The UK Health Alliance on Climate Change has responded to the NHS Scotland Climate Emergency and Sustainability Draft Strategy 2022-2026.

The climate crisis is already resulting in negative health impacts as a consequence of extreme weather, polluted air, food and water shortages, forced migration, and the aggravation of disease. We must do all we can to ensure the health and care services that people turn to during ill health, is not one of the major contributing factors to that ill health.

We strongly welcome the recognition in the draft strategy of the clear link between climate change and public health and agree that it is the right direction of travel for Scotland with the core ambition of delivering a sustainable service that enhances wellbeing and reduces health inequalities.

We have also welcomed the commitment to reduce transport emissions linked to hospital and care services. Access to more localised services and better integration of care will be critical in achieving this. The link between the National Health Service and new National Care Service, along with sufficient workforce resource to deliver these services will be essential to enable success.

The supply chain and excessive consumption and waste of materials are of significant concern in terms of the NHS Scotland carbon footprint. The ambition to embrace a circular economy focused on reduce, re-use and recycle is welcome and may benefit from putting in place fixed terms on suppliers in what NHS Scotland expects from them in relation to their carbon emissions.

Engaging with people – communities, patients, and staff will be critical to the success of climate mitigation and adaptation in NHS Scotland. A communications and engagement strategy that sets the expectations of the healthcare workforce, patients and visitors of the way in which the service operates, and how and why it will transform to enable more sustainable practices, new modes of consultation, and in how they travel to and from their hospitals will be critical to its success.

We believe the need for a sustainable approach needs to be embedded into all aspects of the delivery of care, not as an add-on to existing practice. We believe it is important that dedicated resource is put in place to ensure a strategic leadership framework of individuals driving this forward will give it the best chance of success. Staff across NHS Scotland are already stretched with workforce shortages across the system an ongoing concern.  Strong government leadership will be essential to success with assurance that there is accountability to parliament with development of robust metrics to assess performance.

The response has been supported by the Scottish Academy of Medical Royal Colleges and Faculties, Royal College of Physicians of Edinburgh, Royal College of Physicians and Surgeons of Glasgow, and Royal College of Surgeons of Edinburgh.