A decade of greener care: Environmental, economic, and operational impact of the virtual stone clinic in the United Kingdom.

Abstract

Introduction: Outpatient care generates a significant environmental footprint through patient travel, energy use, and resource consumption. As the UK healthcare sector works toward Net Zero targets, sustainable redesign of routine services is essential. This study quantifies the environmental, economic, and operational benefits of the Virtual Stone Clinic (VSC), a telephone-based follow-up model for kidney stone disease (KSD).

Material and methods: We conducted a prospective study of 854 patients managed in the VSC between March 2014 and December 2024. A total of 2,917 telephone consultations were delivered. Using postcode-based travel modelling and UK standard emission factors, we calculated reductions in travel distance, CO₂ emissions, fuel use, time burden, and cost compared with equivalent face-to-face (F2F) appointments. Clinic delivery costs were estimated using NHS Reference Costs.

Results: The VSC avoided an estimated 27,138 km of patient travel, reducing CO₂ emissions by 4.04-4.42 tonnes. Patients saved over 560 hours of travel time and more than £2,000 in personal fuel costs. Clinic delivery costs were £201,273 lower than for equivalent F2F care, rising to over £204,000 when patient fuel savings were included.

Conclusions: Over a decade, the VSC has delivered substantial environmental, economic, and time savings without compromising safety or access. This proven model offers a scalable approach to integrating environmental accountability into outpatient care, with clear potential for adoption across urology and other specialities in the UK and beyond.