Net Zero progress
Five years of a greener NHS: the progress so far
NHS England has published its first report on progress on achieving a greener NHS. This article provides a summary of the key findings.
Healthcare in England is estimated to contribute between 4% and 5% of national emissions, and around 40% of all emissions generated by the public sector. The NHS has a clear responsibility to minimise its environmental impact and, in 2020, the NHS became the first healthcare system in the world to commit to becoming Net Zero.
NHS England has been tasked with providing
regular reviews of progress and, in September 2025, it published the first assessment of how the NHS is performing. To support this work, the NHS Net Zero Expert Panel – comprising global leaders and specialists in environmental sustainability, healthcare and carbon analytics – was convened to provide guidance on the next stages of this critical journey. The report states that, despite the challenges
over recent years, NHS staff have demonstrated extraordinary dedication. They have embraced sustainability principles, implemented impactful solutions and driven change.
In the five years, the NHS’s commitment
to deliver a Net Zero health service has been strengthened by national and international action: l The Health and Care Act 2022 introduced
new duties for Trusts and integrated care boards (ICBs) to consider climate change in their operations, making the NHS the first healthcare system to embed Net Zero in legislation.
l Lord Darzi’s independent investigation of the NHS in England reinforced the benefits of tackling climate change, stating that ‘there is no trade-off between climate responsibilities and reducing waiting lists. Indeed, often health and climate are mutually reinforcing goals’.
l All Trusts and ICBs, encompassing more than 1,000 hospitals and healthcare facilities, now have a green plan – a local strategy for reaching Net Zero, and are required to provide annual updates on progress to their board.
The 10 Year Health Plan sets out how the NHS must change to create a modern health service, designed to meet the needs of our changing population, through three shifts from: hospital to community; analogue to digital; and sickness to prevention. The plan also reinforced the government’s commitment to a Net Zero NHS, stating it will
prioritise the NHS’s existing commitments set out in Delivering a Net Zero Health Service – including achieving Net Zero by 2040 for the emissions the NHS controls and, by 2045, for the emissions it can influence.
Overall progress NHS England reports that the NHS Carbon Footprint, emissions in 2024/25 are estimated to be 4.7 MtCO2e. Compared with a revised estimate of 14.5 MtCO2e for 1990 emissions, this represents a total reduction of 68% and means the NHS is on track to meet its interim target by 2032. This follows a reduction of 14% in the five years since the publication of the NHS’s Net Zero strategy – equivalent to 1 million people flying from London to New York. Meeting the 80% reduction target in NHS
Carbon Footprint emissions would require emissions to fall to 2.9 MtCO2e by 2032, a reduction of 1800 ktCO2e (38%) over the next eight years, or an average of 225 ktCO2e per year. While this will be challenging, NHS England emphasises that this is achievable. However, key actions need to be taken, which
include: l Improving respiratory care and introducing inhaler propellants with lower global warming potential.
l Supporting the government to make Britain a clean energy superpower through the delivery of a £100 million Great British Energy and NHS renewable energy programme.
l The increased roll-out of zero emission vehicles in the NHS fleet.
l The adoption of low-carbon heating solutions and energy efficiency measures across the NHS estate.
NHS England’s report also includes a detailed breakdown, outlining progress and next steps.
Medicines Emissions from inhalers and anaesthetic gases, including nitrous oxide, are responsible for 20% of the NHS Carbon Footprint. The emissions from the manufacture and supply of all other medicines and prescribing contribute 17% of the
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