The transfer of commissioning from primary care trusts to GPs should be used to help drive environmentally friendly policies, according to the head of the NHS sustainable development unit.

Speaking at the Royal College of GPs annual conference in Harrogate on Friday, unit director David Pencheon described the public health effects associated with high carbon use as the “cholera of our time”.

He called on doctors to think about the future and to use their influence to lead the green agenda when they gain control of commissioning.

Dr Pencheon said: “You have a very big opportunity. This is not just about the hard end of clinical practice, it’s about how we embed….a license to operate for organisations and individuals where you have to take sustainability seriously.”

He said consortia needed to put criteria into contracts with providers asking them to outline their commitment to sustainable practices, for example introducing energy monitoring.

He said: “Monitor and the Care Quality Commission are looking at this seriously. So if we want to shape the world in a way that develops appropriately – for people today and tomorrow - this are the hard things you have to get used to.

“We have to look at very gritty issues like single use versus decontamination of instruments and medical equipment.”

He noted it was the influence of the medical profession on politicians that had brought about radical action on tobacco use and HIV, and called for them to do the same for environmental issues, which had indirect health impacts.

He said: “This is happening on our watch, it’s our legacy, it’s the cholera of our time. We have a profound duty of care here and I think we have a huge opportunity to deliver it.”

The sustainability unit has assessed the “carbon footprint” of the NHS, the largest undertaken in the world so far. It revealed the NHS in England generates around 21 million tonnes of carbon dioxide every year, a quarter of public sector emissions.

Of this 59 per cent is from the procurement of services and goods, 17 per cent from travel – both patients and staff – while 24 per cent is from the actual use of energy for things such as heating and ventilation systems.