Public outreach clinics make significant carbon emission cuts

Dermatologists who provide outreach clinics for public patients in rural locations have cut carbon emissions by 52 tonnes, the equivalent of 25 round-trip flights to Australia annually because of fewer car journeys by clients.

A study of the service offered by consultants in the South Infirmary and University Hospital Cork who travel to Bantry and Tralee for patients from across counties Cork and Kerry, also found the clinics cut the distance each patient had to travel by 142km and saved them an average of 129 minutes in journey time.

The outreach clinics also reduce the burden on the primary dermatology clinic in Cork city.

Specialist registrar in dermatology Dr Cathal O’Connor said the operation of the outreach clinics also meant diseases are being picked up a lot earlier.

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Patients in remote areas such as Allihies in west Cork "are much happier to go to Bantry, and they would go at a much earlier stage to a more local centre, rather than having to drive for four hours to Cork city".

Dr O’Connor, a trainee clinician scientist and PhD fellow with the Irish Clinical Academic Training programme, said: “They tend to leave things longer if they have to travel further. There is a lot of evidence that rurality is associated with mortality with cancer, particularly with skin cancers.”

Catching diseases earlier has a knock-on effect “because people don’t need as much follow-up”, he added.

Skin cancer is more prevalent than every other kind of cancer combined, he said. "So about 70 per cent of people will develop a skin cancer in Ireland by the time they're 70."

Patients in Bantry “are a much older population so they would be much higher risk of skin cancer from cumulative sun exposure over the years”.

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Under the scheme there are four half-day clinics in Bantry and a similar number in Tralee as well as two pigmented lesion clinics to treat conditions such as melanoma.

For some treatments patients are required to travel to a clinic three times a week for three months and for many it would not be possible for them to travel so frequently to Cork city.

To establish the environmental benefit the authors got the addresses anonymously (not the names) of patients who attended the Bantry and Tralee clinics in the first six months of last year.

"We put their addresses into three different apps – Google maps, the Apple maps and maps.me. We looked at the difference between their home address and the South Infirmary, and the home address and the local centre and subtracted the difference."

In Bantry they saved an average of approximately 115km round trip, about an hour-and-a-half of reduced driving time. There were more patients in Tralee where the average saving was a 177km round trip of 2½ hours of driving.

They pooled the numbers and subtracted the carbon emissions for each consultant who had to drive from Cork to the clinic.

Dr O’Connor said the outreach clinic model is “perfect for highly specialised services like dermatology” where there are only about 40 consultants in the country and where the resource allocation is “very reserved”.