Author | Raquel C. Pico
When it comes to sustainability, five key elements stand out, defined in English by the words clean, community, culture, care and corporate governance. These are known as the five Cs. All the values of a sustainable strategy are conceptualized within them, and decarbonization is linked to each and every one of them.
Decarbonization is one of the major pillars of sustainability strategies and one of the basic components for achieving global warming reduction targets. Essentially, it involves reducing the use of fossil fuels with the goal of eliminating them completely and thereby lowering emissions until reaching carbon neutrality. Reducing these carbon emissions in key infrastructure such as hospitals helps create more sustainable economies, countries, and cities.
The role of healthcare
Achieving net zero emissions requires a coordinated effort across all sectors, and healthcare must be part of it. In fact, studies have already shown that the healthcare sector has a significant carbon footprint.
A 2019 study by Health Care Without Harm and Arup estimated that healthcare accounts for 4.4% of total global net carbon emissions and that, if it were a country, it would be the fifth largest polluter in the world. Data like these have led some health systems to implement plans to reduce their footprint. One of them is the British NHS.
The NHS climate strategy

The NHS is at the forefront of decarbonization in healthcare. In 2007 it began measuring its emissions, and in 2020 it became the first in the world to set a target date to reach net zero. In general terms, when discussing sustainability, reaching net zero emissions means reducing carbon emissions as much as possible until they are brought down to virtually zero.
The NHS aims to achieve an 80% reduction in the carbon emissions it directly controls between 2028 and 2032, and to reach the same goal for indirect emissions between 2036 and 2039.
The pillars of NHS decarbonization
Simply setting the goal or switching to renewable energy is not enough to achieve it. As leading sustainable cities know well, decarbonization requires a holistic strategy. The first step is always to identify the main sources of carbon emissions, and the second is to establish ways to reduce them.
The NHS is working with five key elements. As part of this, they have begun to shift away from hospital centric care, so to speak. Instead of concentrating all care in hospitals, they have started testing the use of community hubs for specific services and home based treatment, reducing travel and improving accessibility. They are also cutting down on waste and unnecessary procedures, lowering the waste of resources and the tons of items that end up in the trash. Several pilot programs have reduced the number of discarded gloves and used cannulas, as well as IV lines placed unnecessarily.
Another pillar is disease prevention. Although it might appear unrelated to decarbonization, prevention helps reduce severe health problems and the higher carbon emissions that come with them. At the same time, it has a positive impact on many areas of sustainability, such as care and community, which are part of the five Cs. In addition, improving health and disease management is another key pillar. Some success stories have already reduced the footprint associated with inhaler manufacturing thanks to better health education for people with asthma in Hull and East Yorkshire, as well as reduced hospitalizations through clearer diagnosis of preeclampsia in Oxford.
Finally, they are promoting the use of alternatives with a lower footprint, and therefore lower carbon emissions.
NHS Decarbonization: Frequently Asked Questions
Does healthcare have a carbon footprint?
Yes, both direct (for example, the electricity used by hospitals) and indirect (the emissions involved in producing materials or medicines).
Is it possible to decarbonize healthcare?
Yes, and decarbonization does not have to mean lower quality care or worse treatment. In fact, carbon reduction programs often enhance public health by taking a holistic approach.
When will the NHS be net zero?
The NHS aims to reach carbon neutrality between 2028 and 2039.
What progress has been made so far?
To date, evidence suggests that the NHS is achieving results in decarbonization, at least in England. The latest NHS England report shows a 68% reduction in carbon emissions and confirms that the NHS remains on track to meet its internal target for 2032. However, in Wales, the NHS has not only failed to meet its 16% reduction target but has seen emissions increase by 20% since 2018–2019.
Photos | sturti/iStock, Thomas Faull/iStock


