Imperial College Healthcare NHS Trust transformed its sleep apnoea diagnostic pathway, cut carbon and slashed waiting times.
Imperial College Healthcare NHS Trust redesigned its obstructive sleep apnoea (OSA) diagnostic pathway, replacing a slow, plastic-heavy, multi-appointment hospital model with a digitally enabled, postal home-testing service.
Patients previously made at least 3 hospital trips to collect and return bulky equipment. Now, a small reusable wearable device is posted directly to patients, who sleep at home with it and return it the next day. A smartphone instruction video supports completion and improves health equity
The redesigned pathway:
- eliminated 3 hospital journeys per patient, saving an estimated 4.20 kg of carbon dioxide equivalent per patient — around 12.6 tonnes annually
- reduced plastic waste by 99%, from 100g to 0.36g per test
- cut median time to diagnosis from 352 days to below 135 days
- released over 1,500 specialist hours annually through automated reporting
- reduced the outpatient waiting list from over 3,000 to below 1,000
Patients saved up to 82 minutes of travel time and up to £7.15 in out-of-pocket costs per test. The pathway also reached a higher proportion of patients from non-white ethnic backgrounds, supporting more equitable access to diagnosis
The pathway is now embedded as routine care in Imperial College Healthcare NHS Trust and has been shared with 5 other NHS regions, including paediatric and learning disability services
Winner of the Sustainable Healthcare award at the NHS Excellence Awards 2026
