A Net Zero NHS

The UK government has committed to reaching net zero carbon by 2050. This means significantly reducing emissions as well as off-setting using carbon capture, such as planting trees.

The health and care system in England is responsible for an estimated 4-5% of the country’s carbon footprint so has a major role to play in supporting this. The NHS has therefore committed to reaching net zero as soon as possible.

An expert panel, chaired by Dr Nick Watts from the Lancet Countdown, has been looking at how and when this will be possible. This has been supported by an open call for evidence that collected nearly 600 pieces of evidence across a broad spectrum of areas from food and transport, to clean energy production and increasing use of technology to manage health conditions.

The NHS Net Zero Report

The report sets out the considerable advances that the NHS has already made in improving our carbon footprint and reducing the environmental impact of our services. It provides a detailed account of the NHS’ modelling and analytics underpinning the latest NHS carbon footprint, trajectories to net zero and the interventions required to achieve that ambition. It lays out the direction, scale and pace of change. It describes an iterative and adaptive approach, which will periodically review progress and aims to increase the level of ambition over time.

The report examines a number of the areas critical to carbon reduction across the NHS including:

  • Estate and facilities
  • Medicines
  • Supply chain
  • Travel and transport
  • Food, catering and nutrition
  • Research, innovation and offsetting

Our commitments

We are committing to tackle climate change by reducing our emissions to net zero. In doing so, our aim is to be the world’s first ‘net zero’ national health service. We are setting two targets:

  • For the emissions we control directly (the NHS Carbon Footprint), we will reach net zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032;
    For the emissions we can influence (our NHS Carbon Footprint Plus), we will reach net zero by 2045, with an ambition to reach an 80% reduction by 2036 to 2039.

How will we do this?

To deliver a net zero health service the NHS will need to pay close consideration to:

  • New models of care and alignment with the NHS Long Term Plan
  • Workforce and leadership
  • Funding and financial mechanisms
  • Data and monitoring
  • Adaptation


The NHS is in a strong position with over a decade of expertise and progress in sustainable healthcare, and the knowledge that 98% of our 1.3 million staff support our response to climate change.

We have made significant progress:

  • The NHS Carbon Footprint has been reduced by 62% – (compared to a 1990 baseline): this represents the commitments and responsibility under the Climate Change Act.
  • The NHS Carbon Footprint Plus has been reduced by 26% – (compared to a 1990 baseline): this includes emissions beyond the NHS’ direct control but we are able to influence such as supply chain.


COVID-19 is having a profound impact on the world, every health sector including the NHS and, in turn, the work outlined in the report.

There is an interrelationship between the pandemic and the environment, which reinforces the need to minimise our impact on the environment and be prepared for climate change. A host of infectious diseases, ranging from dengue fever to swine flu (H1N1), are in part affected by changes in land use as a result of environmental degradation.

Key changes from the response, such as the roll out of digitalised care, will be evaluated and may deliver long-term future carbon reduction benefits. Conversely, some elements of the response have the potential to increase our impact on the environment such as increased use of single use personal protective equipment (PPE).

The links between these two public health crises – COVID-19 and climate change – are covered throughout the report.

Next steps

The report will be used as a basis of an engagement process over the next six months. The results of this process will be used to inform further commitments and will be published throughout 2021.

If you would like to know more please email greener.nhs@nhs.net.

In addition we will:

  • continue to finalise and then publish the analysis underpinning the dates presented in the report
  • work with government and the full range of NHS organisations to explore the resources available to deliver a net zero health service
  • publish the third Health and Social Care Sector Climate Change Adaptation Report
  • restart the national campaign For a greener NHS to engage with our staff and patients, and to ensure that the health service’s commitments on climate change and net zero are clear to the world

An EasyRead version of the report will available soon and published here.

Download a copy of ‘Delivering a ‘Net Zero’ National Health Service’