A greener NHS
In October 2020, the NHS became the world’s first health system to commit to achieving net zero emissions, recognising climate change as a major threat to health and service delivery. With the ambitious targets of net zero by 2040 for direct emissions and 2045 for indirect emissions.
Why net zero matters
Climate change poses severe risks to health, including:
- Increased heat-related illnesses and mortality.
- More frequent extreme weather events disrupting care.
- Higher air pollution and associated respiratory conditions.
- Spread of vector-borne diseases.
The NHS is responsible for around 4–5% of the UK’s carbon footprint and 30–40% of public sector emissions, making its decarbonisation critical for national climate goals and public health.
The NHS net zero strategy set two key targets:
- NHS carbon footprint (direct emissions): net zero by 2040, with an interim 80% reduction by 2028–2032.
- NHS carbon footprint plus (indirect emissions): net zero by 2045, with an interim 80% reduction by 2036–2039.
These targets align with the Climate Change Act 2008, the Environment Act 2021, and the Government’s Fit for the Future: 10-Year Health Plan.
The NHS has made significant progress in several areas including:
- Emissions reduction
- Direct emissions have fallen 14% since 2020 and 68% since 1990, despite rising demand and service pressures.
- Improvements in carbon accounting have enhanced accuracy and transparency.
- Energy and infrastructure
- Significant investment in solar power, battery storage, and energy efficiency.
- Over half of NHS buildings now use LED lighting, reducing emissions and costs.
- Expansion of electric vehicle (EV) charging infrastructure: from 1,500 points in 2020 to over 4,200 today, with plans for 1,200 more.
- Waste reduction
- Domestic waste to landfill reduced from 32,000 tonnes in 2020 to under 6,000 tonnes in 2025.
- Clinical pathways
- Innovations in net-zero surgeries, anaesthetic gas reductions, and sustainable emergency care.
- Focus on decarbonising medicines and supply chains.
- Global leadership
- NHS efforts have inspired over 40 countries to adopt healthcare net-zero targets.
- Recognised by the intergovernmental panel on climate change (IPCC) as a leading example in climate-health integration.
As well as achieving direct impact on carbon emissions there has also been financial and health benefits, including energy efficiency and renewable projects deliver millions in annual savings, reinvested into frontline care. EV transition expected to save £130 million over 25 years and sustainability measures improve patient outcomes and staff wellbeing.
Image -greenhouse gas protocol scopes in the context of the NHS
Challenges ahead
Climate change impacts will intensify, increasing demand and operational risks. The NHS cannot achieve net zero alone, it will require decarbonisation of the national electricity grid and wider adoption of low-carbon heating, sustainable pharmaceutical production and continued collaboration with suppliers, partners, and government is essential.
Future priorities
The future priorities for the NHS include:
- Accelerating the deployment of low-carbon technologies across estates.
- Embed sustainability into clinical decision-making and procurement.
- Enhance data and reporting systems for emissions tracking.
- Support workforce engagement and training in sustainability practices.
Conclusion
The NHS has made remarkable progress in five years, cutting emissions, saving money, and improving health outcomes. However, the journey to net zero requires sustained effort, innovation, and partnership. By continuing to lead globally, the NHS can deliver a greener, more resilient health service that protects both people and the planet.
Sign up to our workshop to help primary care meet the targets
General practice and primary care networks have a crucial role to play in reducing their carbon footprint. Whilst the idea of reducing your environmental impact may seem daunting, every positive change made, however small, will bring benefits. This two-hour online workshop introduces the green agenda and provides practical advice and support for general practice in working towards the 2040 ambition.
Author: Helen Simmonds, PCC adviser specialising in primary care premises. Contact helen.simmonds@pcc.nhs.uk for advice on planning your primary care estate and development of neighbourhood health centres.