Years of underfunding have left the NHS in England with a £37 billion shortfall, resulting in outdated infrastructure, slow modernisation, and overstretched services, which weakens its ability to respond to climate-related emergencies. Similar funding pressures are evident in the devolved nations, with significant deficits reported in 2023; £732 million in Northern Ireland, around £400 million in NHS Scotland, and approximately £650 million across NHS Wales. Despite this, some efforts have been made to reduce the environmental impact of the health and social care sector. The UK government has made an investment of over £280 million through the Public Sector Decarbonisation Scheme for NHS estates in England. Scotland’s government has committed at least £200 million over five years (2021-26) to decarbonise public sector estates, while Wales has invested £2.4 million over three years in its Health and Social Care Climate Emergency National Programme.
Funding for climate adaptation measures has lagged far behind mitigation investments. Although the UK government has committed £2.65 billion in flood defences aims to protect over 66,000 properties by March 2026. While the primary focus is on homes, businesses, and farmland, there is no specific mention of dedicated funding for healthcare facilities within this allocation. Investment in adaptation initiatives within the NHS has prioritised temporary solutions, such as portable cooling systems, and while this helps to address immediate risks, it fails to provide long-term resilience.
The CCC highlights several early adaptation investments that offer value for money, such as heat alert systems, heatwave planning, early warning systems, and capacity building. Each of these interventions could deliver over £10 in net economic benefits for every £1 spent. The CCC estimates that approximately £10 billion per year will be needed over the next decade for climate adaptation across the public and private sectors in the UK. However, specific financial allocations for health sector adaptation are not outlined in the available plans. To bridge this gap, the health sector could leverage innovative public-private partnerships, as it has successfully done in the past. For example, HCP Social Infrastructure Ltd’s £1.1 billion redevelopment of two of Barts Health NHS Trust hospitals, deemed to be the largest private financing initiative hospital scheme in the UK, showcased how such partnerships can support healthcare planning, design, and construction while maintaining high standards of care.