Policy levers for a net zero NHS: four priorities for the future

Key points

• Transitioning to low-carbon health care is essential for the NHS to respond to the health emergency of climate change and meet its 2045 net zero target in England.
• The new government’s priorities for the NHS, including the shift from sickness to prevention and from hospitals to the community, will help meet this ambitious target. However, these shifts alone cannot drive decarbonisation of the NHS at scale.
• Achieving a net zero NHS will take concerted action. Government and NHS policymakers must apply national policy levers shaping care delivery in the NHS in England – such as financial incentives, regulation, and performance targets – to drive rather than detract from progress.

This long read assesses how national policy levers are currently being used in relation to net zero health care, where the gaps are and what could be changed to make faster progress. As the government develops the 10-Year Health Plan, a new long-term reform agenda for the NHS in England, we identify four priorities for policymakers to ensure progress on net zero is maintained: 

1. Strengthen existing accountability for net zero by building on existing governance, measurement and reporting infrastructure. Robust accountability measures are essential to ensure sustainability is prioritised.
2. Systematically consider environmental sustainability when reforming policy levers. Meaningfully embedding consideration of environmental impacts can identify and unlock co-benefits, help to avoid creating unintended consequences and increase our knowledge of what good looks like. 
3. Coordinate and maintain focus around agreed priorities for action on net zero care. Policy levers for net zero health care should align with other health priorities to maximise co-benefits, while coordinated and consistent policies are needed to drive progress.  
4. Address key policy gaps on net zero. Action taken now on approaches to capital investment, health technology appraisals, innovation, and workforce capacity and capability for sustainable quality improvement can lay the groundwork for progress in the years ahead.