Help and Frequency Asked Questions

What is the ICHD Carbon Calculator?

It is a free online carbon footprint calculator for use in in-centre haemodialysis units. It measures your overall footprint and carbon intensity per patient session, and identifies the greenhouse gas emission hotspots from running a haemodialysis unit.

What is behind the calculator?

End-stage kidney disease (ESKD) requires a disproportionate share of healthcare system resources for its treatment, with correspondingly large cost, resource use and environmental impacts. In 2019, the Green Nephrology Group in The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK (NUTH) approached the Sustainable Healthcare Coalition to launch a project to footprint their renal services, focusing first on one of the most environmentally damaging areas of renal practice - haemodialysis. The project mapped the haemodialysis service delivery within NUTH using the Sustainable Healthcare Coalition's Care Pathway Guidance , using life cycle assessment approaches to understand the whole environmental footprint associated with activities - from manufacture, through service delivery to disposal - and identify opportunities to reduce the environmental impact of the service. The NUTH - Sustainable Healthcare Coalition collaboration delivered a good picture of what in-centre haemodialysis looks like through a sustainability lens.

This calculator has been developed using the insight gained to make an accessible tool available for other in-centre haemodialysis service centres to assess their own footprints, and identify where to focus their efforts to change.

What data do I need to have to use the calculator?

There are several sections to enter information on: the general features of the haemodialysis unit; patient and staff travel; pharmaceuticals, consumables, equipment and utilities used; and waste produced. Data is entered for each of them and covers a full calendar year. The level of detail of data entered is up to you: If you have no data on, for instance, staff travel, a default generic staff travel profile is already loaded into the calculator. The more detailed information you have available to enter, the more accurate the results will be for your unit.

You may find it easier to look at the questions and categories initially, locate the information in your unit then enter the relevant figures from your records.

Do I have to enter all the fields in one go?

No. The calculator will automatically save your entered data to your computer (a 'local save') so you can return at a later stage to add more information. However, please make sure you are on the same computer as the data is not transferred to other machines or browsers.

Why do I have to enter my country and currency?

Emission factors for things such as electricity use will vary depending on how electricity is generated in your country. The calculator has built into its database emission and currency conversion factors so that the results it provides will be as accurate as possible for wherever your in-centre haemodialysis unit is located.

How do I calculate the floor area of my unit?

Floor area should be calculated to include any service areas attached to the haemodialysis unit. There are many free online floor area calculators that you might find useful, for instance:

Please note that we are not responsible for the accuracy of these area calculators.

Do I have to enter a year's worth of data?

Data for a particular calendar year is required. The calculator will also ask you for the number of sessions and number of patients that you treated in the year you have chosen. This enables the calculator to display total annual emissions and emissions per patient or per session for you.

Where you have data for a different period, e.g. from a week-long travel survey, please multiply the figure you have to extrapolate it to a whole year.

Is my data safe?

Yes. If you haven't used the postcode entry options for patient and staff travel calculations, your data is only stored on your computer.

If you have entered postcodes we will submit these, plus the haemodialysis unit's postcode, to Google's Distance Matrix Service to calculate and return an average distance.

Once your unit's assessment is completed, you will have the option of sharing an anonymised copy of the report with the Sustainable Healthcare Coalition. This will be used to help further development of the calculator and may be aggregated with other centre's results to inform the continuing conversation on sustainable renal care, but it is entirely up to you if you choose to do so after you've completed your calculation.

How do I enter patient travel data?

If you have no patient travel data, the calculator already has generic default patient travel data loaded into it from our previous research. It may not be truly representative of your unit as factors such as the location in urban or rural population catchments and the modes of travel favoured in your location may alter from our own research site. They will give a reasonable first estimate for you, though.

If you have average data or detailed patient-by-patient information, these can be entered to improve the accuracy of the results for your unit.

Please remember to double the one-way travel distance to give a total round trip for the patients. We have configured the calculator in this way to allow you to take account of patients who may be admitted to in-patient care during or following their dialysis session or, conversely, being discharged from in-patient care following their dialysis session.

How do I enter staff travel data?

If you have no staff travel data, the calculator already has generic default staff travel data loaded into it from our previous research. It may not be truly representative of your unit as factors such as the location in urban or rural population catchments and the modes of travel favoured in your location may alter from our own research site. They will give a reasonable first estimate for you, though.

If you have average data or detailed individual staff information, these can be entered to improve the accuracy of the results for your unit.

Please remember to double the one-way travel distance to give a total round trip for staff members.

The exact consumable, pharmaceutical or equipment item I use isn't listed. What do I do?

We have sourced data on the most commonly used items. If the ones you use aren't listed, then a default generic option is available. The results won't be quite as accurate but should still give you a reasonable estimate of your unit's footprint.

I don't have figures for my utility use or waste. What do I do?

The more data you can input, the more accurate will be the answer produced for your unit. If you don't have sub-metering allowing you to measure electricity, fuels or water use or waste production, just select “no” to that question and generic default figures will be generated by the calculator based on the floor area and number of sessions you entered in the general section.

Can I save my results?

Unless you clear the data using the button on each entry screen or the results screen, or you clear your computer browser cache, your data will be retained on your device.

You also have the option on the results screen to have the calculator send you a pdf of your results, as long as you have entered a valid email address.

Can I do "what if"" or option analyses?

Once you have completed your data entry and received your results, you can select the “edit my data” option at the bottom of the results page. This will allow you to go back and change one or more of the inputs you've made to see what impact the changes would have on the overall results. Editing and rerunning the assessment will overwrite your initial results in your browser cache so it is a good idea to have selected the option to have the initial results emailed to you by the system so that you can compare the two runs.

What can I do to reduce my unit's carbon footprint?

The footprint calculation results will let you see where the biggest hotspot sources of carbon are for your unit. These would be the best sources to address to make a real difference to your unit's carbon efficiency.

Further resources that may help you are listed below:

How should renewable energy purchases be reflected in electricity import (scope 2) reporting?

There are many questions surrounding the reporting of carbon from imported, grid electricity supplies, such as:

  • What constitutes a renewable energy purchase?
  • What is included in a supplier-specific emission factor?
  • How comparable are green power programs?
  • How can a company claim to use only renewable energy if it uses inherently untraceable grid-distributed energy?
  • If green power is used by some companies, how does that impact the emissions reported by other consumers?

To address these questions, the GHG protocol revised its guidance in 2015 on how to measure and report emissions from electricity use. It now says that companies with any operations in markets providing product or supplier-specific data in the form of contractual instruments shall report imported electricity (scope 2) emissions in two ways and label each result according to the method: one based on the location-based method (using the local grid mix figures), and one based on the market-based method (taking into account specific carbon attributes attached to power supply instruments). This is also termed “dual reporting.”

Electricity suppliers compile emission rates for a variety of purposes. Some supplier emission rates may reflect only the emissions from utility-owned assets, while others also reflect power purchased by the utility from an independent energy generation facility. Many green power programs have been offered directly by utilities, segmenting different emission rates for different consumer classes. Supplier disclosure requirements and calculation methodology differ, making it difficult for consumers to consistently use this type of information.

If you are in any doubt about whether the green power you use is admissible in your location, please refer to the GHG Protocol corporate standard for guidance.