NHS Scotland climate emergency and sustainability strategy: 2022-2026

This document sets out plans for NHS Scotland to reduce its greenhouse gas emissions and impact on the environment, adapt to climate change and to better contribute to the United Nation sustainable development goals. It has been developed by the Scottish Government and NHS Scotland Assure.

Our People

'The health of ecosystems on which we and all other species depend is deteriorating more rapidly than ever. We are eroding the very foundations of our economies, livelihoods, food security, health and quality of life worldwide'.[14]

35. NHS Scotland has made progress in creating a more sustainable health service but more still needs to be done. Much of the work has been taken forward by Health Board Sustainability Managers or local teams who have taken the initiative to make positive changes. We need to support our people so that sustainability becomes everyone's responsibility and help them build on the good work which has been done already.


36. People need to know that they will have the backing of senior managers and executives when they take the initiative to make changes for the better. Business as usual is not enough. Senior leaders have to provide their energy and allocate resources to support improvements to sustainability. Leadership does not just come from the top. The health service is full of talented people at all levels who are taking the lead on making the health service more sustainable.

37. To ensure all levels of the NHS are involved and actively contributing to meeting our climate and sustainability aims, each Health Board will, where it hasn't already:

  • appoint a Climate Emergency and Sustainability Champion from amongst its Board members
  • appoint an executive lead for its Climate Emergency and Sustainability response
  • ensure that environmental impacts are taken into account in decision making
  • ensure that its progress in responding to the climate emergency and sustainability issues is regularly considered by its Board
  • establish a strong governance structure for implementing this strategy and achieving its aims, ensuring that those aims and their local sustainability strategies are fully integrated into all planning, management decisions and operational practices across the organisation

38. At a national level, we will develop training on climate literacy and sustainability which will be mandatory for senior NHS managers and prepare and co-ordinate other training opportunities.

Working together

39. Each Health Board will put in place a Climate Emergency Response and Sustainability Team with the right resources to help the Health Board deal with the challenges of decarbonisation, climate resilience and environmental sustainability that it faces. That team will report directly to the Board with the executive lead holding overall responsibility for its performance. We will ensure that NHS Climate Emergency Response and Sustainability Teams have the authority, resources, training and skills they need.

40. Significant greenhouse gas emissions arise from the manufacture and supply of medicines and equipment and from staff, patient and visitor travel. The level of those emissions is determined by clinical decisions and models of care and so the involvement of all health professionals in efforts to improve sustainability is essential to success.

41. Each Health Board which provides clinical services, will establish a sustainable care clinical planning team as a core part of its Climate Emergency Response Team, to work in collaboration with members from other disciplines. These teams will work with other clinicians across the NHS to help make clinical services environmentally friendly.

42. The size and skills of each Health Board's Climate Emergency Response Team will depend on the scale of the challenge faced by that Health Board. Some national Health Boards are very small and their staff work in offices or from home while, at the other end of the scale, NHS Greater Glasgow and Clyde is the largest NHS organisation in the UK. Because of these differences, this strategy does not prescribe the precise composition of each Climate Emergency Response Team. Staff will be provided with protected time to participate in this team.

43. The wider workforce needs to be mobilised and supported to improve sustainability. All Health Boards will put in place mechanisms for front-line staff to share ideas with their Climate Emergency Response and Sustainability Teams. We will work to incorporate planetary health and environmental sustainability as a core component of the education and training of all NHS staff, at all career stages and develop a Climate Emergency Module to sit alongside the training module on shared decision making which has been developed to help ensure better value care is provided – for patients and for the system, reducing waste and harm.

44. To support senior leaders and staff to share best practice and better understand what they can do to promote sustainable development, NHS National Services Scotland will establish an NHS Scotland Sustainability Network. This will provide opportunities for peer mentoring and support as well as sharing best practice and the latest developments in sustainability.

45. An engaged NHS workforce will be key to delivering our aspirations of providing a truly sustainable health service, as will the support of the public generally. Climate change is a major concern for the UK public, with four in five people agreeing that it is a global emergency. Engaging our communities as we accelerate our action to tackle the climate emergency is a key theme of this strategy.

46. Unabated, the climate crisis will continue to disrupt care and affect patients and the public at every stage of our lives. While there are many barriers to overcome (an aging demographic profile, health inequalities, waiting lists, tightening public health budgets, a workforce crisis, environmental stressors which exacerbate health problems to name a few), ultimately the actions set out in this strategy will support other health system priorities.

Raising awareness

47. Awareness of the importance of the climate emergency and sustainability has never been greater but it can still be challenging to know how we can make a difference. A wide range of staff across NHS Scotland were involved in creating the 'Sustainability Action' brand 'Our NHS, Our People, Our Planet'. All NHS staff have access to the resources that have been developed to help drive forward action on climate change and sustainability. These can be found on the NHS Scotland Sustainability Action Website.

48. To help raise awareness, each Health Board will develop and implement communications plans to help staff, patients and visitors to take sustainable action and raise awareness of its own plans, actions and progress in developing a more sustainable health service.


Email: DHFCGVAdminSupport@gov.scot

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