The climate crisis
The climate crisis The World Health Organisation recognises climate change as the single biggest health threat facing humanity. It affects the social and environmental determinants of health, such as clean air, safe drinking water, food supply and shelter. Over the next few decades, it will increasingly threaten the health and wellbeing of people and communities across the globe, as well as placing health services under growing pressure on multiple fronts. By the latter half of this century, the rise in global temperatures will mean parts of the world will become increasingly less habitable. This, alongside the growing frequency of extreme weather events, such as flooding, will likely see shifts in infectious disease patterns, while changes to weather patterns will affect the distribution of air pollutants. Furthermore, from 2050, research has shown that crop yields may decline on average by 10% or more, threatening food security and food production.
On a national level, the United Kingdom has seen nine of its 10 hottest years on record within the last decade, with heatwaves expected to become more frequent and severe. Flooding events have been identified as one of the most severe climate risks to the country’s population and wider infrastructure. Coastal flooding, as a result of sea level rise, is likely to threaten the long-term viability of some coastal communities and introduce significant challenges for the resilience of health and care services in these areas.
If we are to keep global temperatures from exceeding the 1.5 degrees Celsius threshold that was agreed in the 2015 Paris Agreement, and reinforced in the United Nations COP26 climate change agreement, it must be a priority across a range of sectors including the NHS and its supply chain.
Even if the aims set out at COP26 are achieved, the UK's climate will be different from today by 2050. Population growth and demographic change, combined with changes to biodiversity and local weather patterns, will mean that the NHS must work differently. Preparing now is crucial which is why it is so important that the NHS has recognised climate change as a public health priority.
The NHS' contribution
The NHS is responsible for 4% of the country's carbon footprint. This figure comprises the NHS' direct and indirect emissions, generated by diverse factors including buildings, medicine production, patient and staff travel, transport, manufacturing and food and catering. The NHS therefore has a central role to play in efforts to reduce carbon emissions and meet the national net zero targets set out in the Climate Change Act 2008. As anchor institutions in communities, often operating at considerable scale, trusts can make a positive contribution in their local area by embedding sustainability into how they work and deliver health and care services.
As the country’s biggest employer, and making up over 7% of the economy, the work trust leaders are doing to tackle climate change and drive action on environmental sustainability should be an engagement activity that brings the enthusiasm of their staff to the fore. With 98% of frontline NHS employees believing the health system should be more environmentally sustainable, and nine in 10 supporting NHS commitments to reach net zero, there is a real opportunity for trusts to connect with the enthusiasm and commitment we know that many staff feel for this agenda, to raise awareness, promote change within the workplace and to support a broader conversation about the green choices staff could make outside of work.
Climate change also presents a risk to population health, and contributes to poorer health outcomes, with direct consequences for health and care systems. For example, air pollution has been shown to contribute to increased rates of respiratory conditions and heart disease. Improving air quality represents a tangible change that could bring health benefits to populations across the country. By contributing to improving the quality of the air local residents breathe, the NHS can impact demand for services and tackle both adult and childhood illnesses, improve the health of local communities, and reduce health inequalities.
Many trusts recognise that tackling climate change and improving health services is more than just about reducing carbon emissions. Adaptation and building resilience into health and care services needs to be considered alongside carbon reduction plans. Much of the effort so far has focused on mitigating the impacts of climate change by reducing emissions. However, even if interventions to reduce carbon emissions are successful, and we are able to keep average temperature increase below 1.5 - 2 degrees Celsius, the reality is that we can expect wider changes to the climate, such as rising sea levels. Health services will need to be prepared for the impact of changed weather patterns on infrastructure, supply chains, and health needs, and for the NHS to be at the heart of local resilience planning.