Why environmental sustainability must be part of the 10-Year Health Plan

As anticipation builds for the launch of the 10-Year Health Plan, there is one topic notably absent from debate. 

Climate change is described by the World Health Organization as ‘the single biggest health threat facing humanity’, and it is increasingly impacting not only the UK’s health but also its economy (currently costing 1.1% of GDP and projected to reach 3.3% by 2050). For the 10-year plan to successfully create an NHS that is financially sound and fit for the future, it must explicitly support building an environmentally sustainable and resilient health system.

The good news is that the essential components of sustainable health care – maximising prevention and good health, delivering care efficiently and close to home, eliminating waste and unnecessary interventions, and using low-carbon options – also make for good care and make good financial sense. 

Each of the government’s proposed three shifts – hospital to community, treatment to prevention and analogue to digital – could help make health care more environmentally sustainable. But to maximise the health, sustainability and financial win-wins of these shifts, environmental sustainability must be explicitly considered in their design and implementation.

Often environmentally sustainable care is seen as a desirable but dispensable goal that comes at an additional cost. However, health care providers and integrated card boards have shown how greener care can in fact contribute to financial goals. Even relatively simple steps can result in significant savings, from reducing medical gas wastage (already saving £5m per year nationally) to switching off operating theatre equipment when not in use (£30,000 per theatre per year, which could save £90m per year nationally). 

Meanwhile, undertaking quality improvement with sustainability in mind has already enabled many trusts to simultaneously achieve benefits across the ‘triple bottom line’ of improved health, social and cost outcomes. For example, Oxford University Hospitals reshaped how high blood pressure in pregnancy is risk assessed and managed, resulting in more women receiving care at home instead of in hospital. It was estimated the reduction in admissions could save £4m nationally per year, along with reduced environmental impacts, and this risk assessment approach is now part of NICE guidance. 

Nationally, Getting It Right First Time’s recommendations for decarbonising care pathways – such as one-stop clinics and reducing equipment waste – demonstrate how making care more sustainable can simultaneously improve patients’ experience, reduce hospital waiting times and lower health system costs. 

Making the NHS more environmentally sustainable could not only deliver progress on the government’s health mission but also on other cross-sector commitments. It supports the move to decarbonise the economy by 2050, improve energy security, become a world leader in tech and innovation, and boost growth. 

For example, building on government investment in greening public sector buildings (already set to save the NHS £260m per year), the £100m partnership between Great British Energy and the NHS will put the service at the forefront of homegrown clean energy. And the Design for Life roadmap towards a circular medical technology economy in the UK brings opportunities for green growth and improved supply chain resilience to future global shocks. 

Decarbonising health care and the wider economy allows the UK to build on existing initiatives like the National Institute for Health and Care Research net zero research hubs and further grow the UK’s research, innovation and life sciences sectors, stimulating investment and job creation. The NHS can be a leader in all of this by supporting the development of solutions, translating the benefits of innovations into practice, and being a key player in the green economy. 

But accelerating progress on sustainable healthcare requires action now. The longer this is delayed, the greater the costs to the public purse, the NHS and our health. Climate change is already affecting people’s health, including through increasing heat-related deaths and the mental health impacts of flooding. And the NHS is insufficiently prepared to deliver services during increasingly frequent extreme weather events. Sustainable healthcare that has a lower impact on the environment and is resilient to climate impacts protects patients and service delivery. 

Climate change is an unavoidable challenge facing the NHS today, over the next decade and beyond. This reality must be accepted and tackled for any health plan to prepare the NHS for what lies ahead. But the 10-year plan is also an opportunity to harness the benefits of sustainable care to address the NHS’s financial and productivity challenges, and help meet the government’s three shifts and wider commitments. 

Ultimately, environmental sustainability must be at the heart of reform if the 10-year plan is to help the NHS ‘stick to its net zero ambitions’, as Lord Darzi urged, and reap the benefits for patients, the health system and planet. To sideline environmental sustainability would be to miss out on making the NHS truly fit for the future.