Climate change is already affecting the NHS through more frequent flooding,  heatwaves, and worsening air pollution. During summer 2022’s record breaking temperatures, England experienced an estimated 2,803 excess deaths.

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

The NHS Climate Change Risk Assessment (CCRA) tool supports NHS 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

The CCRA tool provides a foundation for planning, rather than a complete adaptation plan.

To get the most out of the tool, you should:

• work with experts and stakeholders to develop identified adaptation measures
• collaborate with sustainability leads, public health, emergency response teams and estates leads at trust and system level
• share outputs with system leaders to build an understanding of cumulative climate risks across local services

The tool was developed collaboratively with health sector partners and piloted with NHS trusts to ensure its effectiveness and relevance.

This Framework provides a holistic approach to organisational change, for any NHS organisation to prepare for and respond to the impacts of climate change. It is based on the principle that an organisation has adaptation ‘capability’ that determines its ability to respond to the impacts of climate change.

The Framework is split into 4 capabilities that every NHS organisation will need to adapt and become resilient to climate change, providing step by step tasks to guide the adaptation journey.