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Objective: Health services contribute significantly to carbon dioxide (CO2) emissions and, while services in the UK are beginning to address this, the focus has been on reducing energy consumption rather than road transport, a major component of emissions. We aimed to compare the distances travelled by patients attending mobile breast screening clinics compared to the distance they would need to travel if screening services were centralized. Methods: Anonymized postcode records were analysed to determine driving distances potentially saved through attendance at 20 mobile breast screening clinics rather than at two centralized locations. Based on assumptions for the typical car used, the CO2 emissions were calculated for the current case of decentralized service through mobile clinics compared to a hypothetical case where only centralized services are available over one complete three-year cycle of breast screening invitations. Results: The availability of mobile breast screening clinics for the 60,675 women who underwent screening over a three-year cycle led to a return journey distance savings of 1,429,908 km. Taking into account the CO2 emissions of the tractor unit used for moving the mobile clinics around, this equates to approximately 75 tonnes of CO2 saved in any one year. Conclusions: Decentralizing health care delivery can potentially provide substantial reductions in emissions at the same time as improving the patient experience. Thus, the 'care close to home' agenda can simultaneously improve health outcomes and the environment. [ABSTRACT FROM AUTHOR]

Radiology registrars were observed performing a left renal artery angioplasty using a proprietary training simulator up to five times during their first year of training. Total procedure time, fluoroscopy times, and metric information from the machine were recorded. Each step of the procedure was judged by an observer and a mistake profile was generated. Fifty-two runs were completed by 12 trainees. The mean procedure time decreased from 16.6 min to 9.8 min over the five runs. The number of mistakes ranged from zero to ten and the mean number of mistakes made varied from 0.7 to 2.6 per procedure without any particular trend. Our study demonstrates that training on the simulator does improve performance. The mistakes made throughout training indicates the potential benefit from further simulator training. It remains unclear how to integrate this form of training in current educational programs.