Sustainability at work - Simple steps for lasting change

The NHS, responsible for about 4% of the UK's total carbon emissions, faces mounting pressure to accelerate its transition to net zero. Five years after committing in 2020 to become the world's first health system to reach net zero—directly controlled emissions by 2040 and influenced emissions by 2045—the organisation marked the anniversary in September 2025 with a progress report showing a 14% reduction in its Carbon Footprint since 2019/20 and a 68% drop since 1990. This puts it on track for the interim goal of an 80% reduction by 2032, but the pace must quicken as easier wins give way to harder structural changes.

Recent developments underscore the urgency. In 2025, NHS England refreshed guidance for Green Plans, requiring trusts and Integrated Care Boards (ICBs) to update strategies aligning with national net zero targets. A February 2026 study of English NHS Trusts revealed progress in adopting renewables, energy efficiency, and digital tools, yet 21% still lack clear roadmaps to the 2040 target—down from 31% in 2024—and 21% fail to measure their carbon footprint adequately. By the end of 2026, all trusts and ICBs must develop sustainable travel strategies, as patient and visitor travel accounts for over 40% of transport emissions.

The real-world stakes are high. The NHS estate, fleet, supply chain, and clinical practices like anaesthetic gases and inhalers contribute significantly to emissions that exacerbate climate-related health risks—heat-related mortality in England alone costs billions annually and is projected to rise sharply. Staff across hospitals, primary care, and community services are directly affected: they must integrate low-carbon practices into daily work amid operational strains, while patients face the dual burden of health impacts from climate change and potential disruptions if the system falls behind. Wider supply-chain emissions, including medicines and equipment, remain a major challenge, with new procurement rules from 2024 onward mandating carbon reduction plans and, from 2027, public reporting aligned to NHS targets.

This push occurs against broader NHS reforms, including the 10 Year Health Plan, which emphasises efficiency and prevention—areas where sustainable practices can deliver co-benefits like cost savings and better resource use. With grid decarbonisation, low-carbon heating, and zero-emission vehicle mandates (all new non-ambulance vehicles from 2027, ambulances from 2030) depending on external progress, the window for embedding simple, lasting workplace changes narrows as 2032 deadlines loom.