In this keynote, Dr Nick Watts, the NHS’s first chief sustainability officer, describes the organisation’s net-zero strategy vision, the transformation process, and some of the innovative actions taking place across the system.

Royal College of Physicians president Andrew Goddard began his EHD 2022 keynote talk with a sombre depiction of the current state of healthcare, which, he said, is currently being visited by the “four horsemen of the apocalypse” – conquest, war, pestilence, and death.

This talk outlines how to mobilise the necessary skills in healthcare design, and to present both risks and benefits in climate-smart solutions, to pave the way towards delivering the world’s most climate-smart hospital.

This paper aims to discuss through a case study of two contrasting sites for University Hospitals Bristol and Weston NHS Foundation Trust the practicalities and pitfalls of decarbonising the existing NHS estate.

Ghent University Hospital is reorganising its 40-hectare campus over the next two decades and is aiming for a carbon-neutral campus by 2050.

In order to meet strategic, operational, and clinical goals, the transformation of Swedish First Hill will modernise every building and system, and implement a district energy strategy that will create the first carbon-negative healthcare campus in the US by 2030.