Supporting the delivery of net zero health and social care system

The UK is the 17th largest global emitter of greenhouse gases per capita and health services contribute around 4-5% of total UK carbon emissions. The Climate Change Act (2008), which committed the UK to reduce its carbon emissions by 80% by 2050, is superseded by the government’s ambition to pledge to net zero by 2050. Building on this, the report from NHS England and NHS Improvement, “Delivering a ‘Net Zero’ National Health Service” sets out a comprehensive plan for achieving a net zero NHS by 2045 (NHSEI, 2020). NHS England’s Long-Term Plan for the NHS also sets targets to deliver significant and accelerated reductions in total emissions.

Climate change has altered weather patterns and increased sea levels globally and will continue to do so without immediate action. There are increasing numbers of illnesses, and deaths from extreme events (e.g., heat waves, storms, and floods) and these risks will exhaust the healthcare system capacity in the future. In addition, vulnerable people are likely to be at greater risk of effects of climate change, from disruption to services to impact of extreme weather events. The 2021 Climate Change Committee Progress report has made recommendations for the Department of Health and Social Care to assess health and social care sector vulnerability to existing and future climate risks, and to support the NHS in delivering its Net Zero plan whilst playing an active role in climate policy development. In a recent BMJ editorial, more than 200 health journals have urged governments to take emergency action to tackle the “catastrophic harm to health” from climate change.

The healthcare sector is a large-scale consumer of energy, pharmaceuticals, and chemicals and therefore, considering how products are chosen, purchased and utilised can have a huge impact on patient well-being, healthcare costs and reducing environmental harms.  While the setting where care is delivered plays an important factor on the environmental impacts, sustainability raises more fundamental questions about how and what kind of care is delivered. There is a need to understand which care pathways have the greatest impact on the environment and what clinically appropriate alternatives might be available. Innovative examples of decarbonising procurement and medicine such as reducing anaesthetic practice at the University Hospitals Bristol Trust may help to understand the impact including contextual factors, barriers, and facilitators to implementation of these practices.

The COVID-19 pandemic crisis has underlined the need for being prepared in the management and prevention of the serious consequences of climate change around the world. The post-pandemic recovery is an opportunity to redirect environmentally damaging products and services to more productive and sustainable options . Although measures to control the COVID-19 pandemic (e.g. lockdowns) are associated with some positive environmental effects, including reduction in global carbon dioxide emissions, there have also been negative impacts such as waste management of personal protective equipment (PPE) including single use surgical masks, gloves, and gowns and people using cars more to avoid public transport.