PATIENTS and doctors will have to adjust to an increasing proportion of consultations being carried out remotely as the NHS tries to cut carbon emissions, according to a top medic.

Mike McKirdy, a breast cancer surgeon who is set to take over as president of the Royal College of Physicians and Surgeons Glasgow (RCSPG) in December, said the "pushback" against holding more appointments via video and telephone - especially in primary care - was "misplaced".

"There's a lot that can be done well remotely and it can be a good experience for people, but perhaps we'll all have to get more used to that as the years go by" said Mr McKirdy, who helped to draft a joint statement on the climate emergency on behalf Scotland's medical royal colleges - collectively known as the Scottish Academy.

"Covid has speeded that process up for all of us. Before the pandemic I think I had taken part in about three Zoom meetings in my life.

"In my own service it was absolutely standard when I first started for all women who had previously been diagnosed with breast cancer to physically come to the hospital for a care review and an annual mammogram as part of their surveillance.

"But even before the pandemic we had already moved the majority of those visits to a virtual clinic. We'd been able to demonstrate there was absolutely no value in them coming in other than saying 'hello' - it didn't add anything to their care.

"The bit they needed was the mammogram. They come into hospital for that. But the care review could be done by telephone.

"That's been accelerated by the pandemic, so we've moved from having about 3000 visits in person to the hospital each year to all of this is now done virtually."

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Healthcare services in the UK are estimated to contribute to five per cent of the UK's carbon footprint, with 25% of these emissions coming from medicines such as anaesthetic gases and inhalers.

The NHS has committed to being a 'net-zero' greenhouse gas emissions organisation by 2045.

In addition to reducing unnecessary patient journeys to hospital and adapting medicines to more climate-friendly forms, Mr McKirdy said he would expect parking around NHS sites to be increasingly curtailed.

Transport was estimated to account for more than one third of Scotland’s greenhouse gas emissions in 2018 - yet the Scottish Government recently abolished all charges for hospital car parks.

The Scottish Academy's statement on the climate emergency noted that "investment in the right infrastructure can support active travel" and called for this to be promoted more by the NHS to staff.

Mr McKirdy, who is also the College's director of global health, said cutting travel-related emissions would benefit the NHS as well as the climate given growing evidence that air pollution is linked to around seven million premature deaths worldwide every year from conditions ranging from cancer to neurological disorders.

He said: "I graduated in 1985 and in 1985 you wouldn't have found anyone cycling to work at a hospital.

"Now, in the summer months, large numbers of people are cycling in and even as I walked into work at 8am this morning there were three people in the bicycle sheds locking up their bikes.

"I'm a bit of a fair weather cyclist myself - on the dark morning in the traffic you think 'do I really want to do this?'. But walking, cycling, active travel - if the NHS, as Scotland's largest single employer, is saying that we need better public transport and cycle infrastructure to move our staff around, then hopefully that has a bearing on councils and Scottish Government.

"It's already the case that many staff who were previously able to park on site can no longer do so.

"There was controversy about that at the Queen Elizabeth [University Hospital in Glasgow] and that's the case for hospitals up and down the country: they can't get planning permission to build huge car parks around hospitals because city planners want to encourage active travel.

"You can't see anything other than that continuing."

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Mr McKirdy, who is based at the Royal Alexandra Hospital in Paisley, added that in addition to serving locally sourced food to hospital patients and in NHS canteens, he expects the health service to "follow the trend" towards less consumption of red and processed meat, in favour of more environmentally-friendly and healthier plant-based diets.

"That's a journey we've started on. The consumption of red meat is reducing and that's partly because people are cutting it out completely, and because people are having fewer servings in a week.

"The NHS as providers of meals to people will follow that trend.

"We need to look at how we all, including patients in hospitals, eat in a way which is environmentally friendly and sustainable."