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Queue of ambulances at the accident and emergency department at Queen Alexandra Hospital in Portsmouth, Hampshire
Queue of ambulances at the accident and emergency department at Queen Alexandra Hospital in Portsmouth. 信用:保罗雅各布/ alamy股票照片。


Marina Romanello医生

Marina Romanello医生

来宾帖子 帖子:计算英格兰NHS的碳足迹

2017年Lancet Countdown on Health and Climate Changewarned that the impact of climate change on human health is now so severe that it should be considered “21世纪的主要威胁”.



In our recent study, published in the柳叶刀行星健康,我们估计全国的碳足迹Health Service (NHS) in England. Unpacking where these CO2 emissions are coming from, we calculate a total for 2019 of around 25m tonnes of CO2 equivalent. This is around 7% of the UK’s total carbon footprint for that year.

While this is sizeable, total emissions have dropped by approximately a quarter since 1990. And the emissions per patient have fallen by almost two-thirds. However, with the NHS aiming to reach net-zero emissions in 2045, there is still some way to go.


卫生界肩负着保护公众的责任,在减缓气候变化的努力中发挥着突出的作用——促进其可持续发展health co-benefitsand building resilience to face future increases in healthcare demand.

This extends to reducing its carbon footprint. For example, healthcare in the world’s largest economies currently accounts for4.4% of global CO2 emissions.

任何努力减少卫生体制的足迹ms must be underpinned by a thorough understanding of emission sources and the activities that drive them.

为此,美国已经公布了医疗保健系统的碳足迹澳大利亚,Austria,Canada,中国,Japan,而且我们– alongsideinternational estimates.

However, the National Health Service (NHS) in England holds the only such effort carried out by the health system itself, which it has been developing and refining since 2008.

In 2020, a year dominated by the Covid-19 pandemic, the NHS announced its commitment to become theworld’s first net-zero national health systemby 2045.

The benefits of this commitment will hopefully spill over to other healthcare systems. As the largest single employer in Europe and the largest single-payer healthcare system in the world, the NHS can use its size and influence to drive its own emissions reductions, while paving the way for other health systems to follow suit.


在其温室气体(GHG)排放会计中,NHS遵循“温室气体协议公司标准“–由世界资源研究所(WRI) and the促进可持续发展世界商业理事会(WBCSD).


The NHS approach also incorporates patient and visitor travel, which it is not directly responsible for, but it can influence.

The method covers seven GHGs: carbon dioxide (CO2), methane (CH4), nitrous oxide (N2O), hydrofluorocarbons (HFCs), perfluorocarbons (PCFs), sulphur hexafluoride (SF6) and nitrogen trifluoride (NF3).



In this way, the approach combines the accuracy and adaptability of available data from monitoring and reporting efforts with the broad coverage of top-down carbon accounting.

In addition, this approach lends itself to the incorporation of new monitoring data as it becomes available. This last point is essential to measuring progress and assessing the impact of decarbonisation, as well as for breaking down the carbon footprint to the individual facility level.

The carbon footprint of the NHS in England


We estimate the carbon footprint of the NHS in England in 2019 at 25m tonnes of CO2 equivalent. This is roughly equivalent to theannual CO2 emissions of Sri Lanka.

虽然相当大,但从1990年级别减少了26%。这种转变主要由a驱动decarbonisation of the national electricity system,从而减少了运营医院和其他建筑的排放。这可以通过下面图表中粉红色阴影的区域看到,该区域按温室气体源进行分解。

Timeseries of total greenhouse gas emissions of the NHS in England, broken down by source of emission for 1990 to 2019
Timeseries of total greenhouse gas emissions of the NHS in England, broken down by source of emission (in MtCO2e) for 1990 to 2019. Source: Tennison et al. (20.21.).


在其总足迹中,24%来自NHS可以直接影响的来源(“直接排放”)。其中包括舰队和商务旅行、建筑、麻醉气体,prescribed metered dose inhalers(MDIs), waste and water, and electricity consumption.


We also separated out the NHS carbon footprint by type of clinical activity, which further enables the identification of mitigation targets.

For example, providing “acute care” – which deals with short-term treatment for a severe injury or episode of illness, an urgent medical condition or during recovery from surgery – comprised more than half of the total footprint in 2019.

This makes it the most carbon-intensive care pathway, with 125kg of CO2e per day for hospitalised patients, and 76kg of CO2e per outpatient acute care appointment. The large carbon footprint is because acute care typically requires more medical equipment, protective equipment and other resources.

In contrast, “primary care” – the first point of contact in the healthcare system – is considerably less carbon intense. For example, a visit to a general practitioner produces an average of 66kg of CO2e.



Shifting to a net-zero health system presents unique challenges, requiring the reduction of emissions without compromising on healthcare quality.

投资于加强初级、社区和长期护理,以及优先考虑早期疾病检测和治疗,可以帮助实现这一目标。通过早期和改进疾病管理、减少病人出院时间、增强病人能力和减少对急症护理的需求,NHS可以提供帮助minimise healthcare demand and resource consumption, deliver health gains, and lower costs.

Shifting to remote digital care whenever suitable can also drive emission reductions, as well as increase access to health and patient comfort. However, while remote delivery has accelerated during the Covid-19 pandemic, rollout plans will need to be closely accompanied by adequate access to digital technologies and digital literacy to avoid exacerbating inequalities.



挥发性麻醉剂和MDI推进剂的排放 - 贡献NHS所有排放量的巨大温室均可通过废物管理和有效的交付减少,并在临床上适当地转移到低碳选项。


That said, through implementation of green procurement guidance, the NHS can reduce consumption and promote shifts to low-carbon or reusable alternatives whenever these are available.


Our work reflects more than 10 years of analytical effort dedicated by the NHS to tracking its carbon footprint. We hope it will help guide other health systems in developing their own carbon accounting.


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  • 帖子:计算英格兰NHS的碳足迹



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