and a secure, pre-paid postage envelope was provided for ease of return. This means the patient does not have to travel unnecessarily for a 5-minute appointment the removal of the tube, and they could post back the monitor to us with ease. Over the past 5-years this has saved approximately 20,000 patient journeys which could be multiplied more than 10-fold if adopted across the UK.
We adopt a hybrid approach to working, enabling staff to work from home where possible to reduce unnecessary travel. Both the clinical and admin teams use video calls to ensure clear avenues of communication despite working from different locations. Many of our team members choose to use public transport or cycle to work, and our fleet cars are electric or hybrid to keep carbon emissions to a minimum. Additionally, video platforms such as Zoom have been employed to deliver virtual conferences, further reducing the need for travel.
Our HMBT kits are 95% recyclable, made up of a cardboard box, paper instructions. The only non-recyclable elements are sample tubes and bubble wrap (essential for safe transport), which must be disposed in a sharps bin and general waste, respectively and we are working with the infectious waste disposal companies to see how we can improve this. Similarly, GES and H. pylori postal kits are made from recyclable products where possible.
For 24h pH monitoring, the enveloped provided to return the kit and the monitor batteries are also 100% recyclable.
In clinic, the team recycle all possible waste, including batteries and carboard boxes from deliveries. Clinic members also use reusable and recycled consumables including face visors.
Paperwork is only printed where necessary and admin teams email signatures encourage others to do the same. Furthermore, we only use recycled paper and recyclable ink cartridges.
Our clinic staff and guests have access to a water cooler to discourage use of plastic bottles, which will save around 64kg of CO2 per year compared to single use bottles.
We have sensor lighting to ensure lights are not left on. Individual storage units are present in separate areas instead of a central heating system so unused rooms are not unnecessarily heated. Additionally, our team have been provided with fleeces to reduce the need for high heating settings. At our Cambridge clinic we also have a garden to promote green areas, grow vegetables and encourage local wildlife.
In summary, Functional Gut has a long-standing commitment to reducing our impact on the environment and we continue to look for ways to continue this progress and educate others on how to implement these practices.
We are all in this together!