GIRFT Greener Pathways – a sustainability collaboration

13 Feb 2026

The National Joint Registry (NJR), hosted by HQIP, has been a key contributor to the development of GIRFT’s new ‘Greener Pathways’ guide to decarbonising the hip replacement pathway, which has been written to support the NHS to reduce environmental impact while improving patient care.

Development of the guide has been in collaboration with: Greener NHS, the Royal College of Anaesthetists, the British Orthopaedic Association, the British Association of Day Surgery, the British Orthopaedic Trainee Association, the British Hip Society, the Royal College of Surgeons of England (RCS), the Sustainable Health Systems Hub. The mix of collaborators has enabled the guidance to be shaped by input from leading clinical experts spanning primary to tertiary care, as well as having benefitted from the involvement of patients.

The guide lists 13 high-impact and practical clinical recommendations for decarbonising elective hip replacement surgery, covering every step of the patient pathway from community care and referral through to pre-, peri- and post-operative processes. For each recommendation, the potential annual emissions reduction, should the recommendations be carried out, is also given.

Each of the recommendations is supported with key actions to achieve carbon saving (for example, rationalising equipment in surgical tray sets and using absorbable sutures instead of staples), as well as a rationale for the changes and the benefits for both patients and the NHS.

Further information and the full guide are available on NJR’s website.