Statement on the climate emergency

The Scottish Academy recognises that climate change is a global public health issue; that decarbonisation is vital to protecting public health and mental health1; and believes there is a role for healthcare professionals in leading climate change mitigation in the Scottish healthcare system.

Healthcare professionals in Scotland must be supported to make their working practices more environmentally sustainable, including how they care for their patients.

As such, for real change to happen, activity must be taken at all levels of the healthcare system – including by government, health boards, hospital departments and other healthcare settings – and by healthcare professionals themselves.

At NHS Board level, sustainability work must be supported and adequately resourced - and that must be seen as a priority by all departments. At an individual level, healthcare professionals must be assisted in making greener decisions about what medical products they use in relation to carbon intensity – such the asthma inhalers and anaesthetics one may use.

As one of Scotland’s largest employers, the NHS in Scotland has a vital role to play in helping to make the healthcare system more ‘green’. The NHS has committed to being a 'net-zero' greenhouse gas emissions organisation by 20452, and it is clear that many staff are eager to deliver a greener NHS in Scotland in line with the Scottish Government’s own ambitions.

Yet the experience on the ground is not always consistent with those ambitions. The Scottish Academy is concerned by reports of wastage in the NHS (particularly around medicines and single use items like PPE, plastic drinking cups and blood collection tubes which are currently in short supply due to increased global demand linked to the COVID-19 pandemic).

Waste must be reduced. The Scottish Academy is calling for an open public consultation on NHS sustainability strategy in Scotland.

Around 25% of NHS carbon emissions are from medicines3 and therefore specific actions are required to reduce the environmental impact of medicines. This should include taking a Realistic Medicine approach to avoid unnecessary prescribing and changing from metered dose inhalers4 to lower carbon inhalers.

In addition, single-use aprons, face masks, gowns and gloves are currently not recyclable or biodegradable and the Scottish Academy is calling on the NHS and the NHS Supply Chain to be innovative around the sustainable recycling of PPE, but only where these products meet quality and safety standards.

For items that are recyclable, the Scottish Academy believes that there should be sufficient recycling bins in all clinical areas, as well as in patient waiting areas, since the recycling of general waste is also a challenge.

The Scottish Academy is aware of the benefits that video technology brings. Video technology now affords options that can help patients and clinicians avoid unnecessary journeys, which cause vehicle emissions. For example, transport accounted for more than one third of Scotland’s greenhouse gas emissions in 20185. Investment in the right infrastructure can support active travel, and the Scottish Academy is calling for this to be promoted more by the NHS to staff where appropriate, as part of its contribution to cleaner air ambitions.

Finally, the Scottish Academy is calling for the NHS to ensure that it provides patients and staff with healthy, sustainable food choices. Individuals can choose to eat locally, reduce meat consumption, eat with the seasons and grow their own food to help the environment6 – and the Scottish Academy believes that if the NHS in Scotland applied these principles, it would help reduce carbon emissions. Furthermore, by offering healthy, locally sourced food in healthcare settings, the NHS would be doing its bit to help tackle obesity and diabetes.

While the Scottish Academy notes the Scottish Government’s and NHS’ current efforts on climate change, it believes that changes on the ground need to happen for any impact to be made – and that governance of sustainability activities must be robust to ensure progress. The healthcare community in Scotland is concerned about the current and future impact of climate change on population health – and they stand ready and willing to do their bit to reduce healthcare’s carbon footprint.

1 Decarbonisation of the health sector: a commentary by EASAC and FEAM:
2 Chief Medical Officer - annual report: 2020 to 2021:
3 Greener NHS – areas of focus:
4 A metered-dose inhaler is a small, hand-held device filled with medicine. It helps deliver a certain amount of medicine through the mouth and into the lungs. It is commonly used to treat breathing difficulties related to asthma, chronic obstructive pulmonary disease (COPD), and other respiratory problems.
5 Update to the climate change plan – key sectors:
6 Eating healthy and sustainable food: