We need a common pathway to decarbonise healthcare

March 6, 2023

Solar Panel wall on Building with tree leaves — Image: © T_kimura | Istock

Kristian Steele, Associate Director at Arup, argues that the climate crisis is also a health crisis. We, therefore, need a common pathway to decarbonise healthcare

The effects of climate change not only significantly impact our planet but also severely impact human health. From temperature-related illness and injuries caused by other extreme weather events to the wide-ranging impacts of air pollution, the consequences of a changing climate are being felt globally.

The healthcare sector is on the frontline for dealing with the effects of climate change. However, as a major emitter, the sector also contributes to the problem. Many of the emissions associated with healthcare are common across several sectors and organisations, such as energy consumption, transport, and waste generation. There are, however, additional sources of emissions that are unique to the healthcare sector, notably anaesthetic gases, and metered dose inhalers (MDIs), which account for approximately 5% of total emissions within the NHS.

Why do we need to decarbonise healthcare?

The healthcare sector’s climate footprint is equivalent to 4.4% of global net emissions; if it were a country, it would be the fifth largest emitter in the world (1). As a major contributor to, and a sector left carrying the consequences of climate change, the industry must take a leading role in tackling the issue. However, the responsibility for addressing healthcare’s significant Greenhouse Gas (GHG) emissions has been devolved to individual providers for too long.

What is the roadmap for decarbonisation?

Arup calls for a concerted collective effort to adopt a common pathway and decarbonise healthcare. In partnership with Health Care Without Harm and three health authorities, Arup has helped create a methodology to support authorities in measuring their carbon emissions and developed a decarbonisation roadmap aligned with the principles of the 2015 Paris Agreement. The hope is that this guidance will enable health authorities to deliver a greater impact at scale.

The process outlines several steps in road mapping, including establishing governance structures for decarbonisation, stakeholder identification and management, baseline setting, trajectory, projection creation, modelling of actions and pathways, and what measurement, reporting, and verification should look like.

Establishing an accurate understanding of how the national or regional healthcare sector is structured is a crucial starting point for any health authority. Healthcare structures vary significantly between countries and regions, so there’s no ‘one size fits all’ approach. It is important to develop a bespoke approach to governance that fits the individual context. One way they differ is in the number and nature of stakeholders involved. A national or regional healthcare decarbonisation roadmap cannot be delivered by any single organisation – it requires input, commitment and cooperation between various organisations and individuals. Identifying the key stakeholders and their level of interest and influence will allow the practitioner to determine who should be included.

Setting a clear baseline emissions inventory will allow health authorities to track progress towards decarbonisation. The methodology starts by defining which activities will be included in the baseline, including day-to-day healthcare activities and the supply chain. A baseline year should also be chosen, which will act as a reference point against which future emissions estimates can be benchmarked.

Understanding the required rate of change for the sector requires analysis of future emissions scenarios, which can be compared with a Paris-aligned emissions reduction trajectory. Understanding how the target pathway differs from a business-as-usual or “no further climate action” future for the sector can highlight the emissions gap to be addressed by the sector. Once the scale of the challenge is identified, policies can be designed to address this emissions gap and bring emissions in line with the goals of the Paris agreement.

How likely is it to be successful?

A decarbonisation programme’s ongoing success relies upon effective emission measurement, clear reporting of results, and verification of findings by peers and third-party experts. It is important to measure progress and publish the findings to understand whether the ambitions set out within the decarbonisation roadmap are being met. Regular public reporting is highly recommended because it provides a layer of transparency and offers an opportunity for public scrutiny and challenge.

There is no doubt that enacting change on this scale will not be easy – particularly with many healthcare systems under pressure post-pandemic. However, adopting a more strategic, common approach to decarbonisation will facilitate better resource allocation and policy development. There is a clear opportunity here for the sector to lead by example and reach net-zero emissions fairly and equitably. At the same time, health professionals must use their trusted voices to educate on the health impacts of climate change and advocate change.