Decarbonizing the Healthcare Estate: Lessons Learned from NHS Trust Green Plans in England

Climate change threatens human health and healthcare systems while also contributing to greenhouse gas emissions. NHS England has addressed this with the Health and Care Act 2022, which mandates NHS trusts to develop green plans for emission reduction from 2022 to 2025. This initiative presents an opportunity to assess national scale efforts to decarbonize the healthcare sector. The paper identifies the interventions NHS trusts are adopting to decarbonize their estates and meet national net-zero targets while also highlighting opportunities for further progress. A thematic content analysis was conducted on green plans developed by NHS trusts in England to outline their strategies to decarbonize the estate. The main elements the NHS trusts have considered in terms of reaching net zero through built asset management; implementing heat decarbonization; and switching to renewable and low-carbon sources of energy. The analysis has recognized a strategic shift towards decarbonizing the healthcare estate by prioritizing the maintenance, refurbishment, and repurposing of existing buildings over new construction, coupled with a heat decarbonization strategy focusing on the transition to low-carbon technologies. Most long-term decarbonization strategies, particularly for achieving net zero through built asset management, are still in the early stages. There is a lack of comparable KPIs for monitoring progress and insufficient information on essential passive strategies. NHS in England should adopt a more integrated approach to decarbonization including both active and passive interventions, improve the standardization of performance metrics, and establish SMART objectives and standardized KPIs to effectively monitor trusts’ progress towards net-zero emissions in future green plans.