Intended for healthcare professionals


New legislation places duty on NHS to tackle climate change

BMJ 2022; 378 doi: (Published 07 July 2022) Cite this as: BMJ 2022;378:o1681
  1. Elisabeth Mahase
  1. The BMJ

The Health and Care Act—which came into effect on 1 July 2022—has placed new duties on the NHS in England to consider climate change when making decisions.1

The legislation states that NHS organisations will have to think about and be compliant with the UK’s Climate Change Act 2008—which set targets to reduce greenhouse gas emissions2—and the Environment Act 2021—which outlined targets for improving the natural environment, including air quality.3

The NHS must also “adapt to any current or predicted impacts of climate change” as identified in the climate change reports that the government is required to put before parliament at least every five years.

Speaking to The BMJ, the NHS’s chief sustainability officer, Nick Watts, said this is the first piece of national legislation in the world that “directly—or even peripherally—addresses the health professions response to climate change.”

“This is an exciting moment for the profession,” he said. “The NHS has really stepped up its game on sustainability and climate change in the past 18 to 24 months, and the Health and Care Act is the final piece. This act now says, ‘listen, the NHS has a duty, has a responsibility, to tackle climate change.’ It places that on every single trust, every single foundation trust, every single integrated care board, and NHS England.”

Watts said work has already started. In October 2020, the NHS committed to reaching carbon net zero, in a world first. Every trust in the country now has its own net zero strategy and all NHS procurements include a minimum 10% net zero and social value weighting.4

Watts said he thought the legislation would inspire other countries to take similar action. “The NHS is big and we have a big ambition to be net zero by 2045, but we cannot do it alone. The NHS can only get there if we have our partners in healthcare systems from across the world also pushing it.”

Funding for local initiatives

As the new duties come into effect, Greener NHS—an NHS England programme—has opened applications for a new funding scheme, through which staff can apply for money (between £3000 and £15 000) to put their innovative ideas into practice.

The scheme is looking for initiatives that improve health and patient care, reduce inequalities, and deliver good value, while supporting a more sustainable health service. Applications are open from 6 July until 6 pm on 19 August.5

“This means that if you are a nurse in a trust, if you are a physiotherapist in a community service, if you are a surgeon, and you have an idea for how you could improve patient care, how you could tackle climate change, then we have a small amount of money for you,” Watts said. He said this money could lead to “hundreds of thousands of cool ideas out there in the system.”