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Carbon footprint of health

NSW Health has committed to an environmentally sustainable footprint and all NSW Health organisations will be working together towards a high quality, low carbon and climate resilient health system. It is estimated Australia’s health system contributes 7% of Australia’s total carbon footprint.

NSW Health is adopting a more environmentally sustainable approach to health services and will be delivering a baseline carbon footprint and net zero plan to support the NSW Government’s Net Zero Plan to reduce emissions.

In the UK, the methods used to calculate the NHS Carbon Footprint remain the most comprehensive of any health system to-date. The NHS’s Carbon Footprint shows that whilst energy, transport and building design are important, we also need to address emissions related to clinical care: supply chain, pharmaceuticals, medical devices, equipment, anaesthetic gases and metered dose inhalers.

Graph of NHS carbon emissions: Medicines and chemicals 20%, medical equipment 10%, non-medical equipment 8%, other supply chain 24%; buiilding energy 10%, water and waste 5%, anaesthetic gases and metered dose inhalers 5%, business travel and NHS fleet 4%, patient travel 5%, staff commute 4%, visitor travel 1%, commissioned health services outside of the NHS 4%.
Figure 1: Sources of carbon emissions by proportion of NHS Carbon Footprint Plus. Source: NHS -  Delivering a ‘Net Zero’ National Health Service

Getting started 

All organisations are at different stages in their net zero transition. If you’re just getting started, these are some suggested steps:

  • All NSW Health Chief Executives have been asked to nominate a Sustainability Officer, Executive Sponsor and Clinical Lead/s (some organisations have one clinical lead, others have separate nursing/medical/allied health leads). Check that your Sustainability Officer and any other interested staff are part of the NSW Health Sustainability Network. You may also wish to appoint a Board Lead for your organisation's net zero transition.
  • Review the literature and relevant resources about the environmental impacts of healthcare, carbon hotspots and best practice in decarbonising healthcare - there are many resources on this website.
  • Convene the key stakeholders from across your organisation in an appropriate forum e.g. Climate Risk Committee.
  • Identify and support interested staff, including clinicians. Look for opportunities to train and upskill them (e.g. carbon accounting courses). Link your clinicians in with relevant NSW Health Net Zero Leads Networks.
  • Using available data, estimate the carbon footprint of your organisation. Relevant papers are listed in Resources. Of note, the Climate Risk and Net Zero Unit is supporting an in-depth carbon footprint assessment of a tertiary metropolitan hospital and a regional hospital, and the results will be available to all NSW Health organisations. Support may be available via NSW Government’s Office of Energy and Climate Change. Contact us for further information.
  • Draft a Net Zero Plan, focusing on initiatives to address the carbon hotspots and the 'quick wins'. The plan should list the person responsible for each action (e.g. from your Climate Risk Committee), timeframes and measuring and reporting mechanisms.

How to produce a Net Zero Plan 

In the UK, every NHS organisation is required to develop a three-year Green Plan, setting out their carbon reduction initiatives in line with a net zero trajectory. This document provides guidance for the plans, including the minimum requirements, for example:

  • having a Board-level lead responsible for their net zero target and Green Plan,
  • reducing desflurane to <10% of its total volatile anaesthetic gas use by volume,
  • developing a plan for appropriate prescribing of lower carbon inhalers,
  • purchase and lease low or zero-emissions vehicles,
  • developing a green travel plan for all sites
  • >25% of outpatient activity to be delivered remotely.

As an example, please see Royal Berkshire Foundation Trust's Green Plan 2022-25.

Whilst NSW Health is at a different stage in our net zero journey, this guidance provides best practice examples and could be used to help develop your plan.

Download environmental sustainability plan examples from:

Queensland Health has developed a Climate Risk Strategy 2021-2026. Check out the key objectives in each action area.

Ways to save money and carbon 

Case study: Hunter New England Local Health District

Hunter New England Local Health District has a bold vision to be carbon and waste neutral by 2030. In 2021, the District saved nearly $1million by implementing a range of sustainability initiatives in energy, water, fleet, paper and procurement. Read about Sustainable Healthcare: Together Towards Zero and read about their results in Sustainable Healthcare: Together Towards Zero 2030.

NSW Health responds to environmental and financial challenges by creating sustainability initiatives. These initiatives are a positive change to the way we use energy and help to reduce reliance on the electricity grid and reduce carbon emissions:

  • Solar panels: The Hornsby Ku-ring-gai Hospital photovoltaic solar panels system is expected to produce >1 million kWh per year, saving >$260,000 and reducing CO 2 emissions by 900 tonnes annually.
  • Electric or hybrid vehicles: Nepean Blue Mountains Local Health District Fleet Management have moved beyond GREP compliance with 80% of the fleet now hybrid vehicles. The move has contributed to savings of 47,565 litres and $63,407 in fuel costs and a reduction of 113 tonnes of carbon emissions.
  • Reduce single-use plastics: Hunter New England Local Health District's John Hunter Hospital are eliminating single-use bowls in theatres by shifting to metal hollowware, reducing their carbon footprint, reducing waste costs (diverting ~13.5 tonnes of plastics from landfill every quarter), and saving up to $200,000 per year.
  • Reduce single-use items: The Sydney Children’s Hospital Network are eliminating polystyrene eskies and ice-packs to keep deliveries cold by transitioning to reusable eskies and refrigerated trucks. The trial is saving 170kg of waste per delivery with one vendor alone.
  • Reduce use of desflurane: Anaesthetic gases are 5% of a hospital's carbon footprint. Royal North Shore Hospital Anaesthetics Department saved >$100,000 and reduced their carbon footprint by shifting to clinically equivalent alternatives.
  • Reduce unnecessary tests and procedures: In 2020 Shellharbour Hospital saved $400,000 in pathology costs by reducing unnecessary blood test ordering.
  • Review routine testing: Royal North Shore Hospital ICU reduced inappropriate arterial bloods gas testing by >70% with no change in patient outcomes, resulting in an annual saving of 100L blood and $770,000.
  • Reduce business travel: In one example, attending an international conference is 192 tCO 2 e, whereas a virtual conference is 4 tCO 2 . Virtual conferences also save flights, accommodation and incidental costs.
  • Offer telehealth for outpatient appointments whenever appropriate: This is more accessible and less costly for patients, and also saves transport emissions.
  • Reduce admissions, reduce emissions: Health promotion and public health activities to keep people healthy, well and independent in our communities improves health, saves money and saves carbon.

Find out more about NSW Health's sustainability initiatives.

Position descriptions

Across NSW Health, Sustainability Officers are appointed to lead their organisation in making NSW Health more sustainable.

Download example position descriptions: SESLHD - Environmental Sustainability Project Officer and Northern NSW LHD - Environmentally Sustainable Manager.

Training and education opportunities 

The Climate Risk and Net Zero Unit will coordinate and scale up NSW Health's response, including prioritising staff engagement, education and capability development.

We offer a number of training and education offerings for health professionals delivered in partnership with educational institutions, professional bodies and other government agencies, including:

  • Carbon Footprinting
    The Centre for Sustainable Healthcare is an internationally recognised institution for sustainable healthcare research and practice, delivering a number of courses including a Carbon Footprinting for Healthcare course to help health professionals become carbon literate.
  • Board-level Net Zero Leadership Training
    The Centre for Sustainable Healthcare is an internationally recognised institution for sustainable healthcare research and practice, delivering a Board-level Net Zero Leadership Training to support net zero reform, sustainability engagement and role accountability across board-level leadership.
  • Climate Risk Ready
    The NSW Government in partnership with Western Sydney University delivers a Climate Risk Ready training program in climate change risk assessment and management. The training aims to embed consideration of climate change risk into NSW government decision making and increase NSW government preparedness to respond to the increasing impacts of climate change.

Current as at: Friday 9 September 2022
Contact page owner: System Purchasing