Adaptation
To address climate change, the NHS not only needs to reduce its emissions but also adapt its sites and services to cope with the impacts of severe weather.
The effects are already being felt, from more frequent flooding and heatwaves to worsening air pollution. During the record-breaking temperatures of summer 2022, 2,985 heat-associated deaths were recorded across all age groups in England, highlighting the urgent need for climate resilience across the health system.
Without adaptation, climate change will:
- disrupt health services through extreme weather events
- affect critical infrastructure (water, energy, transport)
- create challenging conditions in hospitals (for example overheating)
- negatively impact health workers and patients
Adaptation is the process of adjusting our systems and infrastructure to continue to operate effectively whilst the climate changes.
It is critical that the NHS can ensure both continuity of essential services, and a safe environment for patients and staff in even the most challenging times.
Health and climate adaptation reports
Under the adaptation reporting powers of the Climate Change Act, the Greener NHS programme has been invited by Department for Environment, Food and Rural Affairs to produce reports on behalf of the sector outlining climate risks, impacts and actions being taken to adapt.
The fourth Health and climate adaptation report (formerly ‘health and care adaptation report’) builds on the previous rounds of reporting and supports the NHS in continuing to deliver a climate-smart, resilient health service.
The conclusions of this report will be used to inform the human health and built environment components of the UK’s National Adaptation Programme.
Read the fourth Health and climate adaptation report (2025)
Read the third Health and care adaptation report (2021)
Read the third National adaptation programme (NAP3) [gov.uk]
Read the third UK Climate change risk assessment (CCRA3) [ukclimaterisk.org]
NHS Climate Change Risk Assessment (CCRA) tool
Developed collaboratively with health sector partners and piloted with NHS trusts, the NHS CCRA tool supports trusts, system leaders and other NHS organisations to:
- identify climate-related risks specific to their operations
- understand their potential impact on healthcare delivery
- plan a response through identifying potential adaptations
- progress towards NHS net zero commitments.
- maintain service continuity during climate disruptions
How to use the tool
The NHS CCRA tool serves as a critical foundation for future planning, rather than producing a detailed adaptation plan. To get the most out of the tool, users should:
- collaborate with sustainability leads, public health, emergency response teams, and estates leads at trust and system level
- work with experts and stakeholders to further develop adaptation measures identified
The CCRA tool can be accessed via the NHS England website, along with the NHS Climate Adaptation Framework.
User guidance for the CCRA tool can be accessed on the Greener NHS Knowledge Hub (FutureNHS login required).
Climate adaptation framework for NHS organisations in England
Drawing from a model developed for the public sector in Scotland, this framework sets out a holistic approach for any NHS organisation to improve its ability to prepare for and respond to the impacts of climate change.
The framework is divided into 4 ‘capabilities’. These include:
- Understanding the challenge
- Organisational culture and resources
- Planning and implementation
- Working together
To develop maturity in each of these areas, the framework includes 43 recommended tasks. By completing these, organisations will enhance their capability for adaptation and resilience to climate change.
Access the framework via the NHS England website.