The UK government has this week become the first national health system in the world to set a target to completely offset carbon emissions by 2040.
Originally it set a target of an 80% reduction by 2050, but in 2019 it upped this to zero emissions by 2050.
And now a new multi-year plan, published this week, further expands on this commitment, intending to reach the target a decade earlier.
The move will put increased pressure on NHS organisations up and down the country to ensure operations are as energy-efficient and sustainable as possible, despite increased demand on services from an ageing population and, more recently, the COVID-19 pandemic.
With poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer, our efforts must be accelerated
In his foreword, NHS England chief executive, Sir Simon Stevens, said ‘no apologies’ were being made for pushing ahead with the greener NHS agenda while the coronavirus pandemic was ongoing.
And he said that, if left unabated, the climate emergency would ‘disrupt care and affect patients and the public at every stage of our lives’.
“With poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer, our efforts must be accelerated,” he warned.
Based on the findings of the report NHS England has formally adopted the target of neutralising the emissions under its direct control by 2040, with an ambition for an 80% reduction by 2028-2032.
Areas pinpointed for action include estates and facilities, pharmaceuticals, transport, and catering.
As an example, the report said plans were underway to road-test a zero-emissions ambulance by 2022; and all new hospitals would be built to ensure they were ‘net zero compatible’.
In addition, with medicines accounting for 25% of emissions within the NHS, greener options would be explored including rolling out lower carbon inhalers for people with respiratory conditions.
And it lays out a series of ‘enabling actions’ that it claims will be needed to turn the NHS into a more-sustainable organisation in the longer term.
These include building on the increased use of digital technology seen during the COVID-19 pandemic, with a move towards more community-based models of care.
Commenting on the plan, Sara Gorton, head of health at the union Unison, said all health workers would need to play a part if the ambition of net-zero emissions were to be achieved.
All groups – from frontline clinicians to strategic leaders working across entire regions – will need to play a part in understanding what healthcare might look like in a net zero future
"Although beating the virus is top of everyone's list, the climate emergency hasn’t gone away,” she added.
“Today’s report will help the NHS move closer to hitting its net zero targets.”
It is reported that, since 1990, the NHS has already reduced its carbon footprint by an estimated 62%.
But, with many of the obvious interventions already undertaken, more-indepth analysis and action will be needed to reach the new target in the given timeframe.
Chris Naylor, a senior fellow for policy at the healthcare think tank, The King’s Fund, said: “We know that reaching net zero is likely to involve making changes to how, and where care, is delivered, and in some cases changes to what care is delivered.
“Making improvements to physical infrastructure such as buildings and energy sources is important, but this can only get us so far as direct energy use in NHS buildings accounts for less than a fifth of overall NHS carbon emissions.
“All groups – from frontline clinicians to strategic leaders working across entire regions – will need to play a part in understanding what healthcare might look like in a net zero future.”
Commenting on the plans to bring in greener alternatives for respiratory patients, a spokesman for the Primary Care Respiratory Society said the organisation was currently consulting with members on a white paper setting out a series of measures to help patients get the right treatment to control their conditions and ultimately reduce waste, as well as longer-term actions including the promotion and facilitation of recycling and greener disposal of inhalers.
He added: “PCRS supports initiatives to improve air quality and minimise short and long-term damage to the environment, particularly those with an impact on climate change resulting from greenhouse gases.
“We believe that such initiatives should cover a variety of issues including better patient education and switching from pMDIs to dry powder inhalers (DPIs) or soft mist inhalers (SMIs) where the change is clinically appropriate, safe, and acceptable to patients.
We want our NHS to be a world leader in achieving net zero by 2040. That clock is ticking and we need to act now
“Therefore we support the NHS commitment to develop resources which aid patients in opting for low-impact medicines where clinically appropriate.”
And Professor Donal O’Donoghue, a Royal College of Physicians registrar, adds: “This report clearly lays out what we collectively in the health care system can do now to protect lives in the future.
“Climate change is a health emergency and we must act now to prevent it becoming a catastrophe.
“As with COVID-19; it’s a challenge for the whole population that cuts across the entirety of public services and the private sector.
“We want our NHS to be a world leader in achieving net zero by 2040. That clock is ticking and we need to act now.”