NHS Scotland climate emergency and sustainability strategy 2022 to 2026 - draft: consultation

The Scottish Government and NHS Assure have developed a draft Climate Emergency and Sustainability Strategy 2022 to 2026 for NHS Scotland. The consultation period has been extended until 10 March 2022. Comments should be returned on the template in the supporting documents by email.

Our Ambition and Approach

'Climate change poses a catastrophic threat to humanity and the natural systems that underpin our lives. It is obvious that tackling climate change will have a positive impact on human health'.[1]

'Global warming of 2°C will be exceeded during the 21st century unless deep and rapid reductions in carbon dioxide (CO2) and other greenhouse gas emissions occur in the coming decades.'[2]


1. The need to act to address the climate emergency and loss of biodiversity is clear and pressing. In recognition of this, in 2019 NHS Scotland became the first national health service in the UK to commit to becoming a net-zero organisation. But like all sectors of society, we need to accelerate our efforts to cut our greenhouse gas emissions and become environmentally sustainable. We are therefore bringing forward our target date for achieving net-zero emissions from 2045 to 2040. The case for the health service to act is about more than simply playing our part. The threats to human health from the climate emergency, both in Scotland and globally, are so serious that climate change has been described by the Lancet Commission on Managing the Health Effects of Climate Change as "the biggest global health threat of the 21st century". [fn]

2. At the same time, many of the actions needed in response to the climate emergency and the environmental crisis have positive health impacts. Cutting emissions and restoring biodiversity improves air quality and can prevent diseases such as asthma, pneumonia, heart attacks and stroke. Well-insulated homes can save lives and prevent illnesses as well as reducing energy consumption. Eliminating pharmaceutical residues from wastewater prevents harm to biodiversity and limits the growth in antimicrobial resistant bacteria, one of the most serious threats to our ability to treat illness. The direct and indirect health benefits are so great that tackling climate change has also been described by the Lancet Commission as "the greatest global health opportunity of the 21st century".[3]

3. The Scottish Government is committed to a just transition from a fossil-fuel based economy. The just transition principles require us to act in a way that helps to address inequality and poverty. The climate emergency, loss of biodiversity, sustainability, health and health inequalities are inextricably linked. Tacking the climate emergency in a just way will avoid exacerbating health inequalities and has the potential to reduce these.

4. As an organisation dedicated to improving and protecting physical and mental health and wellbeing, our National Health Service must be in the vanguard of efforts to tackle the climate emergency and the environmental crisis.

5. NHS Scotland has shown throughout the Covid-19 pandemic that it can act quickly in a crisis. The climate emergency and environmental crisis requires urgent action. Without quick and decisive action, we run the danger of "the biggest global health threat of the 21st century" and the risks of failing to seize "the greatest global health opportunity of the 21st century."

Our Aims

6. Our ambition is to become a service which is both environmentally and socially sustainable. A health service that improves the opportunities, life chances, health and wellbeing of every citizen in our country and fully contributes to a more cohesive, resilient and net-zero society in a just way that contributes to population wellbeing and a reduction in health inequalities. To do this, NHS Scotland aims to collectively:

  • ensure that we, as an integral part of our communities, contribute to the achievement of the United Nation's Sustainable Development Goals and national outcomes for health
  • become a net-zero greenhouse gas emissions health service by 2040 or earlier if possible
  • make our assets and activities more resilient to the impacts of a changing climate, particularly extreme weather events
  • establish a culture of stewardship, where we safeguard and responsibly use natural resources to provide environmentally sustainable healthcare
  • establish NHS Scotland as part of the circular economy through designing out waste and pollution, keeping products and materials in use and contributing to the regeneration of natural systems
  • increase our contribution to tackling the ecological emergency and restoring biodiversity

7. To achieve these aims, we need the help of everyone across the whole of NHS Scotland. Many are already taking action to help create a more sustainable NHS and others have great ideas to share. We need to support the energy and enthusiasm of our people and give them the resources and backing they need to make the changes our communities and the world need. We need to build on the great work which has already been done and scale it up across the whole of NHS Scotland.

Our approach to Net-Zero

8. Our approach to Net-Zero is not based on carbon off-setting. The UK's independent, statutory Climate Change Committee advises that most sectors will need to reduce emissions close to zero without offsetting. We are, therefore, working to bring our emissions as close as possible to zero as early as we can.

Delivering the UN SDGs and a Just Transition

9. Sustainable development, the concept that human needs must be met within the limits of natural systems, has a crucial role to play in ensuring a better quality of life for everyone.

10. In 2015, all UN Member States adopted the 2030 Agenda for Sustainable Development; a shared blueprint that at its heart are the 17 Sustainable Development Goals (SDGs). The SDGs are a call for action by all countries to promote prosperity while protecting the planet. They recognize that ending poverty must go hand-in-hand with strategies that build economic growth and address a range of social needs including education, health, social protection, and job opportunities, while tackling climate change and protecting the environment.

11. The Scottish Government has embedded the SDGs within the current National Performance Framework (NPF). The NPF sets out a vision for Scotland across a range of social, economic and environmental factors. It highlights the need for a 'whole system approach' to successfully deliver the national outcomes for health and recognises the important role that NHS Scotland has in helping to achieve this, ensuring quality healthcare services are available and accessible to all.

12. NHS Scotland is committed to supporting progress on meeting the SDGs and national outcomes in Scotland. Our actions to create a sustainable health service are also informed by the following just transition principles:

  • plan, invest and implement a transition to an environmentally and socially sustainable, climate resilient, health service in a way which builds on Scotland's economic and workforce strengths and potential
  • create opportunities to develop resource efficient and sustainable approaches which help address inequality and poverty
  • design and deliver low carbon and climate resilient investment and infrastructure making all possible efforts to create decent, fair and high value work
Sustainable Development Goals
Image showing the 17 United Nations Sustainable Development Goals

1 No Poverty

2 Zero Hunger

3 Good Health and Well-being

4 Quality Education

5 Gender Equality

6 Clean Water and Sanitation

7 Affordable and Clean Energy

8 Decent Work and Economic Growth

9 Industry, Innovation, and Infrastructure

10 Reduced Inequalities

11 Sustainable Cities and Communities

12 Responsible Consumption and Production

13 Climate Action

14 Life Below Water

15 Life on Land

16 Peace, Justice and Strong Institutions

17 Partnerships for the Goals

The National Performance Framework
Image showing the Scottish Government’s National Performance Framework, including its purpose, values and its 11 outcomes.

Our Purpose

To focus on creating a more successful country with opportunities for all of Scotland to flourish through increased wellbeing, and sustainable and inclusive economic growth

Our Values

We are a society which treats all our people with kindness, dignity and compassion, respects the rule of law, and acts in an open and transparent way

National Outcomes

  • Children and Young People: We grow up loved, safe and respected so that we realise our full potential
  • Communities: We live in communities that are inclusive, empowered, resilient and safe
  • Culture: We are creative and our vibrant and diverse cultures are expressed and enjoyed widely
  • Economy: We have a globally competitive, entrepreneurial, inclusive and sustainable economy
  • Education: We are well educated, skilled and able to contribute to society
  • Environment: We value, enjoy, protect and enhance our environment Fair Work and Business:We have thriving and innovative businesses, with quality jobs and fair work for everyone
  • Health: We are healthy and active
  • Human Rights: We respect, protect and fulfil human rights and live free from discrimination
  • International: We are open, connected and make a positive contribution internationally
  • Poverty: We tackle poverty by sharing opportunities, wealth and power more equally

Working in partnership

13. NHS Scotland cannot deliver its sustainability aims on its own. We also need to work closely with local communities, local authorities and other public bodies, third sector organisations and our suppliers to achieve them. We will actively engage in existing forums for collaboration and assist in creating new ones where they are needed.

14. Actions to improve the sustainability of our NHS will be delivered by Health Boards working in partnership with Integrated Joint Boards, Community Planning Partnerships and Regional and Local Resilience Partnerships. This strategy provides the vision and objectives for Health Boards setting out high level requirements and examples of good practice, recognising that action on the ground will depend on local circumstances and the specific sustainability challenges and opportunities that individual Health Boards face.

Our role as an anchor organisation

15. We are committed to acting for the benefit of the local communities we serve and recognise that we can positively contribute to local areas in many ways beyond providing healthcare. Our strategy will make a difference to local people including our staff through working more closely with our local partners to use our buildings and spaces for social benefit, providing opportunities for recreation and physical activity, improving access to high quality outdoor space, making local sourcing possible, and reducing our environmental impact.


Email: nss.HFSPublications@nhs.scot

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