The healthcare sector is a major contributor of greenhouse gases and plastic waste. GASP (the Greener Anaesthesia and Sustainability Project) is a collaboration between anaesthetists and a range of NHS workers, who want to reduce the environmental impact of surgery and anaesthesia. Working on environmental impact in the health care sector is complex, because of the wide range of different disciplines in the healthcare ecosystem as well as the many financial, political and ethical issues . Dr Groome describes how GASP came into existence as well as some of the many challenges and sucesses of this inspirational group of professionals.