Background

In 2015, The Lancet reported that Climate Change was the biggest threat and the biggest opportunity for human health of the 21st Century – threatening to undo 50 years of positive public health achievements.  Since that point extreme weather events have increased and we have had 24 months above the 1.5oC target agreed in Paris that year.  In the most recent Lancet Countdown report published in 2024 it was noted that ‘of the 15 indicators monitoring the health hazards, exposures and impacts of climate change 10 reached a concerning new record  in the latest year of data’. 

Other concerns highlighted in the Lancet report include: 

• Heat related deaths in 2023 were 167% higher than in 1990-99 

• Heat exposure resulted in an estimated loss of 512 billion hours of labour in 2023 

• Increased heatwaves and droughts led to 151 million people experiencing food insecurity 

• Extreme rainfall hit more areas than ever before increasing the risk of landslides, floods, disease transmission and threatening food and water security. 

In 2023 the UK Government published its latest Health Effects of Climate Change report in which it noted that the potential impacts of climate change on health in the UK will be significant and wide ranging due to: 

• Heat and cold 

• Flooding 

• Vector borne diseases 

• Food imports and increased prices 

• Exposure to wildfire and droughts 

The Fourth Health and Climate Adaptation Report was published in March 2025.  This stated that all areas of the UK had experienced warmer summers and milder winters, with more frequent and severe floods and heatwaves. 

The heatwave of summer 2022 saw temperatures above 40oC for the first time and heat associated mortality in England of 2,985.  This is expected to rise to over 10,000 per year by the 2050s without adaptation or decarbonisation efforts. 

Climate change will disproportionately impact  

• Older adults 

• Those with a physical or mental health condition 

• Children 

• Individuals with disabilities 

• People experiencing deprivation or homelessness 

• Those in settings such as prisons, schools, and social care settings 

The NHS has been actively working to reduce its carbon footprint and reduce its overall negative impact since 2009.  However, the NHS is responsible for over 5% of UK carbon emissions, uses more single use plastic than any other sector, creating 133,000 tonnes of plastic waste.  In addition, 5% of travel in England is related to the NHS, which adds over 7,000 tonnes of NOx (Nitrous Oxides) and 330 tonnes of PM2.5 (particular matter 2.5 microns or smaller) pollution, air pollutants that have been shown to have adverse health impacts. 

In October 2020 the NHS declared that by 2040 it will be carbon net zero for all of its Scope 1 and 2 emissions (that is, everything under its direct control) with everything else, its carbon footprint plus, being net zero by 2045.  There are also sustainability requirements within the NHS Long Term Plan, Standard Contract and CQC Well Led Section. 

In 2024 Lord Darzi’s report stated: 

“Given the global health imperatives, the NHS must stick to its net zero ambitions. There is no trade-off between climate responsibilities and reducing waiting lists. Indeed, often health and climate are mutually reinforcing goals: cleaner air is good for the environment and good for respiratory health.” 

Northampton General Hospital NHS Trust provides general acute services for a population of 380,000 and hyper-acute stroke, vascular and renal services to people living throughout whole of Northamptonshire, a population of 692,000.   Our 166,357m2 (40 acre) town centre site has 16 operating theatres, over 750 beds with have over 750,000 patient contacts a year; our services being provided by 6,200 staff.   

The organisation is also an accredited cancer centre and provides cancer services to a wider population of 880,000 who live in Northamptonshire and parts of Buckinghamshire. 

Progress since our last Sustainability Plan 

In 2022 Northampton General Hospital set out its intentions in its Board approved Green Plan which focussed on six key areas agreed as important to the Trust: 

• Reduce our scope 1 and 2 carbon emissions in line with the Net Zero 2040 target 

• Improve our resource efficiency 

• Reduce air pollution from trust operations 

• Embed wider social value aspirations within our operations 

• Ensure our staff are more informed about the environmental impact of healthcare and that are premises and care patterns are prepared to deal with a changing climate 

• Adapt our models of care to low carbon pathways and utilise new innovations and digital solutions 

Following the Green Plan Refresh guidance published by NHS England this refreshed Sustainability Plan will incorporate the above areas of focus in following sections which allows easier alignment across the system: 

• Workforce and Leadership  

• Net Zero Clinical Transformation 

• Digital Transformation 

• Medicines 

• Travel and Transport 

• Estates and Facilities 

• Supply Chain and Procurement 

• Food and Nutrition 

• Adaptation 

This Sustainability Plan also incorporates requirements from the following documents from NHS England: 

• Net Zero Supplier Road Map 

• Estates and Facilities Net Zero Carbon Delivery Plan 

• Net Zero Transport and Travel Strategy 

• Clinical Waste Strategy 

Sustainability and Climate Change are also included within the Health and Social Care Act of 2022 which puts the duty on all Trusts to have a Green Plan, reduce carbon emissions and reduce waste.  Sustainable Healthcare is now included in the Well Led section of the CQC reporting, and all Trusts from 2024 must report on their climate actions and impact via the Taskforce for Climate Related Financial Disclosures (TCFD) requirements. 

NGH NHS Trust view these as minimum requirements; this Sustainability Plan sets out how we will meet these and go further, contributing to a more sustainable healthcare system. 

Key Highlights since our 2022 plan 

• Reduced emissions from buildings by 744 tonnes CO2e (6.7%) 

• Reduced emissions from anaesthetic gases used in theatres by 39.5% or 223 tonnes CO2e 

• Held three Green Team competitions with projected annual savings of over 120 tonnes of  CO2e and £425,000 

• Added Sustainability into the teaching curriculum for 3rd year Leicester Medical School students, and Foundation Year 1 and 2 doctors at NGH 

• Increased segregation levels of clinical waste in line with NHS guidelines 

• Warp It (our reuse platform) users increased to 221 from almost zero 

• Highly Commended in the HSJ Awards Towards Net Zero category on two occasions 

• Carbon Management Plan written setting out a roadmap to achieve net zero building emissions 

• Steam removed from the site to reduce our carbon emissions and replace 50 year old pipework and boilers as part of a £20.6million government grant 

• Replaced old steam kitchen dishwashers and cooking equipment with more efficient electric equipment  

• Explored novel innovative technologies to reduce single use items 

• Maintained Investors in the Environment Green Accreditation  

• Established multidisciplinary Sustainability Committee, Go Greener Nursing and Midwifery forum 

• Featured in national Design for Life, CCU Sustainable Recipe Book, British HIV Association’s Ten Steps to a Greener Sexual Health and HIV Clinic 

• Installed 79 EV charging points for staff and visitors 

• Promoted Digital Technology to reduce the need for patients and staff to attend site 

Carbon Emissions from the areas included in the 2040 target and their reduction since the last plan are shown below along with the target for the end of this Sustainability Plan:

Carbon emissions reduction since the last plan

Carbon Emissions	21/22	22/23	23/24	24/25	21/22 to 24/25 Change%	2028 Target
Carbon Emissions Energy (gas, electricity and renewables)	21/22 10,992	22/23 11,045	23/24 11,231	24/25 10,248	21/22 to 24/25 Change% -6.8%	2028 Target 7278
Carbon Emissions Anaesthetic gases  including  nitrous and Entonox	21/22 1539	22/23 1521	23/24 1611	24/25 1358	21/22 to 24/25 Change% -11.7%	2028 Target 950
Carbon Emissions F-gases	21/22 131	22/23 330	23/24 33.2	24/25 44.5	21/22 to 24/25 Change% -34%	2028 Target 31
Carbon Emissions Business mileage	21/22 186	22/23 211	23/24 236	24/25 232	21/22 to 24/25 Change% +24.7%	2028 Target 162
Carbon Emissions Water	21/22 66	22/23 67	23/24 77	24/25 59	21/22 to 24/25 Change% -10.6%	2028 Target 41
Carbon Emissions Waste	21/22 39	22/23 39	23/24 39	24/25 41	21/22 to 24/25 Change% +5.1%	2028 Target 29
Carbon Emissions Metered Dose Inhalers	21/22 67 (8.27kg per inhaler)	22/23	23/24	24/25  85 (10.28kg per inhaler)	21/22 to 24/25 Change%	2028 Target 60
Carbon Emissions TOTAL tCO2e	21/22 13,020 (Excluding inhalers)	22/23 13,213 Excluding inhalers	23/24 13,254 Excluding inhalers	24/25  11,734 Excluding inhalers	21/22 to 24/25 Change%	2028 Target 8551