4th Health and climate adaptation report

Our climate is rapidly changing. With 6 of the last 10 years (2014-2023) ranking among the warmest on record since 1884, the impacts are already proving costly to both society and the NHS, with future costs expected to rise.

While estimating the full extent is challenging, heat-related mortality in England alone costs £6.8 billion annually, likely to increase to £14.7 billion per year by the 2050s. These figures underscore the urgent need for action.

Despite rapid decarbonisation, global temperatures will continue to rise, and without adaptation, health impacts from heat, cold and flooding will worsen due to climate and sociodemographic changes.

Emissions reduction and climate adaptation are mutually reinforcing, essential aims to minimise the adverse effects on population health and health services.

The health sector’s resolve to adaptation is ever more essential given the vulnerability of the population we serve.

Health system adaptation demands strong leadership to integrate climate data, assess local vulnerabilities, empower the workforce, and allocate resources to reduce climate-related risks to health, healthcare infrastructure, and supply chains.

Recognising this, the NHS became the world’s first health system to commit to reaching net zero emissions, with the Health and Care Act (2022) reinforced this commitment, placing new duties on integrated care boards (ICBs), NHS trusts and foundation trusts to consider statutory emissions and environmental targets in their decisions.

Importantly, it also requires health services to adapt to both current and predicted climate impacts, as outlined in the Climate Change Act (2008).

As a fundamental public health issue, climate change is likely to exacerbate existing health inequalities without targeted adaptation measures, as the impacts of climate change will be unevenly distributed across society.

Tackling this requires close collaboration across sectors – including industry, local authorities, the NHS, social care, and the communities they serve.

The public health workforce is uniquely positioned and equipped to lead this whole-system approach to adaptation.

However, driving forward the adaptation agenda across the health system will require the full engagement and support of the entire health workforce.

This 4th health and climate adaptation report builds upon our 2021 report. Drawing on stakeholder and expert insights, it outlines the progress made in building resilience, identifies further opportunities for adaptation, and provides recommendations for the health sector.

The ambition of this report is to help local, regional, and national teams prepare for and respond to climate change while delivering on statutory net zero commitments, ultimately creating more resilient health systems that support whole population health and wellbeing.