This section integrates both the health workforce and service delivery components from the WHO framework, as they complement each other and help prevent duplication.
As climate change intensifies and its health impacts grow, health professionals play a crucial role in raising public awareness and managing climate-related health conditions. To adapt to the health impacts of climate change, NHS staff must be provided with adequate training and resources to support patients during climate-related events, such as heatwaves and flooding, as well as to identify and manage emerging diseases. Yet, engagement with climate adaptation strategies within the UK health system remains minimal. Even awareness among health professionals that climate change is a health issue, and understanding of mitigation strategies despite their relatively higher political visibility, remains limited.
Staff shortages are a significant issue, with vacancy rates at 8.4% for NHS England, between 3-7.5% for NHS Scotland, 5.4% for NHS Wales, and 6.1% for Northern Ireland Health and Social Care. These shortages hinder the ability to effectively manage surges in healthcare demand during extreme climate events, alongside providing routine care. The ongoing workforce challenges impact the availability and response of staff to meet patient needs during such events. Emergency departments, in particular, which deal with patients suffering from acute health issues caused by extreme weather, will struggle to respond unless the current capacity issues, including high patient volumes in corridors or temporary facilities, are urgently addressed.
Few healthcare organisations have dedicated roles for overseeing climate resilience at the workforce level, possibly due to a lack of central support and the low profile of adaptation measures, resulting in limited prioritisation within NHS organisations or a shortage of expertise within the NHS to deliver this work. In their 2023-2026 Green Plan, University Hospitals of Coventry and Warwickshire NHS trust committed to appointing a climate change adaptation lead by 2023-24 to help implement the recommendations from the third Health and Social Care Sector Climate Change Adaptation Report.
NHS England’s Fourth Health and Care Adaptation Report, published in 2025, noted it has expanded climate adaptation training through e-learning platforms, incorporating climate risks into existing programmes. The Carbon Literacy for Healthcare e-Learning pathway helps green champions recognise vulnerable populations and understand how extreme weather events affect healthcare, with around 3,000 staff completing the training. Additionally, over 900 leaders have taken part in the Sustainability Leadership for Greener Health and Care Programme, designed to equip decision-makers with the skills to build a more sustainable health system. Further plans include appointing climate adaptation leads in regional health protection teams, strengthening public health expertise in adaptation, and creating concise training modules to improve workforce understanding of healthcare adaptation.
NHS Wales and NHS Scotland have introduced training programmes to help healthcare staff understand and respond to climate change. In Wales, healthcare workers can become Climate Smart Champions by undergoing training on sustainable healthcare and lead efforts to make the NHS more sustainable and carbon neutral. Additionally, the health and social care adaptation toolkit offers a deeper understanding of climate adaptation and provides guidance on how to achieve it. In Scotland, NHS staff can take an environmental sustainability course that explains how climate change affects health and what actions can reduce its impact. Training also includes ways to make healthcare services more sustainable while maintaining quality care. No dedicated training initiatives for the healthcare workforce by the Health and Social Care Northern Ireland could be found.
Regulators play an important role across the four nations to ensure clinicians have sufficient training and knowledge to meet the needs of patients experiencing the health impacts of climate-related events. There is a commitment in the UK’s Nursing and Midwifery Council’s (NMC) Environmental Sustainability Plan to promote sustainable practices among healthcare professionals. Similarly, the UK’s General Medical Council (GMC) has integrated education for sustainable healthcare into undergraduate medical education curricula but studies have shown significant variability in how these are adopted by medical schools in practice. Without mandating the inclusion of this curricula, its implementation will likely remain limited. In 2023, the GMC updated Good Medical Practice – the ethical standards that guide doctors working in the UK. While two duties were added under a new heading on managing resources effectively and sustainably, these revisions failed to adequately articulate the urgency of the issue.[25] There has been guidance issued from the Council of Deans of Health and Intensive Care Society on embedding sustainable healthcare in the curriculum for allied health professionals, yet this is not mandated by the Health and Care Professions Council.
The Adverse Weather and Health Plan (AWHP) for 2025-2026 sets out key measures to prepare the health workforce in England for the challenges posed by adverse weather events. It highlights the need for targeted training and education to equip healthcare professionals with the skills required to effectively manage climate-sensitive health issues. The plan emphasises interagency collaboration between public health, emergency services, and local authorities to ensure a coordinated response during weather-related emergencies. The AWHP also stresses the importance of sufficient resource allocation, including staffing and medical supplies, to address the increased demand for healthcare during extreme weather.
Individual actions by healthcare workers must be supported by services that are designed to adapt to climate change, yet these measures are largely underdeveloped. For example, the new green plan guidance published by NHS England focuses significantly on mitigation but misses an opportunity to encourage providers to adequately address climate adaptation. There is a lack of comprehensive occupational health guidance for providers to protect healthcare workers from the health and well-being effects of exposure to extreme temperatures. Existing guidelines tend to be general and often overlook the specific challenges of different clinical settings. Public education on climate-related health risks remains largely reactive and limited to event-specific measures, such as heat-health alerts. There is a clear and urgent need for a sustained national campaign to improve climate-health literacy and support long-term behaviour change. Evidence from the Royal College of Paediatrics and Child Health (RCPCH) and Clean Air Fund on air pollution communication reveals that many health professionals do not engage with patients on these issues because they underestimate the urgency and relevance. This inaction is driven by gaps in understanding the health impacts, perceived insufficiency of evidence, a misleadingly optimistic view of air quality in the UK, and the persistent framing of air pollution—and by extension, climate change—as environmental rather than health concerns.