With the NHS pledging to be net zero by 2040, the Hand therapy team at Chelsea and Westminster hospital have been focusing quality improvement projects on increasing sustainability. Realising that traditional splinting materials produce a significant amount of landfill waste and greenhouse gases, the team is gradually replacing plastics with a biodegradable and reusable alternative. The response from the hospital, the Trust, and patients has been extremely positive. 

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The project lead by Zoë Thompson, a Specialist Occupational Therapist in Hand therapy and Green Champion, aims to significantly reduce the amount of non-green products and materials used for splinting in her hand therapy unit. The goals align with the Greener NHS initiative, but the original spark for making a change came from Thompson’s own passion for the environment. Hand therapists create splints to help patients with a variety of hand injuries and long-term conditions. Traditionally these splints are created using thermoplastics, which are both non-recyclables, take hundreds of years to biodegrade and can leak toxins into the ground when disposed of.

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“The climate crisis is a health crisis. As a health care professional, I believe it is part of our role to make changes in this area and be a visible sign to patients that we care about the long-term health of the population and planet. The best way to make change is to start where you are”, Thompson explains. 

Finding greener alternatives

‍When Zoë Thompson began the project in March 2021 to replace plastics with greener alternatives, minimal green options for hand therapy, splinting, and casting were in use at the hospital. However, a wood-based biodegradable and heat-mouldable material called Woodcast had been trialled in the department a few years earlier. It was introduced to the department by Thompsons colleague Hayley Fay.

‍“It had been challenging for the team to embrace the change. Therefore, we did not pursue it further” explains Thompson, “However, climate consciousness has increased over the last few years and the timing was right this time around with the whole team keen to support the transition.”  

The material is made from aspen-wood and biopolymers and has been used in casting and splinting for a decade. In fact, it was already in use in other hand therapy units.

‍“I gathered feedback from other therapists to ensure this time around our team could overcome previous challenges. We trialled it again and found it so easy to use and natural! I brought the material in, and our team has used it since June 2021”, Thompson recounts.  

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No compromises on patient comfort, safety, or care quality  


The splint can be reheated and refitted on the same patient multiple times and sorted in biowaste after they have healed. The team has also now been made aware of another green product called UCAST. They are currently trialling the product, which is fast to apply and very comfortable for the patient to wear in addition to being sustainable. 
 


“Reactions from patients have been extremely positive. We completed a survey in September 2021 to ensure patients were happy with the comfort of the material; it is not about making compromises at all. 84% of patients reported that using biodegradable materials was important to them. Visibility of this project is key as it inspires others to make the changes they can too”, Thompson says.

Speaking out for greener healthcare  

The whole Hand Therapy team at Chelsea and Westminster has been instrumental in this project led by Thompson, from helping with gaining funding for the new equipment needed to measuring the plastic waste to monitor its reduction.

This project has highlighted the greener cause internally and within the Trust. A recent data analysis has shown that the thermoplastic waste has been reduced by 54 % following the introduction of Woodcast. The goal is to continue to increase this percentage. 



In June 2022, Zoë Thompson takes her initiative outside her unit and hospital as well. She is going to speak in a high-profile hand therapy and hand surgery conference IFSSH about greener splinting solutions and reducing plastics waste from splinting. The goal is to spread the knowledge and let others know there are effortless ways to provide highest quality care while also having a positive impact on the environment. 
 
“This event is a great opportunity to speak about a subject that I am passionate about, and that no one else has really talked a lot about before. My whole team are looking forward to sharing this project and its success, an example that NHS grassroot level initiatives can really have a big impact.” 

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Would you like to hear Zoë speak about greener splinting and sustainable healthcare? Register for the event here. 

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