Green Theatre Accreditation Scheme

The Green Theatre Accreditation Scheme (GTAS) is an RCSI-led initiative that supports operating theatres to embed sustainability into everyday surgical practice.

Funded by HSE SPARK, GTAS builds on the principles of the Intercollegiate Green Theatre Checklist, translating them into a practical accreditation framework. It enables surgical teams to assess current practice, identify opportunities for improvement and demonstrate progress towards more sustainable operating theatres.

Why sustainable surgery matters

Operating theatres are complex, resource-intensive environments. Surgical care requires significant amounts of energy, equipment, consumables, medicines and other resources, and can generate substantial waste.

Healthcare organisations have an important role to play in responding to climate change and reducing the environmental impact of healthcare delivery.

GTAS helps surgical teams turn sustainability ambitions into practical, measurable action. By supporting more sustainable practices in operating theatres, the scheme contributes to the delivery of the HSE Climate Action Strategy and efforts to reduce the environmental and carbon impact of surgical care.

How GTAS works

Participating hospitals complete a structured self-assessment covering sustainability across 10 areas of theatre practice. Hospitals provide evidence of sustainable practices already in place and identify opportunities for further improvement.

Submissions are independently reviewed by a multidisciplinary accreditation panel, with Bronze, Silver or Gold accreditation awarded according to performance against the GTAS criteria.

GTAS is designed not only as an assessment, but as a framework for continuous improvement. It enables theatre teams to recognise progress, share good practice and set priorities for further action.

The accreditation process

Following submission of a hospital's self-assessment and supporting evidence, RCSI carries out an initial review before the application is assigned to an independent multidisciplinary assessment panel. Assessors review the submission individually before reaching a consensus recommendation. Where clarification is required, further information or a site visit may be requested.

The recommendation then goes through the GTAS governance process before the hospital receives its accreditation decision and feedback.

Successful organisations are awarded Bronze, Silver or Gold accreditation.

The GTAS pilot

GTAS has been developed and tested in partnership with four pilot hospitals representing a range of surgical and operating theatre environments:

• St James's Hospital
• South Dublin Surgical Hub
• Royal Victoria Eye and Ear Hospital
• Midland Regional Hospital Tullamore

The pilot has enabled the accreditation criteria and assessment process to be tested in real-world theatre settings, while supporting the collaborative development of the scheme with the healthcare professionals who will use it.

Learning and feedback from pilot sites and accreditation assessors are helping to inform the ongoing development of GTAS.

A collaborative approach

Creating more sustainable operating theatres requires collaboration across the surgical pathway. GTAS encourages involvement from surgeons, anaesthesiologists, nurses, theatre managers, procurement teams, facilities and estates staff, sustainability teams and hospital leadership. This multidisciplinary approach recognises that meaningful, lasting change requires collaboration across professions and departments.

GTAS also provides a framework for hospitals to share successful initiatives and learn from each other, helping sustainable practices become part of routine surgical care.

Through GTAS, participating hospitals can:

• benchmark sustainability performance across their operating theatres;
• identify practical opportunities for improvement;
• formally recognise existing good practice;
• engage multidisciplinary theatre teams in sustainability;
• support organisational climate and sustainability commitments;
• demonstrate progress through an evidence-based accreditation process; and
• contribute to a growing community of practice in sustainable surgery.

Interested in GTAS?

Hospitals and surgical teams interested in learning more about the scheme, future accreditation opportunities or getting involved can contact the GTAS programme manager.