Our new report sets out how trusts are taking the initiative in reducing carbon emissions and improving sustainability.

'Climate change is a public health emergency' looks at the barriers and enablers for trust boards to make change happen and shares good practice from trusts across the country.

The NHS is responsible for 4% of the country's carbon footprint and has a central role to play in efforts to reduce carbon emissions and meet the national net zero targets set out in the Climate Change Act 2008.

The report highlights that a significant majority (78%) of trust leaders agree that tackling climate change and promoting sustainability in how they work is a priority in the next year.

Trusts making changes

Drawing on NHS Providers' annual State of the provider sector survey results, as well as conversations with trust leaders and national policy makers, the report highlights that trusts are committed to delivering greater sustainability.

Well over half (61%) of respondents told NHS Providers they have already made changes to their procurement approach, altered transport fleets to cleaner vehicles (51%), developed a plastic reduction plan (49%), and switched energy suppliers to prioritise green energy sources (48%) and over one third have invested in carbon offset schemes, such as tree planting.

The NHS' ambition is to become a net zero health service for emissions it controls directly by 2040, and for emissions it can influence by 2045. However, it is important that the service, including integrated care systems (ICSs), makes real progress before 2030 to make that ambition achievable.

Need for continued support

The report highlights that trusts are at different stages of progress in the face of significant operational pressures as a result of the COVID-19 pandemic. Ahead of an upcoming deadline for trusts to submit 'green plans' by April 2022, when they were surveyed, only just over a quarter of respondents felt confident of being able to do so, with the remainder flagging that there was much work still to do.

Trusts with ongoing challenges with their estates face an uphill battle to secure funding to improve them, but this investment is vital to make progress on the energy efficiency of their buildings and realise further opportunities in the long term. While government has increased the national capital budget, there are many calls on that funding, meaning access to capital remains a challenge.

To help enable trusts to address climate change, the report highlights the importance of a system-wide effort, and the need for ICSs' to also embed sustainability and climate change into their strategies and plans.

Environmental sustainability needs to be woven into the NHS' day to day business and aligned with broader strategies and operational priorities, the report recommends.

Trust leaders also recognise that in order for them to make the far-reaching changes required, access to good examples of best practice, support from peers and industry expertise to supplement their efforts will be critical.

The director of policy and strategy at NHS Providers, Miriam Deakin said:

"This report shows that trust leaders understand the need for action on climate change. They are also committed to taking their responsibilities seriously.

"Trusts are altering their ways of working, the services they offer, and embedding sustainability into their business as usual. This includes embracing digital, using data to accelerate change, evolving clinical practice with both clinical and environmental benefits in mind, and focusing on the role of trusts as 'anchor institutions' to drive change.

"However, it's also clear that some trusts are more advanced with their planning and delivery than others, and the enormous challenges of managing the pandemic have undoubtedly made this progress even harder.

"As trusts and systems develop their green plans, it will be important that their broader approach galvanises staff to propose changes within their organisations and encourages them to adopt changes in their own lives. That is why engaging with NHS staff and drawing on their enthusiasm for this mission is a common thread throughout our report.

"We support the national focus on sustainability, but more work is needed to help the NHS to move faster and further. This includes examining where supplier relationships need a clear service-wide steer to support large scale improvement in the sustainability of supply chains. And it means looking at how best to ensure a standardised approach to reporting carbon impact, and how to ensure trusts' have appropriate access to capital to support these vital net zero ambitions."