Insufficient action to protect people from the impacts of climate change and a health system not equipped to cope

The Climate Change Committee Progress Report on Adaptation says that the current record pace of climate change will mean the UK’s weather and climate will continue to change faster than ever over the decades ahead, posing risks across society. Flood risks for homes, infrastructure and businesses will rise without better defences and response planning. Heatwaves will pose risks to the health and lives of vulnerable people and stress the functioning of key infrastructure systems. Agriculture and ecosystems will increasingly be stressed by weather extremes throughout the year.

Climate change will also influence the prevalence of some vector-borne and infectious diseases, including tick and mosquito presence and distribution. The number of months with climatic conditions suitable for the spread of malaria and tickborne disease across the UK has risen since the 1960s. Since 2001 there have been on average around five months per year when conditions are suitable for tickborne diseases, and one month per year on average when conditions are suitable for malaria. However, more data collection and reporting on actual cases of, and mortality from, climate-sensitive diseases is needed to assess adaptation progress. 

An already existing upward trend of heat-related mortality will continue over the next decades, rising to over 10,000 deaths in an average year by 2050 without adequate action to adapt. In a Lancet Countdown UK policy brief in 2024, we reported that adults over 65, young children and pregnant women are particularly vulnerable to heat exposure with health impacts such as dehydration, kidney disease, heart disease, stroke, poor pregnancy outcomes, and mental health impacts. There is also an economic impact as a result of labour capacity reduction during periods of extreme heat. We highlighted the need for nature-based solutions with better access to green spaces in urban environments to provide cooling during periods of heat. The latest adaptation progress report highlights that the lack of national datasets recording measures such as urban greening or the availability of publicly accessible cool spaces, makes it impossible to even evaluate adaptation to urban heat.

Similarly, the ability to assess building-level adaptation to heat, or up-to-date pictures of overheating incidences or installation of active cooling measures in homes and buildings, are not available.

In the NHS, available data shows a long-term rise in overheating and flooding of NHS buildings, which can result in equipment malfunctions, IT and laboratory disruptions, health risks to staff, and surgery cancellations. However, there are significant gaps in data that monitor the vulnerability of health care delivery (including effects on care disruptions and infrastructure damage) to climate change and adaptation actions. Beyond the NHS, there is no routinely collected data that covers adaptation in other healthcare settings such as care homes, domiciliary care, and GP surgeries, and documents extreme weather disruption. 

It is clear that a lack of available data on all of the risk factors mentioned above makes it impossible to fully understand the impacts that climate change and the implementation of adaptation strategies have on population health and health systems. The Climate Change Committee stresses the need for monitoring and evaluation underpinned by regular data collection and reporting as essential for tracking climate impacts and the effect of adaptation measures at a national level in order to deliver meaningful progress.

The Committee highlights UK Health Security Agency’s Adverse Weather and Health Plan as a useful step in improving the coordination of the health response to extreme weather by clearly defining roles and responsibilities across national, regional, and local levels. However, it says it needs to go further to address fully all climate risks and provide an approach to health adaptation that can be effectively monitored. 

It calls on the government to develop an improved climate and public health adaptation plan that builds on the current Adverse Weather and Health Plan but covers a greater range of hazards and responses. It says this needs to be an action-oriented plan that provides improved quantitative targets and associated indicators to monitor progress related to health adaptation across sectors.

The Committee also calls for further strengthening of NHS Green Plan guidance and NHS Climate Adaptation Framework with clearly defined outcomes and targets for implementation and accountability, monitoring, and links with net zero targets.

Currently, funding allocations to adapt hospitals, care homes and other healthcare buildings are not set out, and this needs to be addressed. The government’s mission to deliver an NHS fit for the future provides an opportunity to integrate adaptation within the NHS estate combined with a focus on prevention by ensuring resilience across wider societal infrastructure to protect population health from climate risks. The next spending review is an opportunity to ensure that climate adaptation is sufficiently resourced across government and critical public services, such as the NHS to ensure steps can be taken to improve resilience to current and future climate impacts.

The Climate Change Committee has warned that adaptation progress is either too slow, has stalled, or is heading in the wrong direction. This needs to change now with rapid action to make up for time lost in order to reduce the risk of further threats to peoples’ lives and livelihoods.