Carbon Copy: A step in the right direction?

It has been more than three years since NHS England launched its aim to reach net zero for its carbon footprint.

The health service plans to eradicate all emissions it can control by 2040, as well as those it can influence by 2045 as well. 

Greener NHS, the sustainability team in charge of the mission, was initially meant to report progress twice a year to the main NHSE public board.

Its last such report in 2021 had plenty of good data. This included how much of its expected reduction in emissions would come from NHS action, or a decarbonising national grid and wider government action (which was most of it).

It has since switched to a yearly overview in the NHSE annual report, which Carbon Copy understands was considered to be more efficient. These updates tend to be lighter on detail and without discussion at the public board. 

But they still give us a glimpse at how the NHS sustainability drive is going. And if the headline figures in the last annual report – published at the end of last month – are to go by, it is pretty good news, but we are given very little detail to explain how it was achieved.

Net zero update

The NHS’s carbon footprint deals with its direct emissions only – energy use, buildings and its fleet. As well as the 2040 net zero target, it has an interim aim of an 80 per cent reduction by 2032.

This has reduced by a quarter since 2019, from 6,100 to 4,550 kilotonnes of carbon dioxide equivalent. This is ahead of the 5,000 ktCO2e which it says it needed to stay on track to net zero.

But the data doesn’t break down to show how this was achieved.

We know 100 ktCO2e of the 1,550 ktCO2e reduction comes from changing to less carbon-intensive inhalers, but not the impact of replacing desflurane with a less polluting anaesthetic gas. Nor does it tell us by how much estate emissions – its largest chunk – had reduced.

It is possible most of this comes from cleaner energy being supplied to hospitals from the grid and non-NHS government action – this drove the previous annual reduction in emissions. 

Its wider “carbon footprint plus” – which adds emissions it can only influence, such as supply chain and patient travel – is also ahead of trajectory at 21,7000 ktCO2. This will also include the grid reductions mentioned before.

Asked about the lack of detail, NHS England said it was more complex to calculate these overarching NHS emissions than for the central office, which had much more emissions data in the same report, and it would continue to develop its reporting. 

Work is still happening to improve emissions data, and Carbon Copy understands a more detailed breakdown will probably come out of future work to update its baseline.

But even without the details, the overall reduction is no small feat, even more so considering it has been achieved amid huge pressures elsewhere which can so easily take attention and resources away.

Uphill climb

But it will only become harder to chip away at the NHS carbon footprint from now. 

An NHSE spokesperson told Carbon Copy the job was “far from done” and the effects of climate change would continue to pose “significant challenges” to healthcare.

Sustainability leads say much of the focus to date has been on the easier and cheaper sources of emissions to tackle.

The focus now needs to shift towards trickier and more costly emissions. This includes estates, which currently have more than 60 per cent of the direct carbon footprint.

Government grants have been helping with this so far, but there is significant demand for investment in this area. 

The main route for extra funding for this is the public sector decarbonisation scheme. In a recent round, the NHS – which is considered to do well out of the scheme compared to others – won £200m of the £800m it submitted in bids.

LED lighting

Additional funding is cropping up, albeit more randomly and last minute.

The NHS has been granted £20m for LED lighting from the Department of Health and Social Care and the Department of Energy Security and Net Zero. There was no press release, which was surprising for a positive news story. LED lights are thought to be up to 60 per cent more efficient than current systems.

Nearly half of the NHS estate will have adopted LED lighting when the £20m is spent. 

The new LED projects given the green light will have to get a move on. The funding – announced in January – is only available until the end of the financial year.

This could be doable, with projects understood to have been chosen on deliverability. But while the funding will be welcome, the added time pressure will be less so. 

Carbon Copy understands this was an unexpected source of funding for the NHS, with the money coming from an underspend in the public sector decarbonisation scheme overall. (As a side note, HSJ has previously reported on difficulties in getting allocated funding through this government scheme.)

Although it has come late in the day, discussions are understood to have started in autumn, but the nature of the underspend only became clear later in the year. 

This funding once again shows the scale of demand when it comes to decarbonising estates and improving energy efficiency. 

Around 50 projects were accepted, while 120 rejected ones will have to find – or wait – for another source of funding.