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This article was co-authored by Rose Gallagher, MBE, Professional Lead Sustainability at the Royal College of Nursing and Trustee UK Health Alliance on Climate Change.
In this second article within this series we focus on specific environmental challenges faced by UK healthcare providers at present and in the immediate future. We also consider how healthcare providers, professionals and their insurers, through their cumulative experience and ongoing, commitment to overcoming such challenges, have an opportunity to lead the way.
Environmental challenges
Staff and patients are increasingly aware of the environmental harms that arise because of current healthcare delivery models. These include emissions from transport and buildings, high energy consumption and reliance on fossil fuels, waste generation and the impact of consumables, predominantly single use, including plastics.
To mitigate and reduce environmental harms, healthcare providers must navigate a range of regulatory requirements and policy ambitions, including carbon reduction targets, mandatory disclosures and transition plans for sustainable healthcare. Success in meeting such commitments will rely heavily on the support and individual actions of managers (including Executive Boards), healthcare professionals and patients. Their engagement and sense of responsibility will be the driving force behind real progress toward sustainability goals.
For effective engagement with staff and patients, Executive Boards will need to focus on a clear, manageable set of priorities, co-designed in collaboration with staff, patients and local communities.
Opportunities
Working together through critical mass and membership of groups such as the UK Health Alliance on Climate Change can bring significant benefits to providers and the wider public health. The Alliance openly advocates on behalf of its membership for action on climate change to improve health and create resilient health systems, whilst simultaneously highlighting the current and future health effects of climate change. Such changes inevitably increasing demand for services.
For example, in 2022, the Mayor of London convened government and health leaders together for a Clean Air Summit. This Summit was supported and influenced by Rosamund Adoo-Kissi-Debrah following the death in 2013 of her daughter Ella. Ella died of acute respiratory failure, severe asthma and air pollution exposure. The loss of Ella was tragic and the subsequent Coroners decision, in December 2020, to include air pollution as a cause of death, was the first time in the UK that air pollution had been officially listed as a cause of death. The Summit addressed steps the NHS and wider health system can take to raise awareness of pollution with Londoners. For example, by using technology to reduce harm.
The targeted air quality alert system for healthcare professionals, which was flagged at the Summit, is designed to notify clinicians in GP Practices and Emergency Departments about high and very high pollution episodes; the aim being to enable them to better advise and support patients. Particularly, those with heart and/or lung conditions.
By forecasting and prioritising issues and acting to shape awareness and interventions early through best practices, improved standards and regulatory developments, healthcare providers and their employees are a powerful driver for positive change and set new benchmarks for excellence. Such an approach enhances a provider’s reputation, reinforcing their position as an anchor and example to others, as a leader within the healthcare industry.
We set out below some examples of the measures taken by UK healthcare providers to progress sustainable healthcare.
Net zero
NHS Cheshire and Merseyside took a significant step towards sustainability by appointing a Net Zero Primary Care Lead, which paved the way for a dedicated event in September 2022. This gathering brought together primary care colleagues to provide guidance, introduce key initiatives and inspire action towards collectively achieving net zero.
In their Green Plan 2022, NHS Cheshire and Merseyside reaffirmed their commitment to this transition, emphasising their role as an Anchor Institution. Their approach involves working collaboratively with the local population to enhance patient pathways, minimise waste, and harness energy from sustainable sources. These initiatives are merely part of a programme of engagement to help NHS Cheshire and Merseyside achieve a net zero NHS Carbon Footprint by 2040, with an interim target of an 80% reduction (from 1990 levels) by 2032.
Responsible sourcing
In 2019, the NHS embarked on an ambitious new uniform project, aiming to enhance both the functional nature of uniforms and ensuring sustainability. The initiative, led by NHS Supply Chain, has been progressing steadily.
Sustainability is being secured via the use of cotton sourced from the Better Cotton Initiative (BCI), a globally recognised programme promoting ethical and environmentally responsible cotton farming.
The new uniforms also incorporate 100% recycled polyester, contributing to carbon reduction efforts and supporting the NHS's broader commitment to sustainability.
The framework established by NHS Supply Chain ensures a standardised approach to uniforms, promoting consistency across the healthcare system while upholding high standards of quality, durability and environmental responsibility.
Waste and circularity
Central London Community Healthcare NHS Trust (CLCH) is one of seven NHS Trusts that have come together to form the Circular Economy Healthcare Alliance. This underscores their commitment to building a greener, more sustainable NHS.
In January 2025, these Trusts issued a joint statement affirming their shared ambition, which stated:
“…our collaborative group of NHS trusts aims to reduce single-use medical equipment and consumables, reusing wherever it is clinically feasible and appropriate to do so. This will be reflected in our evaluation criteria for selecting products and suppliers through the procurement process, and through building skills, knowledge, and processes in our Trusts to enable this transition.”
Another sustainability initiative was the Bevan Commission’s ‘Let’s Not Waste’ programme in April 2023. This focused on minimising unnecessary products and services, promoting the reuse of tools, equipment and resources and maximising recycling wherever possible. A key aspect of this strategy was engaging stakeholders to drive measurable waste reductions. The programme also leveraged Bevan Exemplar organisations to catalyse a wider movement for change across health and care services, fostering a culture of sustainability and efficiency.
Comment
As demonstrated by these initiatives above, sustainability requires collaboration between the public and private healthcare sector, the implementation of sustainable policies and incentives to integrate and embed awareness and the fostering of innovation.
Insurers have a key role to play, both as underwriters of a healthcare system that is exposed to risk, and as stakeholders in influencing positive long-term public and private healthcare outcomes. By supporting, and providing incentives, for cleaner approaches and cleaner technologies, the specific environmental challenges can be met and exposure to risk reduced.
In doing so, this sector is well placed, and well on its way, towards sustainable healthcare, which will deliver benefit to patients, staff, communities and our planet.
Related item: Responsible and sustainable healthcare
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