The climate emergency is a health emergency¹. The impacts of a destabilising climate are no longer confined to the global south, with more intense storms and floods, and more frequent heatwaves and wildfires now also affecting high-income countries. Amid a growing risk of infectious disease spread, threats to public health and health equity are rising, increasing the burden on the healthcare sector globally. Moreover, the sector is a major contributor to the climate crisis, producing 4.4% of global net emissions².

Around the world, health system leaders are seeking to mitigate the causes of climate instability while building resilience to its destructive impacts. Clinical services, supplies and logistics, as well as buildings and infrastructure must be redesigned. In the UK, the NHS has committed to be the first national health system to achieve net-zero emissions³. Action is focused in two key areas: a) direct interventions in estates and facilities; travel and transport; and supply chain and medicines; and b) enabling actions in new models of care; workforce; networks and leadership; and funding and finance. 

At the same time, the Government has launched a major capital investment programme to deliver 48 new hospitals. It’s an opportunity to set new global standards and methodologies for well-designed, sustainable development based on the NHS Net Zero Building Standard⁴. But even if fully delivered, the New Hospital Programme represents less than a fifth of the NHS estate, meaning that net-zero targets will fall short without significant interventions in the existing estate.

In the drive to create well-designed, net-zero hospitals while simultaneously improving patient care, what can international health systems learn from each other? Can we co-create a whole-life carbon roadmap to net zero?

Under this overarching goal sits a range of objectives. What are the best strategies for reducing operational building energy demands, embodied carbon linked to construction, and the whole-life carbon costs of building elements? What role will local renewable energy generation, grid decarbonisation, and offsetting play? How do we apply the lean, clean and green design approach? What role might modern methods of construction and prefabrication play? How can nature-based solutions be applied and what role can bio-based materials play? How are sustainability requirements balanced against service priorities, including infection control? How do we mitigate against unintended consequences and how do we finance this investment?

Net-zero construction and operation of hospital buildings is, however, only part of the story. We also need intelligent design of healthcare delivery – in the best place, at the best time, and aided by advances in digital technology. Such approaches, combined with greater focus on population health, can significantly reduce healthcare’s climate footprint through reduced travel and journey times while also enhancing the quality and accessibility of care. How can integrated care and population health models leverage the co-benefits of a joined-up, system-level strategy to improve health and sustainable development to enable this transformation?

Organised by European Healthcare Design and streamed on SALUS TV in collaboration with leading international partners, the inaugural Sustainable Healthcare Design 2023 International Symposium aims to share knowledge and successful net-zero design and investment strategies. It will explore how to develop transition plans to decarbonise healthcare services and estates across the value chain, while ensuring high-quality care and patient experience remains integral.

To be held on 14 September at the King’s Fund in London, the Symposium will bring together healthcare leaders from across research, practice and policy to share knowledge and collaborate on how to create a credible, ambitious transition plan that leads the healthcare sector to net zero.

References

1. Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the health effects of climate change. The Lancet, 2009; 373(9676): 1693–1733.
2. Healthcare’s climate footprint: How the healthcare sector contributes to the global climate crisis and opportunities for action. Health Care Without Harm and Arup, 2019.
3. ‘Delivering a net-zero National Health Service’. NHS England and NHS Improvement, London, updated July 2022.
4. NHS Net Zero Building Standard. NHS England, London, February 2023.