Pedal & Post has recently completed a 3-month pilot scheme with TSSU

(Theatre Surgical Sterile Unit), a unit of the John Radcliffe (JR) Hospital. The

TSSU processes, packages, and sterilizes surgical instruments and supplies

for internal and nearby procedures. As of November, Pedal & Post couriers

have been transporting dirty and sterilized instruments between local

hospitals in a quick, efficient, and zero-emission way, with the help of our

'Bullitt' cargo bikes.  Whilst cycle couriers fulfilling medical routes is not new

our involvement with the local hospitals is unique and unprecedented.

Whereas vans and ambulances are liable to be stuck in traffic, push bikes are

able to glide through traffic on the cycle lanes, meaning a delivery run will

rarely take over 10 minutes to any hospital unit. 

 The staff of the JR TSSU use the latest decontamination technology to

sterilize their instruments, which is then carefully packaged for transport.

90% of instruments are sterilized in a high-pressure 134 psi steam 'autoclave',

but a STERRAD® NX® System with an hydrogen peroxide gas plasma system

also allows for low-temperature and low-impact sterilization, for example for

surgical cameras (DAVINCI scopes), ultrasound probes, or renal retrievers

(used during autopsies). Supplies are then wrapped in protective bubble-wrap

and secured in boxes to be safely transported by one of our couriers. 

 The John Radcliffe's TSSU serves the surgeons of the whole Oxfordshire

region, and even occasionally all the way to the Royal Free Hospital in London.

An off-site TSSU is not  always popular with surgeons, but where it's essential

in regions such as Oxfordshire, it is vitally important that the flow of

instruments is not hindered by anything. 

 Previously, sterilization units at the Nuffield Orthopaedic Centre and Churchill

would rely on services and private couriers to transport instruments back and

forth, twice a day. A typical cycle would involve transport to two or three

hospitals before use, meaning increased chance of contamination. Any delays

during a surgical procedure waiting for a ‘back-up’ set may lead to an

increased risk of infection, so speed and efficiency is a matter of life and

death. 

 This year also marks one year of collaboration with Baxter, an American

pharmaceutical company. Patient-specific chemotherapy, antibiotics, and

intravenous nutrition products are made at Baxter’s compounding facility in

sterile conditions, ready to be used within a short timeframe between the

product being ordered and then received by the hospital. This route was

historically fulfilled by private vans, but couriers would be slowed by rush-hour

traffic and a lack of knowledge about the hospital wards. With P&P's help,

Baxter always has a fully-trained courier waiting to cycle directly to the

hospital whenever needed. In one year alone, P&P have saved 10tn of CO2

from van emissions. In addition, P&P also collects medical samples from

clinics and pharmacies, which are then transported to laboratories for analysis

via twice-daily trains.

 The NHS is the largest employer in the UK, and with it generating roughly

3.5% of all road travel in England (equivalent to 9.5 billion miles per year), the

Trust is prioritizing reducing carbon emissions in line with its stated goal of net

zero carbon emissions by 2040. Effective decontamination is critical in the

management of healthcare, and Pedal & Post is proud to play a role in ensuring

that the reprocessing of surgical instruments is of the highest quality,

reflecting modern day standards, and at no detriment to the environment! 

Thank you to the staff of the NHS for their continued support of the nation's

health, including occasionally our own riders'! We are thrilled to continue

working with them in delivering their vital services in a zero-emission way. 

Many thanks to Linda Kinane of JR TSSU for her help with this article 

Written by Sam Reid