This October marks 5 years since the NHS became the world’s first health system to commit to reaching net zero emissions – recognising the urgent threat that climate change poses to public health, and NHS service delivery.

For the NHS, these 5 years represent less than 7% of its history. Yet the progress toward net zero has been transformative.

In 2020, NHS on-site renewable energy production was just 5,700 MWh. Today, that figure has more than tripled – enough to power 4,500 homes annually.

Amazingly, it’s set to triple again in 2025/26 thanks to a £100 million investment from Great British Energy in solar power and battery storage. These projects are expected to save around £8.6 million a year and up to £260 million over their lifetime.

Across our estate – 13,500 buildings on 2,869 sites – over half now use energy-efficient LED lighting. These upgrades are not only cutting emissions but also saving millions of pounds that can be reinvested in frontline care.

In 2020, NHS facilities had fewer than 1,500 electric vehicle (EV) charging points. Today, there are over 4,200. This year an £8 million investment from the Department for Transport will fund 1,226 more charging sockets across 227 NHS sites, delivering an estimated £130 million in fuel and maintenance savings over 25 years. This supports our goal to transition the NHS fleet to low, ultra-low, and zero-emission vehicles by 2028—and eventually to achieve a net zero fleet.

We’ve also made huge strides in waste reduction. In 2020, over 32,000 tonnes of domestic waste went to landfill annually. This year, that’s down to under 6,000 tonnes – a remarkable achievement.

Back then, we were just beginning to explore how to decarbonise care itself, ensuring clinical pathways were not only effective and efficient but also environmentally sustainable.

Today, NHS teams and partners are pioneering innovations – from net-zero surgeries to anaesthetic and medical gas changes to emergency departments. The pace of change is extraordinary.

Our bold step in 2020 has inspired global action. In partnership with the World Health Organization, the NHS has helped other health systems accelerate their decarbonisation efforts.

Around 40 countries now have net-zero targets for healthcare, and more than 70 are committed to building low-carbon, sustainable systems. The Intergovernmental Panel on Climate Change (IPCC) recognised the NHS as a leading example in its Sixth Assessment Report.

Yet, some things haven’t changed. Climate change remains a growing threat to health, and to the NHS. Risks from air pollution, extreme weather, vector-borne diseases, and infrastructure disruption are all intensifying.

The 10 Year Health Plan outlines 3 key shifts to build a modern NHS: from hospital to community, analogue to digital, and sickness to prevention – and reaffirms the government’s commitment to the NHS’s net zero targets – by 2040 for emissions we control, and by 2045 for those we influence.

Our progress shows how sustainability goes hand-in-hand with high quality care and financial savings – supporting both patient health and the government’s core priorities.

Nearly 5 years on, we were pleased to be able to share a full update at the NHS Public Board on 23 September.

The updated overview of emissions demonstrates that the NHS’s actions to improve patient care and deliver financial savings, while reducing emissions, have been successful. Direct emissions are down 68% since 1990 and 14% in the last five years. We’re on track to reach our 2032 and 2040 goals.

The journey is far from over, but our driving force remains unchanged: the commitment of NHS staff. They know this work is about more than sustainability – it’s about safeguarding health for generations to come.

Together, we’ve made world-leading progress – and it’s thanks to the incredible dedication of NHS staff who understand just how vital this mission is.