From the Ward to the Web: Why Net Zero Healthcare is Personal
by Shelley Garlington, Growth Director at HBSUK
When I started my career as a Registered General Nurse, healthcare was defined by the physical. It was the sound of the ward, the smell of the disinfectant, and the face-to-face comfort we gave patients. In those days, the idea that a significant portion of patient care could happen outside the hospital walls probably never entered our heads.
Today, as Growth Director at HBSUK, I look at healthcare through a different lens. I see the strategic challenges of capacity, the urgent need for sustainability, and the ambitious NHS Net Zero targets. But recently, the gap between my past life as a nurse and my current life in leadership closed in a very personal way.
The "Daughter" test
Like so many of us in this sector, I recently found myself on the other side of the system. I became the carer, juggling a demanding job while taking my mother to her hospital appointments.
The reality of that experience was a wake-up call. It wasn’t just the anxiety about her health; it was the logistics. The negotiation with my diary to find a three-hour window for a 15-minute consultation, all while wondering if the Wi-Fi would stretch to the outpatient’s department! The stress of traffic, the hunt for a parking space, all add to the difficulties.
Sitting in that waiting room, I realised that for every patient we treat, there is a hidden cost. There is the economic cost of time off work, the emotional cost of stress, and crucially the environmental cost. Every mile driven, every paper form filled, every heated waiting room contributes to the NHS’s carbon footprint.
The carbon cost of "face-to-face by default"
The data tells us that in-person appointments generate an average of 2.84 kg of CO2 per visit. That might sound small, but when you scale it across the millions of outpatient appointments the NHS handles, the impact is staggering.
At HBSUK, we’ve calculated that shifting just 10% of a single Trust’s outpatient appointments to digital remote consultations could save over 355,000 kg of CO2 annually. That is a massive contribution to the NHS’s goal of reaching net zero for direct emissions by 2040.
But sustainability isn’t just about carbon; it’s about sustaining the service itself. When a patient struggles to get to the hospital because of transport costs, mobility issues, or work commitments, they often don’t show up. These “Did Not Attend” (DNA) slots are a waste of precious clinical time and energy.
Is digital a greener, kinder way?
This is why I am so passionate about the work we are doing with digital outpatients. It’s not tech for tech’s sake; it’s a solution that respects the patient’s time and the planet’s resources.
By using digital remote consultations, we allow patients to be assessed from the comfort of their own homes. For a daughter juggling a full-time job, this means no need to drive to the hospital. For the NHS, it means reduced footfall, lower energy consumption, and a streamlined pathway that reserves physical infrastructure for those who genuinely need it.
And it works. We’ve seen our digital outpatients reduce DNA rates significantly, in some cases dropping from 30% to under 17%. That is efficiency and empathy in action.
The hybrid future: Insourcing & innovation
Of course, as a former nurse, I know that digital can’t replace everything. Hands-on care is the heart of medicine. This is where our insourcing model complements the digital side perfectly.
For those who do need to be seen in person, we must ensure our physical spaces are used just as efficiently. By bringing specialist teams into NHS facilities during evenings and weekends, we maximise the use of buildings that are already heated and lit, rather than building new carbon-intensive infrastructure. It’s a circular economy approach to healthcare, using what we have more efficiently to cut waiting lists and emissions simultaneously.
A personal vow
My journey from nurse to director has taught me that “efficiency” isn’t a dirty word. It’s the mechanism that allows us to be more productive and to care for more people.
When I look at the future of the NHS, it’s about the ‘experience’ of both providing and receiving care. I see a system that values a patient’s time as much as their health. I see a system where a patient can choose, because the appointment can happen on a tablet in the living room.
That is the sustainable, net-zero NHS we are building. And for me, it’s personal.
Shelley Garlington was appointed Growth Director of HBSUK in 2024. She leads the company’s strategic expansion, building partnerships with NHS Trusts and private providers, and oversees the Business Development and Marketing functions.
Find out how HBSUK is delivering sustainability in healthcare
We’re excited to be part of the conversation on building a greener, more resilient NHS. Read our latest whitepaper on sustainability in healthcare here.