Press Release

Scottish Government Endorses ESAIC Glasgow Declaration on Sustainability in Anaesthesiology and Intensive Care

The Scottish Government has formally endorsed the Glasgow Declaration on Sustainability in Anaesthesiology and Intensive Care, an initiative led by the European Society of Anaesthesiology and Intensive Care (ESAIC) to reduce the environmental impact of perioperative and critical care practices across Europe.

This milestone follows the historic first national endorsement by the Spanish Ministry of Health and the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) in October 2024, positioning Scotland as a leading force in the United Kingdom and Europe for climate-conscious healthcare.

Launched at Euroanaesthesia 2023 in Glasgow, a city known as “The Dear Green Place”, the Glasgow Declaration¹ builds on ESAIC’s tradition of collaborative, patient-focused standards such as the Helsinki Declaration for Patient Safety. It sets out a science-based, actionable roadmap for integrating sustainability into anaesthesiology and intensive care. These commitments include promoting low global-warming-potential anaesthetic agents, improving energy efficiency in operating theatres and intensive care units, increasing the use of renewable energy, reducing waste, and minimising pharmaceutical pollution.

The Declaration aligns directly with the European Union’s climate targets to reduce emissions by 55% by 2030 and achieve climate neutrality by 2050, as outlined in the European Green Deal. The urgency of such action is underscored by the World Health Organisation, which warns that failure to address climate change could result in 250,000 additional deaths every year worldwide between 2030 and 2050.²

Health Secretary Neil Gray said: “The Scottish Government is working with the health service to deliver a range of initiatives to help NHS Scotland reach its net zero target by 2040. I am pleased the Scottish Government has been able to endorse the Glasgow Declaration as a sign of our commitment to ensure that clinical practices take place with minimum environmental impact.”

In 2023, ESAIC’s Sustainability Committee published over 90 evidence-based recommendations for greener perioperative and critical care, validated through European-wide expert consensus.³ An updated amendment in 2024 further strengthened the Declaration’s clinical relevance by explicitly endorsing regional anaesthesia as a sustainable option, calling for greater reductions in the use of high global-warming agents such as nitrous oxide and desflurane, and highlighting the importance of changes that are both measurable and adaptable to different healthcare systems.

“The ESAIC Glasgow Declaration on Sustainability in Anaesthesiology and Intensive Care is a crucial step towards fulfilling the European Union’s commitment to address climate change and achieve climate neutrality by 2050,” commented Prof. Wolfgang Buhre, president of the ESAIC.

By endorsing the Declaration, Scotland reaffirms its integration of sustainability into national healthcare policy and practice. Measures include:

• Creation in August 2022 of a National Green Theatres Programme, including a national network of key specialists across all areas of surgical care and monthly national meetings to coordinate strategies and projects
• Removal of Desflurane from clinical practice in January 2023
• Mitigation of Nitrous Oxide use and decommissioning of nitrous pipeline systems
• Waste segregation, management and recycling projects
• Review and safe rationalisation of out-of-hours theatre ventilation and anaesthetic scavenging systems
• Review and rationalisation of single-use devices and consumables

The European Society of Anaesthesiology and Intensive Care is Europe’s largest professional body for anaesthesia and intensive care medicine, dedicated to promoting patient safety, scientific advancement, and professional excellence. ESAIC leads pan-European initiatives to improve standards of care while addressing global challenges, such as the climate crisis. 

References

1. The Glasgow declaration on sustainability in Anaesthesiology and Intensive Care European Journal of Anaesthesiology | EJA
2. European Society of Anaesthesiology and Intensive Care consensus document on sustainability: 4 scopes to achieve a more sustainable practice https://pubmed.ncbi.nlm.nih.gov/38235604/ 
3. World Health Organisation. (2021). Climate change and health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health