Report

Environmental sustainability in the NHS

This report from UK think tank The King’s Fund examines a new approach to national leadership and accountability.

This report argues that environmental sustainability is no longer a peripheral issue for the NHS but a central requirement for its future viability.

Climate change is described as the greatest health risk of the 21st century, while the NHS is identified as the UK’s largest public sector contributor to carbon emissions. Rapid decarbonisation in this decade is therefore essential to avoid higher costs and greater disruption later. The report stresses that environmental and financial pressures on the NHS are closely linked, as both depend on reducing waste, improving efficiency and focusing resources on interventions that deliver the greatest value for patients and populations.

The authors emphasise that improving environmental sustainability brings tangible benefits for patients, staff and taxpayers. Initiatives that reduce waste and improve the efficiency of care can simultaneously lower costs and improve service quality, while also increasing the NHS’s resilience to climate-related risks such as heatwaves, flooding and supply chain disruption.

The research underpinning the report examines how trusts and integrated care boards are held to account for sustainability in England. While progress has been made through the Greener NHS programme, existing accountability mechanisms are often weak in practice because sustainability is routinely deprioritised compared with other NHS objectives.

The report concludes that stronger leadership, a clearer narrative and more robust accountability are required, alongside embedding sustainability within wider NHS performance and reform agendas.