The NHS is the UK’s largest public service – and one of its biggest emitters, responsible for around 4% of the nation’s carbon emissions and 40% of public sector emissions in England. Now, the NHS has set one of the most ambitious climate targets in the world for a health system: to become the first net zero national health service by 2040 for direct emissions, and by 2045 for those it can influence.
This goal is not just aspirational. It is embedded in legislation via the Health and Care Act 2022 and backed by a comprehensive strategy known as the Greener NHS programme. The path to net zero is supported by detailed modelling, nearly 600 pieces of reviewed evidence, and an NHS Net Zero Expert Panel.
The plan covers three types of emissions: Scope 1 (direct emissions from NHS operations), Scope 2 (emissions from purchased energy), and Scope 3 (indirect emissions from supply chains and services). Progress has already been made: between 2015 and 2019, the NHS Carbon Footprint Plus fell from 27.3 MtCO₂e to 25 MtCO₂e. However, recent years have seen a slowdown, highlighting the need for sustained momentum.
To accelerate change, the NHS is investing heavily in energy efficiency and renewable energy. Over £550 million has already been spent under the Public Sector Decarbonisation Scheme. Initiatives include the rollout of 100% LED lighting, the removal of coal and oil heating systems, and solar panel installations. Just one such project at Royal Manchester Children’s Hospital saved £80,000 and 380 tonnes of CO₂e.
Intelligent energy management will play a crucial role. AI-driven monitoring and smart thermostats are being trialled to optimise energy use. NHS Property Services, which manages around 10% of the estate, is implementing smart metering, building management systems, and training energy leads to drive change locally.
Sustainability also extends to clinical care. Lower-carbon alternatives to anaesthetics, shifting care from hospitals to community settings, and avoiding unnecessary interventions all contribute to emissions reductions. Programmes like the Sentinel Project and virtual wards have shown that sustainable care can reduce both costs and CO₂e.
Delivering net zero care is a monumental challenge. But through innovation, leadership, and collaboration, the NHS is working to transform itself into a model for sustainable public health – one hospital, one ward, and one patient at a time.
