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Background NHS England generates approximately 4.7 mega tonnes of carbon dioxide equivalent (CO2e) emissions per annum. 1 The 2020 Greener NHS initiative aims to reduce NHS carbon footprint to net zero by 2040.2 The cardiac catheterisation laboratory (hereafter, Cath lab) at Cumberland Infirmary, Carlisle switched from disposable to reusable gowns in 2022 as part of the ‘Greener Theatres checklist’ introduced by the UK Royal Colleges of surgeons.3Here, we analyse the financial and environmental benefits of switching to reusable gowns, as well as variations among specialities in responding to the need for change.Methods The uptake and consumption of reusable gowns in the Cath lab was reviewed over a three-year period. Procurement and disposal costs associated with reusable gowns use were compared against the cost and carbon footprint associated with disposable (single use) gowns.Reusable gowns are provided by a linen company, and the Trust is charged for laundry only. In contrast to disposable gowns, there are no purchase or disposal costs incurred with the use of reusable gowns.We quantified the 3-year environmental and financial impact of reusable gowns and compared these metrics against projected values for disposable alternatives. Global warming potential (CO2e), blue water use and solid waste generation were derived from published life cycle impact assessment of surgical gowns.4Consistency of reusable gown use by other departments in the hospital was reviewed to determine compliance and adherence to this sustainable initiative.Results From December 2022 to November 2025, the Cath lab used 6,570 reusable gowns, accounting for more than 90% of total Cath lab gown usage. The annual cost of reusable gowns is shown in table 1 along with the estimated prices for disposable gowns. Reusable gown use resulted in a 13% cost saving (total cost £2,219) compared with disposable alternatives.The use of reusable gowns resulted in 64% lower carbon dioxide equivalent emissions (3,679.2 kg cf. 10,774.8 kg). Reusable gowns generated significantly less solid waste and utilised less blue water throughout their life cycle (262 kg and 1,182 kg cf. 1,708 kg and 7,227 kg respectively). These values represent an approximately 84% reduction in waste generation and water consumption compared to estimated impact of disposable gown usage. (Table 1)Use of reusable gowns has been consistent in Interventional Radiology and Cardiology whereas, this has been fluctuating in surgical theatres. (Figure 1)Conclusions Transitioning to reusable gowns in cardiac catheterisation laboratory is easily achievable and results in significant financial and carbon emission savings.Cardiologists have learned from surgical initiatives and embraced the ‘Greener Theatres’ checklist. Surgical specialities can learn from radiology and cardiology on how to maintain beneficial change.Abstract 480 Figure 1Abstract 480 Table 1Financial and environmental benefit of reusable gowns