Hello, it's Anthony Chadwick from the webinar vet, welcoming you to our second live webinar during VC 2021. Very fortunate today to have Zoe Halfare on the webinar, and Zoe's going to be talking about championing sustainability in the veterinary profession. Zoe is a Cambridge graduate and works as a soft tissue surgeon at Davis vet referral service in just outside London.

And of course, Davis has been a real leader in this whole area. We're gonna see how things are developing, but also how we can be involved in this whole movement. This isn't just for individuals.

I think everybody has to be involved. We're, we're in. Trouble with the climate, and we need to start to act sustainably and even sort of to be able to rebuild some of our systems as well.

So, really looking forward to what Zoe's going to speak about today, and Zoe, it's over to you. Thank you very much, Antony, for the introduction. So I'm really delighted to have the opportunity to speak with everyone today, and thank you to those of you, here, who are taking the time to attend this session.

My session is going to be about, environmental sustainability in the veterinary profession. And particularly looking at some of the things that that sustain are doing with regards to the work in clinical veterinary practise. And for those of you who don't know, Vet Sustain is a group of veterinary professionals and and veterinary power professionals who are passionate about championing sustainability in the veterinary profession.

So I've had a kind introduction, from Anthony already, just a little bit more. I worked in first opinion practise for a couple of years, and before then moving to referral academic, practise at the Royal Veterinary College where, I worked for, for many years and went through an internship residency training and then was a soft tissue surgeon, for, for a long period of time there. And I currently work at Davies, veterinary Specialists.

And in the summer. I was fortunate enough to be able to attend a course at Cambridge Institute of Sustainable Leadership, which was a really fascinating course looking at the different approaches that we can take to try and tackle these enormous challenges that we're facing, as a society and as a planet. I have been, chair of the Greener Veterinary practise working group over the last year, and, I'm involved in work with Vet Sustain.

So the Greener Veterinary practise Working Group is one of the arms. Of that sustain. There are two other broad arms.

One is the veterinary curriculum working group, looking at, how sustainability can be signposted and emphasised within the veterinary curriculum. There's in the Food and farming working group, and then the third group, the one that I chair, is the Greener Veterinary practise Working Group. And this group, actually looks at What potential problems are there and what solutions might there be to sustainability issues in clinical veterinary practise.

So, all, aspects of veterinary practise are represented. We have, veterinary surgeons, at a range of stages in their career, registered, veterinary nurses as well, both in, in small animal equine, and, mixed practise. What we hope to be able to do is to facilitate cooperative engagement between all areas of the profession, and signpost to leading examples, of, situations where practises have looked at at problems, and identified solutions, and we want to make it easy to be able to access, these, examples and these resources that are available.

We, sort of a group of about 12 people and at the moment what we've been doing is meeting once monthly in a virtual capacity. I wanted to just launch a poll at this point, please, and just to find out how many people actually have established a sort of a green team, so a group within your practise who are thinking about environmental issues, and I'll just leave that a moment to run. I'm not sure if you can see that, Zoe, so I will shout out the numbers.

So we have just given people a couple of more seconds to vote. I think there's still some more who can vote if you want to vote. .

But it looks like 14% said yes, and 86% said no, so the majority don't have a green team. Great, thank you, Antony. And then the second question, within that poll, was actually, asking if people have been thinking about it.

Are they thinking of starting a group interested in in environmental issues, just to, to have an idea of where people are. So again, people are voting on that. Let's give her a few seconds.

You should just be able to click on it and register your vote, so don't be shy, do do vote and then we can see what people are, are thinking. So we have 65% saying they are thinking of starting one and 35% saying no at the moment. OK, great.

Thank you very much. That's great. So we can close the polls for the moment and just move on to the, to the next slide.

So. What, that sustain has done is created a website that's got, lots of resources on there. There are webinars, and there are links to, useful articles.

The Greener Veterinary practise Working Group, has, collated a number of different case studies and from practises that have already, embarked and progressed a long way, in their journey to sustainability. One of the, the leading, practises, within the United Kingdom, is Davey's veterinary Specialist, where I do, now work, but I have to say at the, the time, of them achieving, the sort of fantastic green credentials that they, they have, I, I wasn't a part of the, the Davies team, and actually, my move to, to work with them, . Was was partly related to being drawn to an employer with very strong green credentials.

Now, Davey's veterinary specialist actually was the first practise to achieve environmental management accreditation with the investors in the environment and now, are actually accredited with the green award. And Davis have got lots of really useful resources on their website, and documenting how, their journey progressed, with, with lots of useful guides, as to, how you, you could, do the same. Another, example on the website is Regent Court Veterinary practise in Penzance, who were awarded, a plastic-free status award from Surfers Against Sewage and environmental charity, recognising the fantastic work, that they had done to try and minimise the use of plastic, within their premises as much as possible.

Now we know that within clinical practise, I mean, with modern medicine, that, that plastic does play an integral role in, in what we do. This was, sort of looking at, at reducing the use of plastic in, in any way, that they could. There are numerous other, really fantastic, examples, that, we have been kindly.

Provided with by these practises who've done such a lot of work, in terms of improving environmental sustainability, in, in their practise. And these are available to read, on the site and it's somewhere I would recommend having a look, to be inspired, and then stimulated and to take action. So thinking about what is the environmental impact of clinical practise.

Unfortunately, it really is huge and that that that's quite depressing, but looking at it from an optimistic perspective, if you're in a position where you haven't yet started. Thinking about what you can do with regards to environmental sustainability. And the great news is that there's plenty of potential to really make a difference.

And that's why it's really important for us all to be involved as veteran professionals because we can make decisions that do make a significant difference. So, the really big, impacts, upon the environment is energy consumption, and the procurement, of both equipment and pharmaceuticals and the processes that need to happen for those items to, to be, produced, to be packaged, to be transported. There is also the consideration, of, healthcare waste of which an enormous amount is generated.

On top of that, there's the consideration to the environment, of our use of pharmaceuticals, and anaesthetic agents gets a special consideration because, of its impact, upon the atmosphere and that the, halogenated. Indolent anaesthetic agents are potent greenhouse gases, which I'll come on to discuss in a moment. Healthcare Without Harm is an environmental charity that looks at global healthcare and estimates that global healthcare, if it were ranked as a country, would be the 5th largest carbon emitter in the world.

And so we as veterinary. Professionals really have a significant responsibility to try and minimise our impact and therefore mitigate for this this effect. And that's not only because of our responsibility to, the environment, and it's, it's also to ensure that We are building in business resilience to, our daily practise so that we can continue to provide the outstanding level of veterinary care that we currently do.

And unless, we adopt a strategy, strategy to be as green as possible, and it may well not be possible in the future for us to continue to practise at the level that we currently do. So, one of the big initiatives, of the Green Veterinary practise Working Group has been to create a resource, that helps everybody to more straightforwardly go through the simple steps to start embarking upon green changes within your practise. This, is produced as a sustainability checklist.

And it's actually a checklist that has been endorsed by BVNA, BVA and SIS, and it's due to be launched very soon, in the next couple of weeks. And it's. Split up into some basic categories, and practising responsible resource use, being sustainable in your operation, what do you do, you know, what decisions do you make, within your practise, using medicines responsibly and then very importantly also sustaining the team.

Once you've been through these steps, you're already on your journey to being more sustainable, and it then is a really great idea to start a green team, communicate what you're doing, within, your staff team with your clients, and more broadly, and then, it would be fantastic to look. Gaining environmental management, accreditation, and with an organisation such as investors in the Environment who have had experience and supported many different veterinary practises throughout the United Kingdom to achieve environmental accreditation awards. I'm going to go through a few of the different aspects of considerations that you can make when you're in practise and to try and be more environmentally sound.

So an example of looking at responsible resource use, and this is in particular in surgical practise as an example here. This is an area that I have worked in for . For basically nearly 20 years, and it's an area where we can really make a big difference.

Healthcare has a high environmental impact. When looking at which parts of a hospital have the greatest environmental impact, it is the surgical theatre, and that is because that's where anaesthesia occurs and where a lot of waste is generated. Some simple things that you can do to reduce the amount of .

Waste that is generated is consider what you are doing in terms of your personnel attire. It has been clearly demonstrated that the use of scrub hats does minimise environmental contamination and it is important to minimise the risk of surgical site infection. A recent publication in the Journal of the American College of Surgeons actually documented that the use of a freshly laundered cloth scrub hat had superior performance to reduce microbial and dander contamination compared to the single.

Use disposable scrub hats. And so we know it's good to wear scrub hats, but there's actually some evidence to show that the use of a reusable scrub hat, if it's clean, actually, can have equivalent or perhaps even superior performance. In terms of minimising environmental contamination.

They also look very cheerful as well, and they communicate to the practise and the team, the message about environmental sustainability being important. I've known of some teams to talk about getting very personalised scrub hats and, and also And the consideration of placing an embroidered name across the front of the scrub hat can be helpful if you're working within a busy team to aid in communication, and that in turn can minimise mistakes that occur because of problems in communication. So there can be wide reaching benefits of, of making some changes in terms of what you do.

The use of alcohol and preparation. Is a really great switch, from the traditional scrub technique. It's been quantified that on average for a single surgeon to scrub using a traditional surgical technique, it uses between 10 to 15 litres of water.

Now within the United Kingdom, we don't . Feel the the sort of sense of water shortage, but globally there is a water shortage and as environmental, as the environmental situation changes, we may see differences throughout Europe potentially as well. And it's also important that even if the water is there to utilise, we've got Remember, the energy that has been taken in terms of processing, that water if it's water that is just running down the drain, whilst we're going through a traditional scrub technique.

So switch to an alcohol hand preparation and save a lot of water, which again will also save upon, finances as well, if for your metre water bill. Switching to the use of sterilisation tins for your surgical kit is a really fantastic way to reduce your paper waste in theatre. The wraps that go around the surgical kits that are torn off the kits when they're being opened and and are then discarded or can be recycled.

. But the use of the surgical sterilisation tins, and these are then available for using for your kits year after year after year, and whilst they would have an initial financial outlay and over time, they can save the practise money. It's also been demonstrated to be quicker to open. And to reduce the potential, for, for actually getting perforation, of the wrapping by sharp instruments.

So there are other advantages as well. Then coming on to the consideration of surgical textiles, which I'll talk a bit more about in the next slide. So Surgical textiles.

Include the gowns that are worn during surgery and the drapes that are used for the patient. Different practises will have different approaches and some practises will universally use single-use drapes and gowns, and some will use reusable cloths, drapes and gowns. And there may be a number of different reasons for those choices.

I have worked in referral practise for the last nearly 18 years, and during that time I have predominantly used single use materials. And Now, Over time I've questioned. What is the environmental impact of the Single-use item that I I've been using and when I've sort of discussed it with colleagues, what has been raised is that, well, overall, when you consider the fact that you have to re-launder the gown, you have to wrap it and re-sterilize it overall, it was suggested that it probably balances out in terms of the environmental impact.

But that never really sat that comfortably with me. Now, last year in 2020, there was a really useful publication which was made in one of the nursing journals and it looked at. The environmental analysis of reusable and disposable surgical gowns and what was done was a life cycle analysis.

And what this means is looking from cradle to grave is the term that's used. So basically every step in the man. Factor in the processing, in the cleaning, in the disposal of each item and looking at the environmental impact of all of the different factors into play within that and comparing the two.

And what was very clearly shown. Was that reusable gowns compared to single-use disposable were far, far less, damaging or demanding upon the environment and the resources from the environment. And it's really valuable to have this publication.

Because it, it actually highlights that by making a choice, of using a reusable gown when appropriate, I must add, that we can be having a significant reduction in our environmental impact. Now, when I've been considering this and, and discussing it, a lot of the time, the thoughts that I've had in, in discussions with colleagues have been, well, we want to be providing gold standard care and the having the minimum risk of effect basically on our patients in terms of the risk of surgical site infection. And therefore, the consideration has been that, that, that actually the reduced permeability of the single use gown was actually a a benefit that meant that that therefore needed to be utilised over and above the environmental consideration.

We've got to think about what evidence is there for that. There was a really useful. RVS veterinary evidence publication in 2019, which was produced as a student, veterinary project by Molly Beanha Kumar, who produced it as her final year project and looking at the evidence base within the literature, and her project was entitled Reducing Veterinary Waste, Surgical Site Infection Risk and the Ecological Impact of Woven indisposable Draps.

And she looked at all of the different publications. In human and veterinary medicine. And what she actually found was that whilst there was very little sort of evidence base, we needed more evidence to really make a strong decision.

There was no compelling evidence that the use of cloth, reusable drapes was actually . In any way inferior in terms of predisposing the risk of surgical site infection. Now, as a specialist soft tissue surgeon, what I would consider as the most appropriate thing to do is to make a rational choice of surgical textiles.

So if I were to be performing a procedure. Where there was likely to be significant volumes of fluid and my gowns and my sleeves may may become contaminated with that and there's a risk of strike through, I would then consider that there would be a risk of bacterial transfer through the material and potentially. Increasing the risk of surgical site infection.

So for those, or for perhaps an orthopaedic procedure where an implant was being used, to me it was irrational to use the more impermeable single use item which is made typically of of polypropylene, but for those procedures where There's maybe a short procedure or minimal risk of fluid contamination. It would be rational to use a reusable cloth gown. We need to do some more work on this and we need to think more, but in a time where, as veterinary standards of veterinary practise continue to improve and improve.

And we're all striving for gold standard. I think we need to make sure that we consider from a one health aspect, what is the environmental impact of our practise and when we're making the optimal decision for patient care that needs to include protecting the environment for that patient and for everyone for the future as well. Now, another example, of an area, of the checklist of, of, of things that we can go through to try and improve our sustainability in practise and is thinking about, your waste and how that waste is managed.

And it's really valuable to do a waste audit of your entire practise both of the, the, the waste. Healthcare waste from the clinical area, but also waste that's generated within your tea room. Do you have a food bin?

Can you offer the option of composting in your practise, to try and improve adherence to recycling, within, within your tea room area as well. But focusing upon the healthcare waste. It's actually a, a, a requirement, in England and Wales that infectious, and non-infectious waste is actually segregated, and.

It's actually important that waste that does not need to go for high temperature incineration is not sent for high temperature incineration and so it is therefore important that offensive waste stream is identified and that Material that is perhaps contaminated with with blood or faeces, but from a non-infectious patient is focused into that offensive waste stream and therefore managed appropriately within that stream rather than all being pulled into a clinical waste stream that goes for high temperature incineration. So have a look at what your practise policy is with regards to your segregation of waste. Have a look at the resources available on the BVA website and consider whether what you are doing is actually optimal within your practise.

Establish a conversation with your waste handler and see if there are any improvements that can be made. Ellie West and colleagues published a really useful article, in, in practise, which was published published last year in 2020, which is entitled How to Manage Healthcare Waste and Reduce its Environmental Impact. So if you are sending Some waste for high temperature incineration in a clinical waste bag and it actually can be managed in an alternative offensive waste stream, and then that is a way to reduce the environmental impact of your waste management and also reduced cost as well.

This was a waste audit that I performed at the Royal Veterinary College in the Queen Mother Hospital for Animals and theatre. It was a final year student project looking actually at the waste that was generated in clinical waste bags and from the theatre. And to really try and identify how much waste we were generating and how could that be improved.

Now, of the the bag, what was identified was that Between about 36 to 46% of the bag was true clinical waste, so, waste that needed to be handled. In, an appropriate way for clinical waste. Now this is, in this, management, structure, there wasn't, a management option for offensive waste, and it has to be questions, could some of that actually have been managed within offensive waste.

14 to 25% of the clinical waste, in each bag from each procedure was gowns and then also a percentage of drapes as well. What was interesting was that on average when analysing all of the different waste, about 50% of the waste from the theatre was plastic. Now, there's been a number of different studies looked at in, in human medicine, in human operating theatres, and discussing the waste that is generated, in operating theatres.

Less than 5% of medical waste is actually recycled, but it has been reported in previous publications that between 40 and 64% of medical plastics are potentially recyclable, but typically they're actually disposed of in clinical waste. So throughout the veteran profession profession, we have the huge potential to make a difference if we are able to improve the management. Of the waste and within our clinical settings.

These are some ways that you potentially can reduce the use of single-use plastic in clinical setting. Now why does single-use plastic matter? We're all very aware of the concern about ocean plastic, and most of us are taking Huge steps within our own personal lives to try and minimise the use of plastic and its impact upon the environment.

We would hope that plastics that are in the healthcare sector don't have the potential to reach the ocean. We would hope that that is the case, but the, the waste. The waste management system is under challenge, and there could be the potential for problems to arise with its management.

We also, know that in other Countries, some of the waste, management structures are not, as thorough, as, within the United Kingdom and Europe, and, and we need to be striving to a situation. In which we try, and minimise what we are using to minimise its potential, impact, globally. Also, plastics are have a significant environmental impact in terms of their production.

It's very highly energy intensive and the production phase is harmful along with incineration of plastics can produce respiratory irritants and toxins, even if there's no physical or microplastics left after incineration. Options include switching to the use of a reusable sharp spin. Now, the One of the steps that Davies, veterinary specialist took in terms of improving their waste segregation and moving towards achieving their high level environmental accreditation was switching to the use of a reusable sharp spin from single-use sharps.

The use of a reusable sharp spin actually has a a significant reduction in carbon cost around 95% less, and also has a significant less financial cost. In terms of the management of those shops. So rather than having the sharp bin, the yellow plastic bin, that most of us are very familiar with using, which once it's completely full, like the lid clicks shut and the whole thing gets taken away for incineration.

You have a larger sharp spin structure which actually has got a flip lid which is improved also for health and safety. And once that has filled and reached a certain level, it's collected by the supplier. The contents are tipped out and incinerated, but the .

Shark's bin is washed and returned and reused, therefore having less environmental impact. There's the potential to have reusable warm air blankets if you use the warm air patient warming blankets that are plastic, and you can have ones that can be washed and laundered. Another great idea is using a distilled water maker rather than actually purchasing the plastic bottles containing distilled water for use in your laboratories.

The changes that you can make to switch to becoming more eco-friendly but still using plastic, is using syringes that have been designed, to actually contain less plastic. So the BD emerald syringes have got 30% less plastic in their production and therefore that has an impact in terms of how environmentally harmful they've been in terms of their generation. You could make a switch from using the soft PVC infusion bags to using the rigid low density polyethylene infusion bags because they are more recyclable, and they also have less impact upon the Environment because when incinerated rather than producing respiratory irritants, which is released from incineration of of PVC low density polyethylene is incinerated to produce carbon dioxide and water, so less environmentally harmful.

You can choose to use plastics that have been made from bioplastics or from recycled sources, and that is less less environmental impact than those from virgin and plastic materials. In another area to focus on is thinking about being sustainable in your operation. So, I mentioned earlier on that we have all become mindful.

Of the use of inherent anaesthetic agents and the fact that these are potent respiratory, sorry, they are er potent greenhouse gases. Ellie Western professor Ronald Jones published a really important seminal paper in veterinary anaesthesia and analgesia in 2019, which highlighted the considerations that should be made when thinking about veterinary anaesthesia. And I highlight here one paper, one table from their publication, which looked At the different atmospheric characteristics of the anaesthetic gases.

Now, what we can see is it includes the inhalant agents, desflurane, aflurane and Cva flurane. In veterinary medicine, we don't tend to use desflurane that much, which is good because it, it does have a very high Global warming potential, but this is, is more of a human anaesthetic agent. We've also got nitrous oxide, which not only has a high global warming potential, but in particular, it actually persists within the atmosphere for a very long period of time and therefore is extremely harmful.

Now, what can we do to minimise the risk, of these different, anaesthetic agents? It's important firstly to, to be aware, and to practise anaesthesia as efficiently as possible. So we need to consider performing low flow anaesthesia where that is feasible.

So if you have a catnograph in your practise, then you can safely perform low flow anaesthesia and therefore reducing the release of these anaesthetic agents into the atmosphere. Also choose what agents you use in your practise. So it's considered really in this current situation, there really is no justification for using.

Desflurane, or nitrous oxide when we have got other suitable alternatives. Nitrous oxide is helpful in terms of providing a proportion of, of analgesia as multimodal therapy, but there are many other multimodal agents that can be used to achieve effective analgesia perioperatively, and that really should be the way that, that we decide to go. Now, this is, a graphic that was really kindly shared to me by Ellie West, who, is the sustainability lead for Linnaeus, and also, a specialist veterinary anaesthetist.

As part of, Linnaeus's commitment to, improving environmental sustainability, and many of the practises have, done an environmental audit, and this is one practises. Data looking at their carbon footprint and within a six month period when they were using nitrous oxide, this practise identified that 30% of their carbon footprint footprint came from the use of nitrous oxide, and it was fantastic that they were Able to identify this because that's then a change that they they could make to have significant impact for carbon saving, and it's something really valuable to, to do and consider and to think about all of the different steps that we do day to day and how we can improve upon them. Now I've given you some sort of snippets from the Greener Veterinary practise sustainability checklist, which is launching really soon.

It's going to be hosted on the Vet Sustain website, and information will be released upon, social media, and via BVA, once that, becomes, live. 89% of UK vets stated that they wish to become more involved in the sustainability agenda, in 2019. And it's clear from the number of people, engaging, with this topic that there's a huge passion, to embrace this and to move forward as a sustainable, profession into the future.

I'd really like to, to thank, Sppis for inviting me to, speak today. It's been a pleasure to, to have this time and to speak with you, and I would be happy to please take any questions. Thank you.

Thanks, Zoe, that was fantastic, really interesting and fascinating. You know, you can see that big difference for that practise just by switching away from nitrous oxide, it can make a massive difference, can't it? Yes, yeah.

Just interested where people are listening in from. We also just, you mentioned the Beckton Dickinson syringes. We did do a webinar with Beckton Dickinson, so I think Dawn is gonna find the link for anybody who's interested in following that up because they have some really interesting innovations in medicine delivery as well as the syringe.

So if, if people are interested to, to go a bit deeper with that, then, then, and do, do go and look, but obviously syringes are a. Big thing of what we what we use in practise so it's it can make another really nice saving. So we've got Elizabeth listening in from Germany, anybody else want to put where they're listening in from that would be great.

Daniela from Belgrade in Serbia. Amelia in Edinburgh, we've got Francesca in Switzerland, Margaret in sunny Trinidad and Tobago, you lucky thing you, Ire in Wey, London. I don't know if that's Webby or Wembley, if there's a mistake there, I don't know.

Do you know Webley, Zoe? And not that I've heard of but it could be somewhere, couldn't it? Cornell is from Romania.

And we've got Jenny listening in from Virginia in the United States and Cornell, yeah, sorry, Timisoar in Romania. Oh, it's great, it's great to have such an international audience. Thank you everyone for listening.

And we've got Sarah in Wageningen in the Netherlands, Cambridge, Sonny Skipton, France. It's great to hear people listening in from, from all over. Do people have any questions?

If you want to, what we're gonna try to do, initiative test for everybody. We have the vet exhibition. Where you can go and obviously have a little nose around.

There's a really nice stand from MSD. This is a fairly new thing that we've, we've done. It's gonna develop into much more of a, almost a mile of where you can go to, to, to use it almost like a Vvaemium for looking up different products and things.

So I think it's gonna be really fascinating as it develops. It's still in its early stages, but do go over one of the, the really exciting bits are the . The video chat rooms, so we may try and get people over there to ask questions and carry on the conversation, but let's stay on here for a little bit and then we'll, we'll see if anybody fancies the initiative test to see if you can make it over and get into the chat room.

In Ray, I think, asked a question which I think you've probably answered, but you may just want to go over it again, reusable versus disposable gowns, are they equal when it comes to maintaining sterility? You obviously talked about if there's lots of fluid around it, they may, the single use 1 may be a better option, might it? Yes, so, so.

It's basically if you're going to have Wetting of the fabric, and then there is evidence that that can allow bacteria to be able to transfer through the fabric. It's clear that that can occur on the basis of of laboratory studies. When you do look at the literature, however, There isn't evidence that that then equates to surgical site infection occurring.

So what we need to do is make a rational decision based upon actually what would be the impact upon the patient rather than theoretical observations. However, it would seem rational that if you do have an increase. In potential bacterial translocation, that that would potentially lead to an increased risk of surgical site infection.

And so therefore making a rational decision based upon what procedure you're performing would seem the best approach. And I suppose if you started up and were surprised and there was loads of fluid and you did get contaminated, of course you can just change your gown and start again as well, can't you? Yes, potentially, however, that's also.

It, when you're sort of weighing up, then if you're having to use more than one item, maybe that's balancing, you know, balancing out so that you, it will be then better off to have used a single use item rather than using a reusable twice and going through the processing of that. Of course. Hilary's wondering how do you carry out a carbon footprint on your practise?

And so there there are some useful online sort of tools to do that in your sort of home life. There are ones that are being developed as veterinary practise carbon calculators, and it's most helpful to sort of have the guidance. Of, environmental management accreditation to have a detailed understanding.

But there are some online links, to, resources. I think the Davies website do you have one on there. I'll, I'll take a look and and post that.

Where can I post things and people to be able to look afterwards? Probably the nice place to do is if people do have more conversations or if, if people are listening to this as a recording during the week, is to actually go onto the Hoover app and register, you know, as, as a speaker on there. And then you can always put some some extra things on there, yes, or start a a little discussion forum within the, the Hoover app as well.

OK, OK, fine. That would be great. We actually have just got silver accreditation with the Investors in the Environment award, which I think is also, I think you have green, don't you at Davis.

Green is the top, silver is 2nd, and I think bronze is 3rd. So we were very pleased to get that. Obviously we are not a veterinary practise, but you know, certainly we do travel, although hardly any, any travelling at all this year.

But we work in an office, so we, we actually campaigned, towards the, the office providers to make sure that they're, Energy was coming from a green source. So there are things like that that you can do. You could get your electricity and, from, you know, a green supplier.

Yeah, that, that's really key is, is energy is the big one and and switching to a a supplier that uses, yeah, green technology, and then also just minimising your use of electricity. So you developing a switch off culture and switching to LED light bulbs and all. Really, really valuable.

Yeah, absolutely. And then obviously watching how you separate waste and and how that's being collected and, and what the actual waste providers are promising you. So I think it is probably it's a key one, isn't it, Zoe, to, to go to your waste provider, be there clinical waste or, or, you know, your, your .

Commercial waste and make sure that you're going with a company that actually takes all of this very seriously. Yes, absolutely, and having a discussion, there are some sort of other questions have have popped up. Yeah.

I see that that Beth is saying, I mean it's the start, so you may have covered this, but which plastics can be recycled, vaccine trays, syringe packets, pet t-shirt bags, any others? So, it, it will be local based upon country and your waste provider as well. There, there is a comment as well about, the local council being very selective about what types of plastics they will take for.

Cycling and that's where we've got to be sort of careful is because we are producing waste within a healthcare facility. We can't expect that that will be processed and as we cycled through. The local councils if it is from a healthcare facility that doesn't mean that it's not potentially recyclable, but that's why it's important to have, a clear, a sort of detailed conversation and develop a relationship with your, waste management company.

So, what, can then happen with the waste sort of depends upon the further channels that that they have. Waste management overall, needs just constant ongoing rethinking, and ultimately what we I would like to achieve a situation where, some streams of medical waste can enter a circular economy and, you know, be, be reused within the medical sector, rather than needing to be sort of recycled to downgraded plastics or or incinerated. No, that's great.

Do, if you know, do please retweet or go on Instagram using the hashtagVC2021 also. Using some of the handles there from Vett sustain if you've enjoyed the webinar just to to get the message out, because I think it's such an important issue. Hillary's asking what the accreditation is again, we actually got the investors in the environment accreditation, Hillary, so just look up investors in the environment.

Hillary asking another question, she said, do you think it's acceptable to go back to no gowns for cats spaces and double castrates and. And I suppose castrates just scrub up and gloves. So, so for cat space and dog castrates, I, I think that we've got to remember the importance that we've also got to be considering about surgical site infection and trying to ensure that we do everything we can to minimise the increase in antimicrobial resistance.

So I think we have to be practising. Careful attention to aseptic surgical technique. And so I would favour the use of a sterile gown, but I, I think there's very strong evidence for procedures like that, .

That they could be cloth, reusable, gowns and drapes, therefore minimising the environmental impact, but there would be no evidence that that would be an inferior standard of care than the use of a single use item in that case, I think. That's great. I think that's pretty much all the questions, but I don't know if people want to go on this little tour to see if you can, if you can find the vet exhibition.com.

It is in the chat box. When you get there, if you click sort of on the back of the hall, you'll see the escalator going up. You have to click on the up button.

And then on the, as you get to the top and you're looking out on the left hand side, you'll see a vet networking room. And we've got some really nice, video, chat rooms there that people can mix in and, and chat about this topic or, or other topics. So we will be using that during the week.

This is the first time, because at 8 in the morning, I think most people would have struggled still waking up at UK time anyway, so. I don't know if people want to try and and get over that, but before you do, obviously did, did want to thank, Zoe again for a fabulous talk. I think this is such an important area, sustainability, and actually, you know, regeneration is, is becoming more and more important, you know, we've had the, the pandemic and the pandemic is still ongoing.

Has that been partly because of. Global temperature rise is the way that we actually sustainably farm. There's lots of really interesting areas here that have, you know, really come to the fore over the last year as well, so.

I would encourage everybody to really think seriously about it, and perhaps the action from this is, is to go on and form a green group and see, you know, the simple steps that you can take, and then obviously, for those of you who want to take it further, then accreditation with the various accreditation groups such as in the investors and the environment, might be a next step. Is is that a fair summary, Zoe? Yes, I think, I think that's fantastic, Anthony.

I'm, I'm sorry for the background noise, my children. Trying to speak to me from the other room, understanding that they weren't to come in but not understanding that shouting from the other room. Well, I think they've been so good, they should be allowed in, and please do feel free to bring them into the exhibition if if you have some time and we can all work it out.

It's an initiative test. Let's see how we all do and I look forward to seeing some of you on the other side. Take care everyone, thanks again, Zoe, and .

We've got another webinar this evening, 7 p.m. Doctor Phil Padred, it's going to be talking about use of inhaled medications to treat respiratory disease in dogs and cats.

It's sponsored by Breathe Easy. There are obviously a lot of sessions that are already on the site as pre-records that you can also go and watch. And yeah, enjoy the conference.

Thanks again, Zoe. Thank you very much, Antony. Bye bye.

Thank you, bye.