climate change health

Can we imagine a carbon neutral NHS?

When Britain announced its net zero carbon by 2050 target, it included everybody. The whole country would have to reach net zero, and that includes the National Health Service. But when the NHS went away and examined their own role, they decided to be more ambitious, and announced that they would aim to be carbon neutral by 2040.

It’s the first national health service in the world to set a zero carbon target, and it will play a significant role. The NHS is the biggest employer in Britain, one of its most important institutions, and a vital part of Britain’s identity and culture. If the NHS is publicly seen to be taking climate change seriously and transforming the way it operates, it could be quite influential.

Besides, climate change will challenge the NHS. “The climate emergency” says Chief Executive Simon Stevens, “is also a health emergency.” Many of the measures that will lower emissions will also improve health, including better diets and lower rates of air pollution. Acting on climate change is entirely consistent with their central mandate to care for the nation’s health, not a distracting add-on.

Last year the campaign For a Greener NHS was launched. They established their carbon footprint as a baseline, and it is currently responsible for around 4% of the country’s emissions. From here they will aim for carbon neutrality in their own operations by 2040, and across their supply chain by 2045.

But what will that look like? Can we imagine what a zero carbon NHS might involve?

One of the most visible aspects of the transformation will be hospitals. Among the first and easiest steps is a £500 million lighting scheme to upgrade to LED light bulbs across the whole of the NHS. This will save an estimated £3 billion in the next 30 years, which makes it a pretty uncontroversial thing to do. Further renovations to heating, air conditioning and ventilation would also pay for themselves in savings in the following years. A low carbon NHS would also seek to maximise renewable energy generation on its sites, following in the footsteps of solar projects such as Northwick Park Hospital in Harrow.

Longer term, they hope to develop a net zero carbon standard for hospitals, and apply it in constructing 40 ‘net zero hospitals’. The NHS can learn from pioneering examples elsewhere, such as the world’s first PassivHaus hospital in Germany.

Another visible aspect will be transport. The first zero emission ambulance is expected in 2022 and an entirely zero-emission fleet will follow ten years later – but the NHS’s own vehicles are the tip of the iceberg. If you take staff, patients, visitors and suppliers together, the NHS creates 9.5 billion travel miles in England alone every year. Tackling transport emissions needs to start further back, with reducing the need to travel, doing more online, and encouraging active and sustainable travel by staff and patients.

These are obvious things that we might associate with lower carbon generally, but there are some very specific sources of emissions that occur in the field of medicine. A low carbon NHS will need new forms of medical equipment, some of which hasn’t been invented yet. It will need a circular economy approach to materials, especially given its dependence on hygenic single-use items. And as a glance at the breakdown of the NHS’s carbon footprint shows, there are some really quite niche problems to solve:

The item in this graph that really jumps out at me is the 20% of emissions that comes from medicines and chemicals. Or within the direct emissions, the green segment, there’s the fact that anaesthetics and inhalers make up 5% of the total NHS footprint – the same as patient travel. A single bottle of the anaesthetic desflurane, for example, has the same warming effect as burning 440 kg of coal. There are alternatives, but until someone starts highlighting this fact and setting targets, there’s no real reason to switch to them.

These sorts of emissions are highly specialist, but they also hint at the kinds of virtuous circles that might arise from the NHS acting on climate change: eliminating fossil fuels will improve air quality, which will lower rates of asthma, and reduce the need for those problematic inhalers. As their report states, “the drivers of climate change are also the drivers of ill health and health inequalities.”

If you want to read more about what the NHS is planning, have a look at their report Delivering a Net Zero National Health Service, and keep an eye on progress on the Greener NHS pages. It’s going to be an epic project.

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