Safe and Ethical Disposal of Nitrous Oxide and Entonox Medical Gases

Challenge Background

Cardiff and Vale UHB along with other Health Boards across Wales have established a group to explore how nitrous oxide can be delivered via small portable cylinders and eliminate the use of the manifold system.

Portable E sized N2O cylinder with a regulator and Schrader valve connection was trialled with success and this change has been rolled out across the University Hospital Llandough and the nitrous oxide manifold was decommissioned in April.

The smaller cylinders have proven to be more efficient than the manifold and have an efficiency of 74%, compared to the piped supply from the manifold. This shows what huge gains there are to be made from moving over to a portable cylinder supply.

We are left with two problems:

  1. There are numerous partly filled large G size cylinders on the manifold which we no longer need. If they are returned, the remaining nitrous oxide will be released to the atmosphere. Current legislation prevents reuse/recycling of this gas. We want to find a way to prevent this nitrous oxide going into the atmosphere.
  2. We also consume large amounts of Entonox (50% oxygen, 50% nitrous oxide) which is predominantly used by women for pain relief in labour. When this gas is used it is exhaled into the atmosphere. We would like to find an alternative solution which is suitable for widespread use in maternity units across Wales and the UK.

The Healthcare Without Harm Report showed that 5.6% of UK emissions are from healthcare. The Welsh Government have declared a climate emergency and published NHS Wales Decarbonisation plan stating that the Welsh public sector will be carbon neutral by 2030. This ambitious plan specifically targets anaesthetic gases and includes nitrous oxide which has a global warming potential approximately 298 times that of carbon dioxide


Challenge Details

We are looking for sustainable and cost effective solutions for the safe disposal of nitrous oxide and Entonox medical gases. Specifically around the following two Themes:

Theme 1:

Safe disposal of gas within partly filled nitrous oxide cylinders prior to return to the supplier; and

Theme 2:

A solution to the problem of the high levels of Entonox being released into the atmosphere following consumption on our wards.

We are looking to identify, develop and demonstrate innovative solutions that could:

  • Reduce our emissions of nitrous oxide and Entonox;
  • Provide a competitively priced and affordable solution to ensure the safe disposal of nitrous oxide and Entonox medical gases in a sustainable way;
  • Reduce our purchasing of Entonox and nitrous oxide;
  • Reduce waste in our Entonox supply system; and
  • Improve air quality in the delivery rooms on labour wards.

Applicants may apply for one or both Themes.


Challenge Phases Structure:

Phase 1: Feasibility – We are looking to fund up to 5 projects up to a value of £50,000 (inclusive of VAT) each for Phase 1.

Note: Only projects successful at phase 1 will be eligible to apply to subsequent phases. Additional phases will be dependent upon funding allocation.

Phase 2: Development – We expect to fund up to 3 of the most successful phase 1 projects up to a value of *£150,000 each (inclusive of VAT).

*Dependent upon funding allocation

Please note any adoption and implementation of a solution from this competition would be subject of a separate, possible competitive, procurement exercise. This competition does not cover the purchase of any solution although we may choose to investigate and explore innovative procurement routes as part of this challenge.

The total funding available for the competition can change. The funders have the right to:

  • adjust the provisional funding allocations between the phases
  • apply a ‘portfolio’ approach

Key Dates table:

Phase 1 ActivityKey Dates **subject to change **
Open Date – Phase 122/11/2022
Briefing event30/11/2022
Close Date12 noon 14/12/2022
Meet and Greet with Suppliersw/c 19/12/2022
Applicants notifiedw/c 19/12/2022
Phase 1 Contracts awardedw/c 19/12/2022
FeedbackEarly January 2023
Projects CommenceEarly January 2023
Projects Complete31/03/2023
Phase 2 ActivityKey Dates  **subject to change **
Phase 2 applications to be reviewed and decision on company/companies to take forward31/03/2023
Feedback to unsuccessful applicants04/04/2023
Contracts signed and commencement03/04/2023
Project closure29/03/2024


Briefing Event

Please follow the link below and register your interest for the virtual Briefing Event held on 30 November 2022:


Commercial plan notice

Please note if you are successful in Phase 1 and go through to Phase 2, you will need to provide a commercialisation plan/strategy as part of your contractual deliverables.


Further information

For more information on this competition, visit: Simply Do

For any enquiries about this competition e-mail:


This competition has ended.