NHS and sustainability

What are the main strategies on sustainability in the NHS?

NHS England

Sustainable Development Management Plan.  This encourages smarter ways of working to create a workplace culture that has a positive impact on its business, and the health and wellbeing of its workforce.

The plan aligns with the UN's 17 sustainable development goals and details how the NHS will support each one.

 Greener NHS Strategy.  For emissions the NHS can control, the aim is to get to net zero by 2040.  For those emissions it can influence, it’s 2045.

The strategy focuses on these areas of environmental sustainability:

Estates and facilities

Reducing emissions through an emphasis on sourcing power from renewables and increasing the energy efficiency of buildings.

Travel and transport

  • Reducing the amount of road travel to and from work and meetings
  • Electrificiation of rhe NHS transport fleet
  • Shifting modes of transport to non-polluting forms such as walking and cycling
  • Encouraging suppliers to reduce their carbon footprint

Decarbonising the supply chain

This seeks to embed sustainability in procurement decisions.  Interventions include:

  • reduce use of single-use plastics
  • refubishing walking aid
  • reducing use of paper
  • reducing food waste

See NHS Supply Chain's strategy to deliver health sustainability.

Medicines and equipment

Medicines account for 25% of emissions within the NHS. Interventions to reduce emissions focus on:

Anaesthetic gases

Anaesthetic gases used in surgery, such as desflurane, have a particularly high carbon footprint.  The NHS wiull:

  • move to low-carbon alternatives
  • capture and destruction of nitrous oxide and reducing its wastage


The majority of the emissions come from the propellant in metered-dose inhalers (MDIs) used to deliver the medicine.  The NHS will:

  • move to low carbon inhalers such as dry powder inhalers
  • increase the greener disposal of inhalers
  • support innovation in and use of lower carbon propellants

Research and offsetting

Net zero will be included in the NHS’ research strategy, and will inform engagement with industry, research centres of excellence and other key partners.

Having reduced emissions as far as possible, the NHS will need to consider offsetting and mechanisms to secure negative emissions.

NHS Digital

See their Sustainabile Development Management Plan 2017-2022.

While their plan covers areas included in the Greener NHS Strategy, they also include digital sustainability.

This focuses on the 'use of digital technologies and tools to enable carbon savings across both NHS Digital’s own delivery and now to the wider health system.'  It includes:

Spread and adoption

Sustaining spread and adoption is about making sure innovations and changes stick in an organisation and are adopted by others.  It’s about ‘holding the gains’ and ‘evolving as required.’

See NHS England's spread and adoption guide and its 7 interconnected principles: complexity; leadership; the individua;l benefit; adopter focus; networks; learning.

See also the Care Quality Commission's Enabling innovation and adoption in health and social care.


Page last reviewed: 14 October 2021