There are examples across the NHS in England, Scotland and Wales where healthcare facilities are adapting to the current impacts of climate change, including integrating green spaces with estates, adopting sustainable technologies, and improving infrastructure.
Green spaces
A key aspect of the NHS’s adaptation efforts is the incorporation of green spaces within healthcare estates.* Initiatives such as the NHS Forest and the NHS Greenspace Demonstration Project encourage the creation and enhancement of green areas around hospitals and clinics, including the planting of food-producing trees. These multifunctional spaces provide multiple health, environmental, and economic benefits: they help mitigate the urban heat island (UHI) effect by cooling the air and lowering temperatures during heatwaves, reduce flooding risks, improve biodiversity, and promote sustainable food resilience. This reduces the health risks associated with extreme weather events, particularly for vulnerable populations.
Green spaces play a vital role in improving air quality by filtering pollutants such as particulate matter (PM2.5) and nitrogen dioxide (NO2). Trees and vegetation absorb these harmful pollutants while releasing oxygen, creating healthier environments for patients, staff, and surrounding communities. Improved air quality can lead to fewer hospital admissions for respiratory and cardiovascular conditions, further benefiting the health sector. Green spaces are increasingly being used in social prescribing, where healthcare professionals refer patients to activities like walking, gardening, or spending time in nature to improve physical and mental health. Studies show that these activities can reduce stress, enhance recovery, and alleviate conditions such as anxiety and depression, further supporting the NHS in promoting well-being and reducing healthcare demand. NHS Lothian in Scotland found that every £1 spent on a green health project (therapeutic gardening) in NHS grounds yields at least £2 in health benefits. NHS Scotland has a dedicated annual budget of £300,000 for green space projects within estates. NHS Estates are one of the largest landowners in the UK. Yet, when it comes to utilising this land for the benefits of climate, nature and health, there is a lag. While individual actions by clinicians or institutions are extremely important, greater reward would come from more joined-up action from higher levels of the NHS to transform the estates into biodiverse rich, thriving green spaces which would offer both climate mitigation and adaptation benefits.
Sustainable technologies
Sustainable technology helps the NHS adapt to climate change by improving energy efficiency, integrating renewable energy, and enhancing resilience to extreme weather. Features like smart heating, green roofs, flood barriers, and water-efficient systems ensure healthcare facilities remain operational during climate-related disruptions and maintain optimum temperatures during extreme heat or cold. Devizes Health Centre in Wiltshire is one of the NHS’s first net-zero buildings. It utilises green technologies such as heat pumps and solar panels to generate electricity and heat, thereby minimising environmental impact. This increases climate resilience as it provides a sustainable, secure, and uninterrupted source of energy during climate-related events, reducing service delivery risks. The UK government has also recently announced more than £100 million in funding from Great British Energy for NHS sites to install solar panels and battery storage systems, including 200 sites in England.
Telemedicine, remote monitoring, and virtual wards offer promising avenues for improving health system resilience to climate-related disruptions. These models, rapidly scaled during the COVID-19 pandemic, can reduce demand on acute care, maintain continuity of services during extreme weather events, and improve access for climate-vulnerable populations. Their wider use also aligns with the UK Government’s strategic ambition to shift care from hospital to community settings, enabling more proactive and decentralised models of care. However, their integration into climate adaptation planning within the NHS remains limited.
Infrastructure
In early 2025, the UK government committed to targeted replacement, maintenance, and critical safety upgrades for the primary care estate within the NHS and UK Health Security Agency, as part of its 10-Year Infrastructure Strategy. The Strategy aims to adapt infrastructure for future operating models, focusing on the government’s three key health system shifts: hospital to community, analogue to digital, and illness to prevention. Following a review of the New Hospital Programme, the government announced a revised timeline to address infrastructure needs in 40 hospitals by 2040.
Many healthcare facilities in the UK still rely on outdated infrastructure that is not designed to withstand extreme weather events like heatwaves and floods. More than 600 days of clinical time were lost in 2024 due to deteriorating infrastructure, such as crumbling roofs at risk of collapse, water leaks, and malfunctioning heating and ventilation systems.
Investment in climate-resilient infrastructure is not keeping up with the growing risks. In addition to high costs of retrofitting, some NHS estates face logistical challenges due to their status as heritage buildings. The government has increased the Department of Health and Social Care’s capital budget by £3.1 billion for 2025/26, with £1 billion allocated for urgent repairs and upgrades. While this is a positive step, the total cost to address the NHS estate’s repair backlog has now reached a record £13.8 billion, highlighting the need for long-term investment to restore facilities and ensure they are resilient to the climate crisis. The COVID-19 pandemic exposed the lack of resilience in healthcare systems, with hospitals overwhelmed by demand and staff overburdened. To prepare for the climate crisis, both the public and private sectors must address infrastructure vulnerabilities and strengthen healthcare systems with innovative solutions to close existing gaps, overcome logistical difficulties, and mitigate climate-related health risks.