Key Points
- Innovation N2O Clear (Nitrous Oxide Cracker) that has been created at Cardiff’s University Hospital of Wales to cut down on nitrous oxide emissions resulting from Entonox (gas and air) in maternity wards can now be used in any hospital in the UK and Ireland.
- This technology was designed in a joint effort of Cardiff and Vale University Health Board, Contracts for Innovation Cymru, and Northern Ireland-based E-Breathe and now will be sold and distributed by BOC.
- The idea was launched in 2021 as Consultant Anaesthetist Dr Charlotte Oliver and her team took part in Dragon’s Heart Institute Spread & Scale Academy to address labor ward waste problem.
- N2O Clear turns exhaled nitrous oxide into harmless nitrogen and oxygen after its use thus managing to significantly reduce emissions of nitrous oxide (by 95% – 95%) and not interfering with the quality of pain relief and maternity care provided.
- Welsh Government has allocated funds to provide N2O Clear units to all health boards in Wales, NHS Lothian, NHS England units in Hull and Walsall and even internationally – in Germany.
- E-Breathe won INVENT 2024 Green Horizons Award and was shortlisted for NHS Sustainability Award in 2025.
Cardiff (Cardiff Daily) October 8, 2026 – A pioneering maternity technology designed to significantly curb greenhouse gas emissions on hospital labour wards has officially become available to healthcare organisations across the United Kingdom and Ireland. Developed initially at Cardiff’s University Hospital of Wales to capture and neutralize nitrous oxide exhaled during childbirth, the breakthrough system represents a major milestone in sustainable healthcare following close collaboration between the National Health Service, the Welsh Government, and industrial partners.
How Was the N2O Clear Technology Developed?
The initiative commenced in 2021 when, as reported by Business News Wales, Consultant Anaesthetist Dr Charlotte Oliver and her clinical team at the University Hospital of Wales participated in the Dragon’s Heart Institute Spread & Scale Academy. Initially intending to address leaks within standard gas and air manifolds, the team quickly expanded their focus to tackle the wider environmental challenge posed by nitrous oxide, a potent greenhouse gas contained within Entonox widely utilized for pain relief during labour.
As reported by Business News Wales, Dr Charlotte Oliver stated:
“When we first walked into the Spread and Scale Academy, none of us could have imagined we would end up here. We came in hoping to reduce waste on our own labour wards, and the technology that grew out of that work is now heading to hospitals across the UK and Ireland. To see it reach this scale is genuinely humbling, and it is proof of what a team can achieve when it is given the confidence and the tools to think bigger.”
To turn their vision into reality, the team approached Contracts for Innovation Cymru, the Welsh Government’s challenge-led innovation programme. This led to an open innovation challenge that ultimately selected Northern Ireland-based firm E-Breathe to design, develop, and test a viable system. The resulting device, named N2O Clear or the Nitrous Oxide Cracker, chemically breaks down nitrous oxide into harmless nitrogen and oxygen immediately after use. Clinical testing demonstrated that the unit reduces emissions by 95% to 99% without altering or compromising the pain relief administered to women during labour.
Reflecting on the transformative journey, Dr Oliver added:
“The Spread & Scale Academy was transformative for us. Before participating, the scope of implementing such a significant change felt daunting. The Academy provided us with both the confidence and the practical tools necessary to bring our vision to life. We joined with the idea of shutting down the old leaky manifolds, but the Academy taught us to focus more on the problem than our proposed solution, so tackling the waste from Entonox was our natural next step.”
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What Impact Is the Technology Having Across Healthcare Networks?
Following rigorous trials at the Maternity Unit at the University Hospital of Wales, the innovation rapidly gathered momentum. According to Business News Wales, the Welsh Government has successfully secured dedicated funding to supply the N2O Clear units to every single health board across Wales. Furthermore, initial deployments have already taken place across NHS Lothian as well as NHS England sites located in Hull and Walsall.
International interest has also gathered pace, with units supplied to Germany and active discussions underway with health organisations in Northern Ireland and the Republic of Ireland. In recognition of its environmental and technological impact, E-Breathe was honoured with the INVENT 2024 Green Horizons Award and shortlisted for an NHS Sustainability Award in 2025.
The latest agreement with industrial gas giant BOC marks the critical next phase of commercialisation, ensuring that hospitals throughout the UK and Ireland can easily access and integrate the hardware into their existing clinical infrastructure.
Commenting on the collaborative success, Cabinet Minister for Health and Care Mabon ap Gwynfor noted:
“The E-Breathe solution is a compelling example of what our Innovation, Technology and Partnerships (ITP) programme exists to deliver. There was no readily available market solution to the environmental harm caused by exhaled Entonox in our maternity units. With the support of our ITP funded delivery partners, the Intensive Learning Academy’s Spread and Scale Academy and Contracts for Innovation Cymru, the E-breathe technology was designed, rigorously tested and successfully scaled to meet a genuine unmet need in our health system. The fact that this innovation has now reached hospitals across the UK and Ireland is testament to what can be achieved when Welsh Government, the NHS and industry work together with the right support behind them.”
Echoing these remarks, Faye Williams, Project Manager at Contracts for Innovation Cymru, highlighted the strength of regional infrastructure:
“This project demonstrates the value of bringing together different expertise at different stages of the innovation journey. The Spread & Scale Academy helped Charlotte and her team develop and refine the challenge, while we provided the challenge-led innovation route to identify, develop and test a solution before supporting its progression through to commercialisation. It’s fantastic to see an idea that originated from a frontline clinical challenge evolve into a commercially available product with the potential to benefit maternity services across the UK and beyond. It’s a great example of how collaboration across Wales’ innovation ecosystem can help turn ambitious ideas into real-world solutions.”
David McLaughlin, Chief Executive of E-Breathe, added:
“The support received from the Welsh team was first class. From identifying and clarifying the problem, critiquing the product design, in situ testing, ongoing support and encouragement. We are delighted that what was once an idea is now a physical product available throughout the UK and beyond to help address the climate impact of nitrous oxide – it simply wouldn’t exist without initiatives like this one.”
Background of the Development
The development of N2O Clear directly addresses a long-standing environmental blind spot in clinical practice: the atmospheric release of nitrous oxide from pain relief gases used during childbirth. While Entonox (a 50:50 mixture of nitrous oxide and oxygen) has remained a cornerstone of maternity pain management for decades, medical research increasingly highlights that exhaled nitrous oxide possesses a significant carbon footprint and greenhouse gas warming potential. Because traditional hospital ventilation systems simply expel waste anaesthetic gases directly into the atmosphere, individual maternity units contribute substantially to institutional carbon footprints.
Faced with this challenge, Welsh healthcare innovators leveraged structural innovation programmes—namely the Dragon’s Heart Institute Spread & Scale Academy and Contracts for Innovation Cymru—to transition from a localized ward-level concern into a structured procurement challenge. By utilizing an open innovation framework, the health board engaged specialized engineering expertise from E-Breathe to design a localized cracking technology. This structured public-sector support model bypassed traditional, slower procurement hurdles, enabling a rapid pipeline from clinical identification at the University Hospital of Wales to commercial distribution via BOC.
The widespread commercial availability of N2O Clear via BOC is projected to significantly accelerate decarbonisation efforts across National Health Service trusts and health boards in the UK and Ireland. For hospital administrators, sustainability officers, and maternity care providers, this development offers a turnkey, clinically validated compliance tool to meet stringent net-zero carbon targets without requiring changes to patient care protocols or clinical workflows.
As health boards face tightening environmental mandates and carbon reduction deadlines, the implementation of emission-cracking technology on labour wards will likely transition from an optional sustainability initiative into a standard operational requirement. Furthermore, the international visibility gained by E-Breathe—including deployments in Germany and expanding talks across European jurisdictions—positions Cardiff’s innovation ecosystem as a leading blueprint for turning frontline clinical challenges into globally exportable medical technologies.
