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Blog: Baby steps are adding up to deliver the world’s first net zero health service by 2045

On Thursday 9 September, Rosie was born in Newcastle.

There was nothing unexpected about her birth. But that day, Rosie and her mum made history.

Rosie’s mum, Kaja, was the first in the UK to use a “climate friendly” gas and air machine. This new machine removes and captures nitrous oxide, a powerful greenhouse gas, from the pain relief Kaja was given, after she had benefitted from it.

With up to eight million litres of gas and medical air used each year at that birthing centre alone, the potential to reduce emissions, one birth at a time, is huge.

Thanks to NHS staff, we’re not just making a difference in Newcastle.

Today marks one year on from when the NHS became the first health service in the world to commit to reaching net zero emissions.

When we set these targets, we knew they were ambitious, and that achieving them would be challenging. But today, I’m proud to share that 12 months on, we are on track to meet our targets, reducing emissions equivalent to powering 1.1 million homes with electricity for a year.

That achievement is down to the passion and drive of NHS staff and leaders, turning ambition into practical actions. Almost nine out of 10 NHS staff support the NHS taking action to tackle climate change, and more than 155 NHS Trusts and Integrated Care Systems now have Green Plans in place or in development.

For Rosie, this really matters. Left unchallenged, the impacts of climate change and air pollution will contribute to increasing cases of cancer, heart disease and asthma in her generation, and disrupt how the NHS treats them.

And it matters for us, now, too. In the UK, the heatwaves of 2020 claimed more than 2,500 lives in the UK, while air pollution is already the single greatest environmental threat to health, playing a part in one in 20 deaths.

As one of the largest employers in the world, contributing to almost 5% of UK carbon emissions, the NHS has a real opportunity, responsibility and interest in tackling this threat head on.

The question is no longer what can we do, but what are we doing?

For a start, investments in renewable energy and smarter buildings that save energy are already set to reduce emissions by 210 ktCO2e – that’s equivalent to you or me taking 340,000 flights from London to New York.

In Milton Keynes, solar panels are set to generate more than 15% of the total electricity that the hospital uses and save the Trust over £225,000 a year in energy bills. The new roofing has also made for a more comfortable environment for both staff and patients.

We’re also driving forward the use of greener vehicles, while improving patient care. In Oxford, using cycle courier bikes has halved the delivery time of cancer treatments, while reducing local air pollution. A new partnership with the Department for Transport in the North West will see 11 electric trucks support the region in transporting medical equipment in the coming months.

And Rosie’s history-making birth is just one example of how we are reducing the impact of medicines, too. In Bristol, doctors are moving away from using desflurane, an anaesthetic gas with an environmental impact 20 times greater than other alternatives. Forty trusts have eliminated desflurane altogether, while maintaining high quality care. In primary care, patients will be supported to use lower carbon inhalers, where this is the right thing for their condition.

All this has been done during an unprecedented public health emergency, when protecting the safety and wellbeing of NHS staff and the health of the nation by tackling COVID-19 has been the overriding priority.

But even on the frontline of the pandemic we have seen innovation, such as a pilot to develop reusable PPE gowns now underway across 60 hospitals.

Despite this progress, we know we can’t reach net zero by 2045 alone. Our 80,000 NHS suppliers make up more than 60% of the NHS carbon footprint, so today we are calling on their support to work with us to reduce their emissions too. You can find out more here – with much more to come.

Tackling climate change can feel overwhelming at times. But it’s important to remember that even baby steps – like those taken in Newcastle – are already adding up to make a big difference.

So to all NHS staff, from ward to board, I encourage you to discover the difference we’re making, sign-up to join our Greener NHS community, and join with me, your colleagues and partners in taking action today.


Dr Nick WattsDr Nick Watts

Dr Nick Watts is the Chief Sustainability Officer of the NHS, responsible for its commitment to deliver a world-class net zero emission health service. Based in London, he leads the Greener NHS team across the country, which focuses on improving the health of patients and the public through a robust and accelerated response to climate change and the broader sustainability agenda.

Nick is a medical doctor licensed in Australia and the UK, and has trained population health and public policy. He is a Member by Distinction of the Royal College of Physicians’ Faculty of Public Health, and an Honorary Associate Professor of University College London’s Institute for Global Health.

Prior to the National Health Service, Nick worked internationally as the Executive Director of the Lancet Countdown and the Lancet Commission on Health and Climate Change, a collaboration of UN agencies and academic centres across the world. He has also focused on engaging the health profession on the links between public health and climate change, having founded both the Global Climate and Health Alliance and the UK Health Alliance on Climate Change.