Sustainable services

In this section we discuss some of the ways in which the health care system of the future is likely to be affected by changes to the natural environment and – equally importantly – by social and political responses to the threats posed by these changes.

In this section

Key messages

  • There is increasing pressure for health services to be delivered in ways that are environmentally sustainable
    This will require action in terms of both mitigation (carbon reduction) and adaptation to climate change. Concerns around sustainability will play a growing role in shaping the future of health services.
  • Carbon reduction targets will challenge all sectors of the economy, including health care
    The UK as a whole has committed to dramatic reductions in greenhouse gas emissions – by 34% by 2020, and by 80% by 2050.
  • The scale of the challenge suggests that a fundamental transformation in service models will be needed
    Although some improvement can be made by increasing efficiency at the operational level (for example, through use of energy-efficient technologies) this alone is unlikely to be sufficient.
  • There are close connections between environmental sustainability and other system goals
    For example, both the sustainability and productivity agendas imply the need for a renewed focus on cost-effectiveness, value and prevention of avoidable activity. Environmental sustainability represents an additional impetus for making changes already advocated for on financial and quality grounds.
  • The current policy framework creates a number of barriers
    These barriers discourage organisations from developing more sustainable approaches at the local level. Policy-makers will need to make changes to create a more enabling environment, and explore how existing policies can be delivered in the most sustainable way.
  • Over time it is likely that sustainability will be seen as an essential dimension of quality
    Sustainability is likely to become a core value akin to equity or accessibility, with mechanisms to monitor and hold the system to account for its environmental performance.

Key uncertainties

It is highly likely that pressure for health services to be delivered in a sustainable way will increase over time. However, the scale and pace at which this will happen is not clear. It will depend on a number of factors, including:

  • the speed at which environmental changes take place
  • social and political responses to the threat (and reality) of environmental changes
  • the extent to which a business case for environmentally sustainable health services can be constructed, in terms of financial savings and/or health gains.

There is also uncertainty regarding the potential direct health impacts of moving towards a low-carbon society and of climate change itself (for more see our broader determinants of health section).

Next page: Low carbon health care >