A sustainable health system that delivers outcomes that matter most to patients and the community, is personalised, invests in wellness and is digitally enabled.

NSW Health is a leading modern, low carbon, low waste, climate resilient health system by focusing on quality, value, innovation and equity.

The imperative for low-carbon, climate resilient healthcare

The changing climate is an existential threat and described by the UN Secretary General as a ‘code red for humanity’. Australia is one of the countries on the frontlines of climate-health impacts, including increasing in extreme weather events, changes in infectious diseases patterns, and food and water security. These impacts will place unprecedented pressure on our health system and are exacerbating existing health inequities, with vulnerable groups and rural communities most affected.

The health sector in NSW produces vast amounts of waste, fossil-fuel air pollution and greenhouse gas emissions: 6.6% of greenhouse gas emissions and 8% of the waste of the NSW economy.1 Our health system itself is therefore a major contributor to climate change, which is harming human health.

However, as noted in The Lancet, whilst climate change poses the largest threat to global health, it is also the biggest opportunity.2 Our health system faces a series of challenges including rising rates of chronic disease, reducing the risks and costs of harmful and low- value care (which may constitute up to 40% of healthcare)3, widening health inequities and the digital transformation. Transitioning to a modern, low-carbon, climate resilient health system is intertwined with addressing these challenges.

A low carbon system would have a strong focus on wellness, community-based care, and the prevention of disease, be integrated and patient-centred, focus on value and evidence-based medicine, be innovative and digitally enabled: all of which have health, environmental and in many cases financial benefits. Further, climate actions such as renewable energy, electric vehicles, active transport, plant-rich diets, and greener campuses would have a raft of public health benefits: reduced rates of heart and lung disease, diabetes, obesity, some cancers, and mental illness.

NSW Health's commitment

This position statement builds on previous strategies and policies within NSW Health, as well as the rapidly growing number of plans and net zero targets established by NSW Health organisations.

Environmental and financial sustainability are key reform areas in the Future Health Strategy (2022-32), including a commitment to an “environmentally sustainable footprint” for NSW Health. The NSW Government has targeted a 50% reduction in carbon emissions (on a 2005 baseline) by 2030 and has a net zero by 2050 target. As a high emitting sector, NSW Health is committed to these targets and to helping NSW to meet and exceed these goals across Scope 1 (direct on-site emissions), Scope 2 (purchased electricity) and Scope 3 (supply chain emissions).

A Steering Committee (chaired by the Deputy Secretary, Patient Experience and System Performance) and the Climate Risk and Net Zero Unit will work collaboratively with partners across NSW Health and the Office of Energy & Climate Change in NSW Treasury to lead and coordinate the transition to a low carbon, climate resilient health system. Many NSW Health staff care deeply about sustainability and wish to work in a health system aligned with their values. NSW Health also recognises that Aboriginal people have been exemplary stewards of this land for more than 65,000 years and that the principles of Caring for Country will inform our net zero transition.

NSW Health Climate Risk and Net Zero Unit

Guided by the Steering Committee, the unit will work in partnership with local health districts, specialty networks, pillar organisations, and other NSW Health entities, as well as with external stakeholders to embed environmental sustainability as a core dimension of quality healthcare. The Steering Committee reports to the Future Health Program Delivery Board to ensure integration and alignment across other reform priorities including virtual care, value based healthcare, procurement, precincts, data and digital.

Whilst energy and transport initiatives are an important part of a low carbon system, we recognise that emissions from pharmaceuticals and chemicals, medical devices, equipment, food and catering, and business services are also substantial. These areas can be difficult to measure and require a consistent and strategic approach. Almost 40% of the NSW health sector’s greenhouse gas emissions are produced by pharmaceutical products and medicinal goods alone. Therefore, changes will be required across the system to decarbonise health in NSW. Much of this work will be led by frontline staff and this transition will involve every one of our 140,000 staff.

The important tasks of the Unit, overseen by the Committee, will be these CORE responsibilities:

  • collaborate and coordinate
  • objectives and performance
  • research and innovation
  • empower.

Collaborate and coordinate

Establish ongoing collaboration with NSW Health organisations, researchers, government agencies and industry.

  • Collaborate with stakeholders to implement structures to share and disseminate research, case studies, reports, and evaluations to ensure best practice across the system; including for feedback to provide transparency and accountability to the unit’s work.
  • In partnership with relevant partners, establish geographical and clinical networks and groups across NSW Health to facilitate the sharing and scaling up of best practice.

Objectives and performance measurement

Set objectives and targets to meet legal, government and regulatory requirements.

  • Identify policies requiring review to meet legal, government and regulatory requirements (including procurement reform and infrastructure policies).
  • Appraise the climate resilience of NSW Health by assessing the responses to the NSW Government’s Climate Risk Ready Assessment.
  • In partnership with HealthShare and the Chief Procurement Officer's team, convene a leadership group with our major suppliers to align our net zero objectives.

Research and innovation

Partner with researchers, industry, and carbon accountants to measure carbon in the system

  • Conduct environmental impact analyses and develop a mechanism to measure, track and report on our environmental performance, alongside health and financial outcomes, over time.
  • Support our staff to work in partnership with researchers to measure the carbon costs of investigations, procedures, services, and clinical pathways; and develop and implement low-carbon models of care.
  • Establish a Net Zero Innovation Program with relevant stakeholders to address challenges and gaps in the evidence base (including emerging technologies and circular economy solutions).


Engage with staff to understand their values and their views about sustainability, and support them to act in accordance with their values

In partnership with existing change management and innovation programs, establish a staff engagement, education and capacity building program, including events with national and international thought leaders.

As described, the chief responsibilities of the unit are metrics, low-carbon models of care and staff engagement, and it is not (directly) responsible for energy, infrastructure, transport, procurement or supply chain initiatives, which are managed by other teams across NSW Health. Physical climate risks (adaptation) will be managed by a collaboration of several teams across NSW Health, including the Environmental Health Branch and the Risk Unit. The unit is not a funding or grant-giving body.

File Link: NSW Health Climate Risk and Net Zero Unit: Position Statement


  1. Malik, Padget, Carter et al. Environmental impacts of Australia’s largest health system. Resources, Conservation & Recycling. 2021; 169: 105556.
  2. Watts N, Amann M, Arnell N et al. The 2019 report of the Lancet Countdown on health and climate change: ensure that the health of a child born today is not defined by a changing climate. Lancet.2019; 394: 1836-1878.
  3. Braithwaite J, Glasziou P, Westbrook J. The three numbers you need to know about healthcare: the 60-30-10 Challenge. BMC Med 2020; 18: 102-02.

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