11 Six of these areas outline carbon reduction measures (CRM) to address the primary sources of NHS carbon emissions, namely, energy, travel, water, waste, procurement and building design. 10 Known as the NHS carbon reduction strategy (NHSCRS), it details 10 key areas of focus for NHS organisations to reduce their carbon emissions. 9 In 2009, the NHS Sustainability Development Unit (SDU), whose responsibility is to measure, monitor and mitigate NHS carbon emissions, published the world’s first healthcare carbon reduction strategy. 8 This mandates all public sector organisations to match these targets, including the National Health Service (NHS) which contributes 25% of total public sector emissions. The UK Climate Change Act (2008) mandates the UK to become carbon neutral by 2050, inline with the Paris climate agreement of 2015. 7 Since policy documents refer to the mitigation of all six GHGs as ‘carbon reduction,’ ‘carbon’ has been used as an all-encompassing term herein. 6 This aims to mitigate the six major GHGs (carbon dioxide, hydrofluorocarbons, methane, nitrous oxide, perfluorocarbons and sulfur hexafluoride) as stated within international climate agreements. The UK is widely recognised as an international leader in GHG mitigation, as the first country to legislate ‘carbon reduction’ targets. 2 3 Consequently, climate change presents a twofold challenge for the healthcare sector: (1) to manage the burden of climate change on physical and mental health while (2) mitigating its own GHG emissions. 1 Worldwide, healthcare-associated GHG emissions are estimated to account for between 4.4% and 4.6% of total global GHG emissions. Researchers gathered data using multiple sources such as interviews and documentary analysis, in addition to analysis undertaken with input from methodological experts, which increases the credibility of the findings.Ī limitation of this evaluation is that the refined initial programme theory was unable to be tested due to the onset of the COVID-19 pandemic.Ĭlimate change, primarily driven by rising greenhouse gas (GHG) emissions, has been declared the ‘the biggest global health threat of the 21st Century’ by an international committee of health and climate change experts. This evaluation fills a critical gap in existing published literature on the implementation of carbon reduction measures within acute hospital settings, how best to mitigate their environmental impact and therefore improve the health of regional populations.

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