Health sector


During the past decade or more, healthcare providers are increasingly finding new ways to reduce their environmental footprint. While energy, waste and water have traditionally been the focus, providers are now looking to ecological impacts and all emissions (including both direct and indirect carbon embedded in the supply chain).

Some healthcare organisations like the National Health Service (NHS) in the UK, have even announced ambitious targets and plans to approach net zero emissions.

This page gives just a taste of what’s possible and why it’s become so important. See also this 2021 Intro to climate mitigation and environmental sustainability in healthcare and our YouTube channel, ‘Sustainability in the healthcare’ here.

The University of California’s Living Green program, is just one example of the progress towards healthcare sustainability and corporate social responsibility.

In the UK, Barts Health NHS Trust is another great example of how greening the health care sector can happen. The NHS has it’s own Sustainable Development Unit which has been an outstanding leader in sustainable health care for decades.

Despite progress towards sustainable healthcare, we could do much more. Here is a highly research-focused UK model for healthcare (at least for the public system).

Some outstanding resources are now available from many different organisations to support and promote sustainable healthcare. For example, Climate for Health have put together an outstanding suite of free resources. Other organisations playing a key role are the Global Green and Health Hospitals, Practice Greenhealth, the UK’s National Health Service and Sustainable Development Unit, as well as Australia’s own Climate and Health Alliance, boasting diverse membership from Australia’s peak medical and health organisations.

For every tonne of carbon dioxide avoided, countries could save an average of $46 in health costs (refer also Our Uncashed Dividend: the Health Benefits of Climate Action, 2012).


Environmental harms are directly linked to health outcomes (Eckelman & Sherman, 2016) and yet the healthcare system contributes to those harms. For example, “the health-care sector causes a substantial share of the world’s emissions of greenhouse gases and air pollutants: 4.4% of greenhouse gases, 2.8% of harmful particulate matter (air particles), 3.4% of nitrogen oxides and 3.6% of sulphur dioxide” (Capon et al in The Conversation July 2020). Furthermore, ambient air pollution accounts for an estimated 4.2 million deaths per year due to stroke, heart disease, lung cancer, acute and chronic respiratory diseases. Around 91% of the world’s population lives in places where air quality levels exceed WHO limits. Approximately one quarter of all diseases caused by modifiable environmental causes (World Health Organization).

Gary Cohen echoes these concerns in this short extract from a 2015 Tedx talk.

Emissions from healthcare delivery are substantial – in some cases, up to 25% of total public sector greenhouse gas emissions (UK, National Health Service, 2009, p. 74).

Australian hospitals consume 14% of energy consumed by all commercial building types (pitt&sherry in DCCEE, 2012, p. 5).

The carbon footprint of the Australian health system represents approximately 7% of Australia’s total emissions, with hospitals and pharmaceuticals contributing the greatest share (Malik et al, 2018).

Aust healthcare emissions 2018


Doctors all around the world have been calling for action on environmental harms.

Australia’s Doctors for the Environment released a report in December 2020 which explains why and shows the range of medical organisations with policy positions acknowledging the climate emergency. For example, peak organisations like the Australian Medical Association and various Colleges have published position statements along these lines, such as the Position Statement by the Royal Australian College of Physicians (Nov 2016).

Here are some examples of how doctors are helping the community join the dots between environmental action and health outcomes.

This group of doctors created this video because we believe it is our duty to promote good stewardship of our beautiful home-planet as a public health strategy; even more than prescribing medicines.

And in Australia, doctors feel the same…

Dr Cheryl Holder on TEDMED in 2020 builds a compelling case for doctors and clinicians to play a role in action on climate change and environmental harms.

Clearly there are compelling reasons for healthcare to act on environmental harm.

The Lancet journal has long taken a leadership role. Now The Lancet Countdown: Tracking Progress on Health and Climate Change is an international, multi-disciplinary research collaboration between academic institutions following on from the 2015 Lancet Commission on Health and Climate Change, which emphasised that the response to climate change could be “the greatest global health opportunity of the 21st century”. Check out the Lancet Countdown to track our progress on health and climate change here and below.


Importantly, there are opportunities to improve health outcomes across the population (and avoid hospital admissions) by acting swiftly on climate change.

The opportunities for sustainable healthcare also include cost-saving with eco-efficiency measures. The health co-benefits associated with sustainable development and climate change action are many and have the potential to improve the air we breathe, water, soils, food security and physical activity opportunities to name a few.

climate hoax benefits colour


Key resource: ‘Why own a green hospital?’ – from the Green Building Council of Australia

Patients are becoming more aware of the need for healthier healing environments and corporate responsibility in health care with regard to sustainability.
people think sustainable health care is a priority


The Global Green and Healthy Hospitals (GGHH) network has been formed to bring together health organisations that are committed to reducing their environmental impact and promoting environmental health worldwide. GGHH-news-banner GGHH is a virtual community for hospitals, health systems and organisations around the world — currently across 53 countries. Most healthcare sustainability challenges are common despite different cultural contexts – so if you have a problem, someone in the network has probably already solved that problem and is willing to share how. A global group of experts are also on hand to provide advice and resources. GGHH focuses on a comprehensive environmental health agenda featuring 10 action areas associated with: waste, energy, harmful chemicals, buying safer and more sustainable products, water, transport, food, pharmaceuticals, buildings and leadership.

The ‘Agenda’ is available for downloading in four languages.

gghh agenda summary

GGHH Connect online

GGHH Connect online

In GGHH, each organisation that joins goes about focusing on two goals which may often deliver financial benefits in tandem. To help this process, GGHH is publishing a series of webinars on different topics such as waste, sustainable buildings and sustainable energy for healthcare centres.


(SDU) in the UK has long been another important leader in sustainable healthcare. The SDU is a proponent of ‘sustainable models of care’ which goes to the heart of healthcare’s core function. The NHS SDU propose that success might include the following.

sustainable models of care

Examples of how sustainable models of care might be implemented can be found in the ‘Operation TLC’ program rolled out across a number of NHS trusts.

Hear more about the NHS journey towards net zero emissions from Dr David Pencheon who was founder and director of the Sustainable Development Unit of the NHS for 10 years…


In Australia, the GGHH network is supported by the Climate and Health Alliance (CAHA), comprising members from many healthcare peak bodies.

CAHA has published many important publications on greening the sector and was instrumental in gaining bi-partisan support for the National Health and Climate Strategy in 2023.national-health-and-climate-strategy_0

CAHA’s GGHH network includes hundreds of health services from Australia and New Zealand. Globally the GGHH network reaches around 9000 hospitals (2015). The network will drive sustainable healthcare, transform the sector, and encourage the sector to contribute to, rather than harm, public health. The network will also influence supply chains so that healthcare providers can more easily access environmentally-friendly alternative products.

For more information visit the Global Green and Healthy Hospitals Network and the Climate and Health Alliance (CAHA) in Australia. Hear from the CAHA Director, Fiona Armstrong here…

CAHA was also engaged to develop a Human Health and Well-being Climate Adaptation Plan for Queensland which is written about here.

Other key reports from CAHA can be found here.


Australian researchers are making a contribution in this area.

recent australian papers

Other research of interest relates to ‘Sustainable Models of Care’.

Other valuable areas of emerging research and action which clinicians and health service managers can influence relate to:

Key Australian researchers and academics in healthcare carbon and planetary health respectively include anaesthetist, Dr Forbes McGain and Professor Tony Capon.


NSW energy use in hospitals 2013

NSW Auditor-General’s Report into building energy use in NSW public hospitals 2013

There are many ways to address the environmental harms created by the health sector. For example, greenhouse gas emissions may come from energy consumption, staff/patient transport and procurement, including pharmaceuticals and single-use devices.

One of the most comprehensive assessment of energy use in hospitals can be found in this 2013 report from the NSW Audit Office – pictured at right and available hereavailable hereavailable here.

The following collection of diagrams provide a broad brush impression of where opportunities may lie for improving financial and environmental performance. Some of the data may surprise you!

For example, the following projected savings by intervention is extracted from a study of exemplar hospitals – Can Sustainable Hospitals Help Bend the Health Care Cost Curve? by Kaplan et al 2012. You will note that impressive savings were made by reprocessing single-use-devices and reformulating operating room equipment packs.
Hospitals bend cost curve 2012

The UK’s National Health Service (NHS) has made a concerted effort over a long period of time to address its carbon footprint – refer to the next few diagrams. Find out more on how the NHS will achieve net zero emissions here.

NHS carbon performance

NHS carbon performance2

NHS carbon performance3

2020 NHS sources of emissions

Europe’s Green@Hospital pilot (2014) found that hospitals could save around 15% of energy consumed through a range of strategies outlined in this 6 minute video

The following table is taken from Sustainable Health and Social Care: connecting environmental and financial performance is based on a literature review and stakeholder consultation carried out by The King’s Fund on behalf of the National Institute for Health Research and the Social Care Institute for Excellence. The authors consider how health and social care needs to change to become more environmentally sustainable. A key finding is that improving efficiency at the operational level is unlikely to be sufficient. A more fundamental transformation in service models will be needed, with a greater emphasis on prevention, shifting care upstream, better integration and co-ordination of care, and an ongoing focus on maximising value for patients.

Change for sustainable health care Naylor applebyThe following outlines some specific practical strategies although each facility should evaluate each on their own merit in their own context. The table is extracted from Health Care & Climate Change: an opportunity for transformative leadership by Boone (2014), published by Health Care Without Harm.

Boone opportunity framework 2014Learn more from hospitals who have saved money (eg with a 2-5 year payback period) by becoming more energy efficiency, using energy management systems, and engaging staff.

Canadian Hospital (2014)

Regular Building Commissioning in Health Care (2017)


Energy is a significant part of the healthcare system’s carbon footprint (although carbon isn’t the whole story). Read about energy benchmarking as follows:

UK hospital wards kwh per m2 2016UK hospital wards kwh per m2 2016 part 2

2016 Benchmarking energy in hospital departments


‘Let’s Talk Health and Climate: Communication Guidance for Health Professionals’ combines values research, communications, and specific messaging into a single resource, so you can learn how to create messaging that truly resonates with the health and healthcare audience.

In addition, check out this podcast (March 2012), ‘Communicating health and climate change’ on the website of the Australian Science Communicators. The panel of speakers includes:

  • Fiona Armstrong, Convener of the Climate and Health Alliance
  • Dr Marion Carey, VicHealth Senior Research Fellow at Monash Sustainability Institute
  • Amanda McKenzie, Communications Director at the Climate Commission (Climate Council on climate and health)

Other key communication resources

Conveying the Human Implications of Climate Change

Conveying the Human Implications of Climate Change

Staff engagement

Engaging our communities and leaders

our climate our health


There are many case studies and other resources on the Global Green and Healthy Hospitals website here (especially for members):

Financial issues



Carbon Trust UK has an easy to read hospital resource here.


NB – Other relevant sections of this website include our page on procurement.