Building a net zero NHS

Primary care carbon footprint

The NHS is the world’s first health service to set a net zero goal. The net zero goal is in recognition that the climate crisis is a health crisis and that tackling climate change offers large health co-benefits.

Sustainability is now mainstream in the NHS and climate action is a core part of healthcare workers’ professional responsibilities.

Primary care is responsible for 23 per cent of the NHS carbon footprint and, with its close contact with patients, clearly has a role to play in delivering this important ambition.

The critical nature of the planet’s health requires urgent action. We have heard enough times that there is a climate crisis, what is needed is action. Professor Sir David King, former government Chief Scientific Adviser, said in 2021: “I believe that what we do over the next five years is going to determine the future of humanity for the next millennium.”

Achieving the necessary reductions in emissions will require action in all areas of our lives:

  • Personal level actions – like eating less meat or not flying
  • National level actions – through letters, petitions or other activism holding government and corporations to account
  • Organisation level actions – through ensuring we deliver care to our patients in the most sustainable way

Primary care staff should also recognise that their voice is also a trusted voice in society, which we can and should use to explain the health effects of the climate and ecological crisis, as well as the benefits of action. 

If you have any ideas, thoughts, comments or inspiration about how to move primary care in Greater Manchester closer to carbon zero, we would love to hear from you:  

What is sustainable healthcare?

The Centre for Sustainable Healthcare defines it as: Sustainable healthcare delivers high quality care without damaging the environment, is affordable now and in the future and delivers positive social impact. 

When reviewing a system, or healthcare procedure, the Centre for Sustainable Healthcare recommends considering the triple bottom line.

Triple bottom line

The framework of the four pillars of sustainable healthcare can broaden our thinking about how to approach the topic.

  • Prevention
  • Patient empowerment
  • Lean care systems
  • Low carbon alternative

By incorporating sustainability into quality improvement projects, we can drive incremental change towards a more ethical, sustainable health system.


Do you feel you want to know more, or find out how you might get started? There is an introductory e-learning module on E-learning for Healthcare (ELFH), which includes some great examples at the end. How about making it part of your staff training package?

There are other modules about:

Greater Manchester Primary Care Sustainability Group

A multidisciplinary group has been set up to support primary care sustainability in Greater Manchester. Since the formation of Greater Manchester Integrated Care Partnership, this group now reports to the Greater Manchester Net Zero Delivery Board.

Seven initial sustainability workstreams were identified through workshops run with the support of the GP Excellence programme and locality commissioners.

  1. Inhaler prescribing
  2. Communications and engagement
  3. Staff and patient travel
  4. Primary care estate
  5. Procurement
  6. Social prescribing
  7. General prescribing (non-inhaler)

Tackling inhaler prescribing has been a key starting point for the team, as it forms a large part of the footprint of the NHS, is amenable to action, has PCN targets attached to it, and we have the tools for monitoring impact. Further work is underway focusing on patient and staff travel, and developing a ‘10 point plan’ to help primary care organisations start on the sustainability journey.

Greater Manchester Green Plan

Given the pivotal role that Integrated Care Systems (ICSs) play, each system has been asked to develop its own green plan based on the strategies of its member organisations.

Workstreams of the Primary Care Sustainability Group have fed into this plan. The Greater Manchester Green Plan has now been approved and work is underway to deliver it through the Greater Manchester Net Zero Delivery Board. 

Coming soon…
  • 10-point plan – a starter road map for greening your organisation
  • Travey survey – a web-based tool for staff and patients to consider low carbon options for travel