Net zero clinical transformation – Green Plan

Clinical transformation is fundamental in delivering a sustainable NHS. The majority of healthcare emissions are driven by clinical activity and decision-making, transforming the way we design and deliver care is essential to reaching net zero.

Achieving this requires rethinking care pathways through the lens of sustainability, placing environmental responsibility alongside quality and safety.

By embedding the four principles of sustainable clinical practice – prevention, patient empowerment, lean delivery, and low-carbon alternatives (source: Towards net zero healthcare, The BMJ) into everyday care, clinicians can lead a shift toward models of care that reduce carbon, improve outcomes, and build a healthier future for patients and the planet.

Our net zero clinical transformation objective is to:

Reduce emissions from clinical activity and redesign care pathways through the principles of sustainable clinical practice, driven by clinical leadership, continuous improvement, and system-wide collaboration to deliver high-quality, low carbon care.

Where we are

  • Renal services have delivered a range of high-impact improvements in virtual care, digital records, and efficient dialysis — resulting in significant carbon emissions reductions
  • Waste streaming in theatres has begun, looking at ways of recycling equipment and medicines

Where we want to be

  • Net zero clinical lead appointment and net zero clinical working group formed with representation from each Clinical Service Unit (CSU)
  • Care is increasingly delivered closer to home, supported by digital consultations and integrated with primary and preventive care, reducing hospital-based interventions
  • Appropriate and safe switches from single use to reusable medical items have been made
  • Reduced inappropriate Personal Protective Equipment (PPE) usage

Actions

We have identified the following actions to enable achievement of our net zero clinical transformation objective:
Action Trust lead Delivery date
Appoint a clinical lead with oversight of net zero clinical transformation Green Plan SRO End of 2025
Introduce a net zero clinical transformation group, chaired by the net zero clinical lead and with representation from each CSU to identify initiatives (e.g., reducing inappropriate PPE usage; reusable medical items; switching from IV to oral antibiotics) and a targeted focus on improving quality of care for at least one clinical area (as per the NHS England guidance) Clinical Lead End of 2025
Consider net zero principles in future service changes, reconfiguration programmes and pathway redesign initiatives, with a targeted redesign of at least one care pathway, engaging with local and national Trusts (as appropriate) Clinical Lead End of 2028
Identify and implement/switch from single-use to reusable medical items Clinical Lead and Head of Sustainability End of 2028

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