NHS Scotland - climate emergency and sustainability: annual report 2025

This year’s report shows how NHS Scotland is working to reduce its environmental impact and adapting its infrastructure and services to address the risks presented by climate change. It also illustrates some of the wider benefits which work in this area offers.


Part 3 – Emissions Data On Scotland’s Health Boards

Building Energy Emissions

Table 1a: NHS Scotland Building Energy Use Emissions (tCO2e) Source: NHS National Services Scotland - National Energy Management System. Figures rounded to nearest thousand.

Energy 2015/16 2019/20 2020/21 2021/22 2022/23 2023/24 2024/25 % Change
Building fossil fuel use 311,000 321,000 323,000 313,000 309,000 306,000 304,000 -2%
District heating and biomass 9,000 3,000 3,000 3,000 3,000 3,000 3,000 -67%
Electricity 271,000 126,000 114,000 106,000 95,000 101,000 96,000 -65%
Total 591,000 451,000 440,000 422,000 407,000 410,000 403,000 -32%
Figure 1a: NHS Scotland Building Energy Use Emissions (tCO2e)
Graph showing NHS Scotland Building Energy use emissions over time. 
The three types of energy depicted are fossil fuels, district heating and biomass and electricity.

Source: NHS National Services Scotland - National Energy Management System

Table 1b: NHS Scotland Building Energy Use Emissions – Breakdown by Health Board (tCO2e) Source: NHS National Services Scotland - National Energy Management System

Health Board Scope 1 2023/24 Scope 1 2024/25 Scope 2 2023/24 Scope 2 2024/25 Scope 3 2023/24 Scope 3 2024/25
NHS Greater Glasgow and Clyde 62,000 65,000 28,000 25,000 13,000 13,000
NHS Lothian 40,000 38,000 15,000 14,000 8,000 8,000
NHS Grampian 38,000 39,000 6000 5,000 7,000 7,000
NHS Tayside 31,000 30,000 4,000 4,000 5,500 5,000
NHS Lanarkshire 16,000 16,000 6,000 6,000 3,000 3,000
NHS Highland 15,000 15,000 6,000 6,000 4,000 4,000
NHS Ayrshire and Arran 10,000 9,000 5,000 5,000 3,000 3,000
NHS Fife 13,000 12,000 5,000 5,000 3,000 2,000
NHS Forth Valley 9,000 9,000 5,000 5,000 2,000 2,000
NHS Dumfries and Galloway 9,000 9,000 3,000 2,000 2,000 2,000
NHS National Waiting Times Centre 4,000 5,000 3,000 3,000 1,000 1,000
NHS Borders 5,000 5,000 2,000 2,000 900 900
NHS National Services Scotland 2,000 2,000 2,000 1,000 500 400
Scottish Ambulance Service 1,000 1,000 1,000 1,000 300 300
NHS Western Isles 2,000 2,000 600 700 600 600
NHS State Hospital N/A 1,00 500 500 50 70
NHS Shetland 300 300 1,000 1,000 200 200
NHS Orkney 500 300 1000 1,000 200 200
NHS 24 70 80 400 400 50 50
NHS Education for Scotland N/A N/A 10 20 0 0
Healthcare Improvement Scotland N/A N/A 10 10 0 0

Note: In this table, figures over 1000 are rounded to the nearest 1,000. Those between 100 and 1,000 are rounded to the nearest 100, and those lower than a 100 are rounded to the nearest 10.

N/A=Not available at time of writing.

Table 1c(i): NHS Scotland Building Energy Use Emissions – Health Board Fossil Fuels Breakdown (tCO2e)

Health Board 2022/23 (tCO2e) 2023/24 t(CO2e) 2024/25 t(CO2e)
NHS Greater Glasgow & Clyde 72,000 73,000 76,000
NHS Lothian 47,000 47,000 45,000
NHS Lanarkshire 18,000 19,000 18,000
NHS Highland 21,000 19,000 19,000
NHS Ayrshire & Arran 12,000 13,000 10,000
NHS Fife 15,000 15,000 14,000
NHS Forth Valley 11,000 11,000 10,000
NHS Grampian 43,000 45,000 45,000
NHS Tayside 37,300 36,400 35,200
NHS National Waiting Times Centre 5,000 5,000 6,000
NHS Dumfries & Galloway 12,000 11,000 11,000
NHS Borders 5,000 5,000 6,000
NHS National Services Scotland 3,000 3,000 2,000
NHS Orkney 600 600 300
Scottish Ambulance Service N/A N/A N/A
NHS Western Isles 2,000 2,000 2,000
NHS State Hospital 3,000 3,000 3,000
NHS Shetland 1,000 1,000 1,000
NHS 24 400 400 400
NHS Education for Scotland 80 80 90
Healthcare Improvement Scotland N/A N/A N/A

Note: In this table, figures over 1000 are rounded to the nearest 1,000. Those between 100 and 1,000 are rounded to the nearest 100, and those lower than a 100 are rounded to the nearest 10.

N/A=Not available at time of writing.

Table 1c(ii): NHS Scotland Building Energy Use Emissions – Health Board Electricity Breakdown (tCO2e)

Health Board 2022/23 (tCO2e) 2023/24 (tCO2e) 2024/25 (tCO2e)
NHS Greater Glasgow & Clyde 29,000 30,000 27,000
NHS Lothian 16,000 16,000 15,000
NHS Lanarkshire 6,000 7,000 7,000
NHS Highland 6,000 6,000 6,000
NHS Ayrshire & Arran 6,000 6,000 6,000
NHS Fife 5,000 5,000 5,000
NHS Forth Valley 5,000 5,000 5,000
NHS Grampian 6,000 6,000 5,000
NHS Tayside 4,000 5,000 5,000
NHS National Waiting Times Centre 3,000 3,000 4,000
NHS Dumfries & Galloway 3,000 3,000 3,000
NHS Borders 2,000 2,000 2,000
NHS National Services Scotland 2,000 2,000 1,000
NHS Orkney 1,000 1,000 1,000
Scottish Ambulance Service 1,000 1,000 1,000
NHS Western Isles 700 700 700
The State Hospital 600 600 600
NHS Shetland 500 500 500
NHS 24 500 500 400
NHS Education for Scotland N/A 15 20
Healthcare Improvement Scotland 10 10 10

Note: In this table, figures over 1000 are rounded to the nearest 1,000. Those between 100 and 1,000 are rounded to the nearest 100, and those lower than a 100 are rounded to the nearest 10.

N/A=Not available at time of writing.

Table 1d: Top 20 emitting sites in NHS Scotland estate

(as selected in 2023/24 based on data available for 2022/23)

Source: NHS National Services Scotland - National Energy Management System

Health Board Site 2022/23 (tCO2e) 2023/24 (tCO2e) 2024/25 (tCO2e)
NHS Grampian Foresterhill Health Campus, includes Royal Cornhill Hospital 36,000 37,000 38,000
NHS Greater Glasgow & Clyde Queen Elizabeth University Hospital Campus 29,000 30,000 31,000
NHS Tayside Ninewells Hospital 24,000 24,000 22,000
NHS Greater Glasgow & Clyde Glasgow Royal Infirmary 18,000 16,000 16,000
NHS Lothian Royal Infirmary of Edinburgh 15,000 15,000 16,000
NHS Lothian Western General Hospital 14,000 13,000 11,000
NHS Highland Raigmore Hospital 15,000 13,000 14,000
NHS Lothian St Johns Hospital & Howden Health Centre 12,000 11,000 11,000
NHS Greater Glasgow & Clyde Gartnavel Health Campus 11,000 11,000 12,000
NHS Fife Victoria Hospital 10,000 10,000 10,000
NHS Forth Valley Forth Valley Royal Hospital 9,000 9,000 8,000
National Waiting Times Centre Golden Jubilee National Hospital 8,000 9,000 9,000
NHS Dumfries & Galloway Dumfries & Galloway Royal Infirmary 7,000 7,000 6,500
NHS Greater Glasgow & Clyde Royal Alexandra Hospital 7,000 7,000 7,000
NHS Lanarkshire Wishaw District General Hospital 6,500 6,000 6,000
NHS Lothian Royal Hospital for Children & Young People, Edinburgh 6,000 6,000 6,000
NHS Ayrshire & Arran Crosshouse Hospital Campus including Ayrshire Maternity 6,000 6,000 5,000
NHS Borders Borders General Hospital 5,000 5,000 6,000
NHS Lanarkshire Monklands District General Hospital 5,000 6,000 6,000
NHS Tayside Perth Royal Infirmary 5,000 5,000 4,000

Note: These figures are based on data recorded on NHS Assure’s central energy data system. Some figures for 2024/25 will be subject to change, due to resolution of billing issues, for example. Updated figures for 2024/25 will be available in the next Annual Report.

Note: In this table, figures over 1000 are rounded to the nearest 1,000. Those between 100 and 1,000 are rounded to the nearest 100, and those lower than a 100 are rounded to the nearest 10.

Medical Gas Emissions

Table 2a: N2O emissions, including Entonox, breakdown by Health Board (tCO2e) Source: Scottish Government

Health Board 2018/19 (baseline) 2021/22 2022/23 2023/24 2024/25
NHS National Waiting Times Centre 170 81 93 119 273
NHS Ayrshire & Arran 1,195 1,118 814 904 831
NHS Borders 562 487 488 205 307
NHS Dumfries & Galloway 642 502 433 445 306
NHS Fife 1,327 1,303 1,154 1,220 1,077
NHS Forth Valley 1,066 969 1,191 625 596
NHS Grampian 3,657 3,544 3,578 2,655 2,145
NHS Greater Glasgow & Clyde 5,734 4,505 5,078 4,904 4,595
NHS Highland 1,059 1,119 802 841 721
NHS Lanarkshire 2,142 1,792 1,606 1,654 1,524
NHS Lothian 4,098 3,799 3,634 3,132 2,287
NHS Orkney 80 97 76 81 76
NHS Shetland 101 89 138 46 48
NHS Tayside 2,009 1,984 2,151 2,439 1,855
NHS Western Isles 113 180 150 114 53
Scottish Ambulance Service (Entonox only) 1,188 1,077 1,135 1,132 1,076
Total 25,143 22,646 22,521 20,516 17,769

Table 2b: Volatile gas - desflurane, sevoflurane and isoflurane - emissions breakdown by Health Board (tCO2e)

Source: Scottish Government

Health Board 2017/18 (baseline) 2021/22 2022/23 2023/24 2024/25
NHS National Waiting Times Centre 29 22 26 55 31
NHS Ayrshire & Arran 685 78 76 51 53
NHS Borders 70 15 16 12 12
NHS Dumfries & Galloway 111 27 17 20 33
NHS Fife 151 50 41 47 45
NHS Forth Valley 419 41 41 46 49
NHS Grampian 1,350 222 133 82 75
NHS Greater Glasgow & Clyde 3,954 394 470 419 391
NHS Highland 349 43 43 40 40
NHS Lanarkshire 916 77 108 101 89
NHS Lothian 1,403 308 257 236 207
NHS Orkney 22 10 26 3 3
NHS Shetland 25 14 7 26 3
NHS Tayside 669 55 89 79 89
NHS Western Isles 19 9 7 5 9
Total 10,170 1,365 1,356 1,223 1,129

Table 2c: Desflurane emissions by Health Board (tCO2e) Source: Hospital Medicines Utilisation Database (HMUD), Public Health Scotland (PHS)

Health Board 2017/18 (baseline) 2021/22 2022/23 2023/24 2024/25
NHS National Waiting Times Centre 13 5 2 - 4
NHS Ayrshire & Arran 620 35 25 - -
NHS Borders 55 6 5 - -
NHS Dumfries & Galloway 87 7 1 - 6
NHS Fife 95 9 -4 - -
NHS Forth Valley 365 0 - - -
NHS Grampian 1,235 152 58 1 -
NHS Greater Glasgow & Clyde 3,576 112 142 73 16
NHS Highland 297 - - - -
NHS Lanarkshire 816 9 21 10 -
NHS Lothian 1,128 158 87 66 54
NHS Orkney 20 7 22 - -
NHS Shetland 22 11 4 23 -
NHS Tayside 591 -5 12 5 16
NHS Western Isles 16 5 3 - 4
Total 8,937 511 378 179 99

*Negative numbers represent pharmacy returns.

Note: Boxes marked “–“ indicate that data was not recorded on the HMUD.

Table 2d: NHS Scotland Piped Nitrous Oxide emissions by year (tCO2e) Source: Hospital Medicines Utilisation Database (HMUD), Public Health Scotland (PHS) and BOC, NHS NSS

Health Board 2017/18 2021/22 2022/23 2023/24 2024/25
NHS National Waiting Times Centre 180 - - - -
NHS Ayrshire and Arran 538 482 242 290 220
NHS Borders 241 214 219 26 74
NHS Dumfries & Galloway 231 140 87 157 44
NHS Fife 188 193 193 299 -
NHS Forth Valley 246 57 420 4 -
NHS Grampian 1,601 1,165 1,133 732 101
NHS Greater Glasgow & Clyde 2,509 1,517 1,790 1,513 1,401
NHS Highland 359 359 131 114 79
NHS Lanarkshire 733 171 223 271 35
NHS Lothian 1,750 864 405 353 214
NHS Orkney 30 35 9 13 -
NHS Shetland 30 26 66 - -
NHS Tayside 895 637 754 1,016 401
NHS Western Isles 59 114 96 48 -
Total 9,590 5,973 5,768 4,837 2,570

Note: Boxes marked “–“ indicate that data was not recorded on the HMUD.

Travel and Transport

Table 3a: Health Board fleet greenhouse gas emissions (tCO2e) Source: Health Board Public Bodies Climate Change Duties Reports (rounded to nearest 10)

Health Board 2019/20 2023/24 % Change
NHS Ayrshire & Arran 1,280 950 - 26
NHS Borders - 140 -
NHS Dumfries & Galloway 20 420 2,000
NHS Fife 440 480 9
NHS Forth Valley 380 270 - 29
NHS Grampian 1,030 - -
NHS Greater Glasgow & Clyde - 1,320 -
NHS Highland - 1,070 -
NHS Lanarkshire - 570 -
NHS Lothian 1,530 1,030 - 33
NHS Orkney 70 - -
NHS Shetland - 40 -
NHS Tayside 770 660 - 14
NHS Western Isles - 50 -
NHS National Waiting Times Centre - 40 -
The State Hospital - - -
Public Health Scotland No fleet No fleet -
Healthcare Improvement Scotland - - -
NHS Education for Scotland No fleet No fleet -
NHS National Services Scotland 160 2,350 1,369
NHS 24 No fleet No fleet -
Scottish Ambulance Service 20,560 19,370 - 6

Note: Boxes marked “–“ indicate that data was not available at the time of writing, or that data was not reliably comparable.

Note: In some cases reported emissions have risen during this period, but some of this at least is likely to be explained by improvements in reporting over this period.

Table 3b: Health Board business travel greenhouse gas emissions (tCO2e) Source: Health Board Public Bodies Climate Change Duties Reports and NHS NSS (rounded to nearest 10)

Health Board 2019/20 2023/24 2024/25 % change 2023/24 – 2024/25
NHS Ayrshire & Arran 1,890 1,720 1,000 -42
NHS Borders - 420 400 -5
NHS Dumfries & Galloway - 480 580 21
NHS Fife 1,400 860 940 9
NHS Forth Valley 600 510 550 8
NHS Grampian - 1,250 1,160 -7
NHS Greater Glasgow & Clyde - 3,180 2,470 -22
NHS Highland - 1,140 1,400 23
NHS Lanarkshire 760 1,360 1,530 13
NHS Lothian 1,420 1,550 1,450 -6
NHS Orkney - 50 40 -20
NHS Shetland 1,150 1,840 40 -98
NHS Tayside - 1,160 1,090 -6
NHS Western Isles - 110 130 18
NHS National Waiting Times Centre - 70 10 -86
NHS State Hospital - 0 0 0
Public Health Scotland - 50 20 -60
Healthcare Improvement Scotland - 30 20 -33
NHS Education for Scotland 260 100 125 25
NHS National Services Scotland 2,010 170 100 -41
NHS 24 - 50 50 0
Scottish Ambulance Service 80 260 190 -27

Note: Boxes marked “–“ indicate that data is not available or not reliably comparable.

Table 3c(i-iv): Composition of NHS Fleet by Health Board, April 2025 Source: NHS National Services Scotland (National Fleet Management System), NHS Ayrshire and Arran, NHS Tayside, Scottish Ambulance Service

Table 3c(i): Composition of NHS Fleet by Health Board, April 2025 (Cars)

Health Board EV Fossil Fuel/Hybrid Total % EV
NHS Ayrshire and Arran 234 16 250 94
NHS Borders 14 29 43 33
NHS Dumfries and Galloway 23 74 97 24
NHS Fife 22 29 51 43
NHS Forth Valley 59 6 65 91
NHS Grampian 3 186 189 2
NHS Greater Glasgow and Clyde 36 69 105 34
NHS Highland 99 299 398 25
NHS Lanarkshire 0 8 8 0
NHS Lothian 291 87 378 77
NHS Orkney 32 0 32 100
NHS Shetland 35 2 37 95
NHS Tayside 95 27 122 78
NHS Western Isles 1 10 11 9
NHS National Services Scotland 8 25 33 24
Scottish Ambulance Service 306 181 487 63
The State Hospital 0 0 0 0
Total 1258 1048 2306 55

Table 3c(ii): Composition of NHS Fleet by Health Board, April 2025 (Light Commercial Vehicles)

Health Board EV Fossil Fuel/Hybrid Total % EV
NHS Ayrshire and Arran 8 105 113 7
NHS Borders 11 27 38 29
NHS Dumfries and Galloway 2 25 27 7
NHS Fife 36 32 68 53
NHS Forth Valley 72 20 92 78
NHS Grampian 12 95 107 11
NHS Greater Glasgow and Clyde 60 135 195 31
NHS Highland 12 200 212 6
NHS Lanarkshire 57 4 61 93
NHS Lothian 95 79 174 55
NHS Orkney 5 0 5 100
NHS Shetland 11 5 16 69
NHS Tayside 46 57 103 45
NHS Western Isles 7 11 18 39
NHS National Services Scotland 7 35 42 17
Scottish Ambulance Service 35 52 87 40
The State Hospital 3 3 6 50
Total 479 885 1364 35

Table 3c(iii): Composition of NHS Fleet by Health Board, April 2025 (Heavy Vehicles)

Health Board EV Fossil Fuel/Hybrid Total % EV
NHS Ayrshire and Arran 0 2 2 0
NHS Borders 0 0 0 0
NHS Dumfries and Galloway 0 1 1 0
NHS Fife 0 0 0 0
NHS Forth Valley 0 0 0 0
NHS Grampian 0 15 15 0
NHS Greater Glasgow and Clyde 2 22 24 8
NHS Highland 0 4 4 0
NHS Lanarkshire 0 7 7 0
NHS Lothian 5 17 22 23
NHS Orkney 0 0 0 0
NHS Shetland 0 0 0 0
NHS Tayside 0 14 14 0
NHS Western Isles 0 0 0 0
NHS National Services Scotland 0 0 0 0
Scottish Ambulance Service 8 993 1001 1
The State Hospital 0 0 0 0
Total 15 1089 1104 1

Table 3c(iv): Composition of NHS Fleet by Health Board, April 2025 (Motorbikes)

Health Board EV Fossil Fuel/Hybrid Total % EV
Scottish Ambulance Service 0 10 10 0
Total 0 10 10 0

Table 3d: Bike Use in NHS Scotland territorial Health Boards as at March 2024 Source: Health Board Annual Climate Emergency and Sustainability Reports 2023/24

Health Board Bikes ebikes
NHS Ayrshire & Arran 0 0
NHS Borders 0 0
NHS Dumfries & Galloway 21 19
NHS Fife 0 0
NHS Forth Valley 0 0
NHS Grampian 0 31
NHS Greater Glasgow & Clyde - -
NHS Highland - -
NHS Lanarkshire 0 0
NHS Lothian 0 22
NHS Orkney - -
NHS Shetland 0 12
NHS Tayside 4 15
NHS Western Isles 6 4

Note: Boxes marked – indicate that either a report was not available or the number of bikes/ebikes was not stated in the report.

Waste

Table 4: NHS greenhouse gas emissions from waste disposal, tCO2e Source: Health Board Annual Public Bodies Climate Change Duties Reports

Health Board 2019/20 2023/24 % Change
NHS Ayrshire & Arran 325 450 38%
NHS Borders N/A 120 N/A
NHS Dumfries & Galloway 235 249 6%
NHS Fife N/A 310 N/A
NHS Forth Valley 271 190 -30%
NHS Grampian 590 592 0%
NHS Greater Glasgow & Clyde 148 2008 1257%
NHS Highland N/A 746 N/A
NHS Lanarkshire 54 906 1578%
NHS Lothian N/A 947 N/A
NHS Orkney 48 15 -69%
NHS Shetland N/A 18 N/A
NHS Tayside 1242 601 -51.6%
NHS Western Isles N/A 55 N/A
State Hospital 38 53 39%
Scottish Ambulance Service 13 33 154%
Health Improvement Scotland 6 NA NA
National Waiting Times Centre N/A 186 N/A
NHS 24 11 N/A N/A
National Services Scotland 28 35 25%
Public Health Scotland N/A N/A N/A
National Education Scotland N/A N/A N/A

Note: NA=Not available.

Contact

Email: nhsfacilitiesandsustainability@gov.scot

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