European Union of Private Hospitals

EPHA Awards 2023 – Green Hospitals and Social Responsibility

1st prize, CUF Tejo – Hospitals and Clinics, Lisbon (Portugal) for its Environmental Sustainability Practises

The CUF Tejo – Hospitals and Clinic, with its CSR pilot initiatives, intends to define transversal methods that can be reproduced in the 23 other hospital units of the CUF group. 

What makes your project so special?

The impact and value that CUF leaves traces of its mark in the society is one of the most relevant aspects of our strategy, for over 70 years. Social and environmental aspects are a highlight of the way we develop our activity and through this project to act in the core of the hospital care and to minimize its own impacts.

What makes your project so special?

This award strengthens the sense of community of a great professional team that is dedicated to caring for people. It is the recognition of a collaborative, multidisciplinary and focused work in caring for the health of people and the environment. It was with great joy and pride that the teams received the news that CUF had won this award and a great encouragement to continue to do more and better.

A high level of sustainability

The CUF Tejo hospital, which opened in 2020, began its CSR journey at the planning stage. Certified NEZB (Nearly Energy Zero Building), it is equipped with solutions that enable it to produce its own energy, such as solar panels, as well as smart solutions such as HVAC (heating, ventilation and air conditioning) temperature control systems and LED lighting throughout the hospital.

Regular carbon footprint measurements will enable the hospital to diagnose its emissions and identify potential areas for improvement.

With its CSR pilot initiatives, the CUF Tejo hospital intends to define transversal methods that can be reproduced in the 23 other hospital units of the CUF group. Other areas of work are targeted: single-use devices, operating theatre instruments, better waste management, etc. Another objective is to engage and inspire team members on the importance of having a positive impact on the environment on a daily basis.

A greener operating theater

The operating theatre, which is the most resource-intensive area of a hospital, accounting for around 21-30% of total waste (NHS), was identified as a priority location to start developing the ‘greener operating theatre’ concept.

“Looking at the Intercollegiate Green Theatre Checklist*, a good international reference on clinical and hospital sustainability, we verified that most of these features are already developed in CUF with the reuse and replacement of the intraoperative equipment needing also more development.”


“In 2022, we checked the considerable weight of anesthetic gases in our carbon footprint and, in collaboration with the pharmacy and anesthetic teams at seven hospitals in the Lisbon district, during the second half of 2022, we gradually phased out a highly polluting drug in these hospitals, desflurane, replacing it with another drug with a much smaller footprint, sevoflurane.

This change is already bearing fruit in 2023, with an expected reduction of more than 1,000 tons of carbon dioxide avoided during the 16,000 surgical procedures carried out using this sevoflurane. We are working with a consultancy specialised in carbon footprint assessment, which has been collecting our data since the first diagnosis in 2021.

Changing the anesthetic gas from desflurane to sevoflurane has also reduced costs, making it a win-win situation.”

An efficient waste management

In addition, a pilot trial began in November 2022 at the CUF Tejo hospital. It aims to recover Blue Wrap, a non-woven fabric that is currently considered undifferentiated hospital waste and sent to landfill. Blue Wrap is a type 5 plastic fabric made from polypropylene and used to wrap boxes containing surgical equipment. This material has high-quality and relevant characteristics such as thermal resistance, water resistance, gas porosity and pressure resistance. Following the example of other countries, we are proposing to reuse this material in a variety of ways, for example to make blankets, covers, bags, pullovers, pillows, ponchos, and so on. By the end of 2022, we had donated more than 200 kg of Blue Wrap to EntrAjuda, a solidarity institution and certified waste operator.

Again, with the aim of recovering waste, at the end of 2022 CUF set up an internal circuit for aluminum bottles to increase their recovery.

We have also developed a mandatory training programme for recycling and waste recovery, which produced good results at the end of the year. The CUF Tejo hospital has doubled the volume of plastic recycled (5,000 kg in 2021 compared with 11,000 kg in 2022).

Reducing incineration is an excellent way of recovering waste and reducing greenhouse gas emissions, bearing in mind that reducing our carbon footprint is our responsibility to society and the environment, and trying to reduce climate change and prevent new health problems is a step in the same direction.”

“As a leading healthcare organisation, we believe it is our responsibility not only to provide a clinically excellent service to our patients, but also to seek to develop good environmental sustainability practices in our facilities and services.”

For additional information, consult CUF’s Integrated Report