Intended for healthcare professionals


A more sustainable NHS

BMJ 2019; 366 doi: (Published 02 August 2019) Cite this as: BMJ 2019;366:l4930
  1. Maria van Hove, clinical fellow1,
  2. Gillian Leng, deputy chief executive1
  1. 1National Institute for Health and Care Excellence, London, UK
  1. Correspondence to: M van Hove Maria.vanhove{at}

Inhalers and anaesthetics with a lower carbon footprint are quick wins that should be implemented now

The Climate Change Act 2008 was introduced to ensure that the UK cuts carbon emissions by 34% by 2020 and 50% by 2025, and Theresa May’s recent announcement committed the UK to reduce emissions to net zero by 2050.12 While the NHS is leading by example in reducing use of natural resources, it also contributes substantially to the UK’s carbon footprint, accounting for 40% of public sector emissions.3

Sustainability is embedded in the long term plan, which calls for reducing carbon emissions by a third from 2007 levels and increasing the NHS’s sustainability.4 The plan lays out several strategies to achieve this, ranging from shifting the NHS fleet to electric vehicles, switching patients to dry powder inhalers when clinically appropriate, and transforming anaesthetic practices. Other necessary steps include reducing waste, water, and carbon use by achieving best practice efficiency standards and adoption of innovative concepts such as telehealth …

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