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Leadership and Governance

Health services across England, Scotland, Wales and Northern Ireland have incorporated climate mitigation into their plans to reach net zero. While some adaptation measures have been taken, this has not been given the same profile as climate mitigation in the UK’s healthcare sector.

As part of the 2024 Wales Climate Adaptation Strategy, there are key recommendations for the Welsh Government, Public Health Wales, and providers to support adaptation efforts in the healthcare sector. In the strategy, all health and care organisations in Wales are encouraged to develop, publish and implement climate change response plans, covering emissions reductions and adaptation planning. NHS Wales has developed a Climate Adaptation Toolkit to help health and care providers assess and respond to climate risks, while Public Health Wales’ Health Impact Assessment (HIA) provides a comprehensive evaluation of climate change’s effects on population health. HIAs support climate adaptation by identifying health risks and benefits of climate policies, infrastructure projects, and adaptation measures, ensuring interventions enhance resilience, protect vulnerable populations, and minimise unintended health harms.

NHS Scotland’s Climate Emergency and Sustainability Strategy aims to strengthen its climate resilience by ensuring healthcare facilities can withstand extreme weather and other climate-related risks. This includes adapting buildings and infrastructure to withstand flooding, heat, and storm damage, improving water efficiency and drainage, and using nature-based solutions like greener estates to support biodiversity and air quality. Some progress has been made as 20 of the 22 Scottish NHS Boards have completed climate change risk assessment; 15 have developed high-level adaptation plans.

In England, the Greener NHS programme reports on progress and planned adaptation activities in its health and care adaptation report. With the latest report published in early 2025, it showed some progress had been made by NHS England, such as the development of a Net Zero Building Standard. This standard aims to mitigate overheating risks, and provide guidance about adaptation measures such as passive cooling solutions through greenspaces and natural ventilation. Integrated care systems (ICSs) and NHS trusts in England are required to develop board-level approved green plans, which should include a dedicated section on adaptation. However, very few of the plans that have been published include a robust section focusing on adaptation measures.

Northern Ireland’s Second Climate Change Adaptation Programme (NICCAP2), from 2019 to 2024, has made little progress in addressing population health and the health and social care system. It included just one health-related action: the creation of an online platform for climate change and health information for practitioners. While the platform is in place, it is not regularly updated. According to the CCC, organisations such as the Public Health Agency and Health and Social Care Trusts lack clear policies on addressing the health impacts of climate change. The Third Northern Ireland Climate Change Adaptation Programme (NICCAP3) will be published in 2025, and will be an important opportunity to enable climate resilience within its health and care system.