The NHS is a unique institution that touches on the lives of every person in the UK. But for the last decade, the NHS has been suffering a crisis of capacity as a consequence of workforce shortages and increasing population need. It is widely recognised that the NHS needs a dramatic change in order to meet the needs of today’s society. As the impacts of the climate and nature crisis deepen, so too will the burden on our health service.
The NHS will need to manage increasing patient demand and the risk to infrastructure from climate-related extreme weather, as well as addressing its own contribution to greenhouse gas emissions. The NHS contributes about 5% of the UK’s emissions and has committed to reaching net zero by 2040/45. The changes needed to deliver a sustainable health service will be transformative.
NHS England’s 2020 report on Delivering a Net Zero Health Service set out a road map for achieving the goal of making the NHS net zero. Health services in Wales and Scotland have also set out their strategies for achieving net zero by 2045. Good progress has been made in reducing the NHS carbon footprint, however, concern has been raised that progress has been stalling and more support is needed. For example, in January 2023 it was reported that on average, NHS organisations consumed 75% of their energy from fossil fuels; an average of 83% of vehicles in the NHS fleet use petrol or diesel; and that most NHS organisations have not received funding for sustainability and decarbonisation.
The government must provide sufficient capital investment and resources to decarbonise the NHS estate through efforts such as the installation of rooftop solar panels and heat pumps, upgrading NHS buildings to energy efficiency standards, accelerating the electrification of the NHS fleet, adopting energy efficiency and waste saving measures, and ensuring all patients, staff and visitors have access to healthy, sustainable food and the means to travel to NHS sites on public transport, walking or cycling. These actions must be delivered in parallel with integrating climate-resilient measures to protect our vital health services from climate threats.
The wider societal benefits of the NHS adapting to meet net-zero targets would be significant. Upgrading the NHS electricity supply would require accelerated action on the national grid, for example, the benefits of which would extend to other sectors across the country. The engagement with patients, staff and visitors on the positive changes that energy-efficient and cleaner travel bring to the wider environment would have a cascading effect on individual and organisational change in other areas.
Interventions that consider climate change, sustainability, and nature should be integral to health system functioning. Placing sustainability at the core of the NHS’s future offers opportunities to deliver better services, support healthier populations, and save costs.
- BMJ Commission on the Future of the NHS