When I talk about the NHS and climate change, I’m used to a variety of responses. They normally run from “well they’ll have to treat malaria in the future won’t they?” to a baffled “what’s one got to do with the other?”

But consider the figures. The NHS employs approximately 1.3 million people and last year GPs held 300 million consultations. Its direct and indirect emissions add up to 18 million tonnes a year – about 3% of the UK’s total – the biggest carbon footprint of any public sector organisation in Europe.

The NHS has to form a major part of any plan to reduce our carbon emissions. But the sheer size and reach of the service means it has the potential to play a catalytic role in the UK’s transition to a more sustainable society.

So we were thrilled to be appointed by the NHS Sustainable Development Unit to help them understand that potential. In our joint report Fit for the Future we’ve shown how a low-carbon NHS can deliver better healthcare in the future.

We’ve looked at the social, political and economic responses to climate change that we might see over the next 20 years and the impacts that these will have on our health and the types of healthcare provision available to us. The report presents four scenarios describing radically different worlds in which the NHS might operate.

Looking across these worlds some clear messages emerge. The first is that far from the radical, robotic, high-tech future of healthcare that is presented by Hollywood, the realities of carbon pricing mean that money available to spend on healthcare is likely to get tighter and high-end treatment regimes are unlikely to be affordable. We need to start seeing a radical shift towards preventing illness rather than treating sickness, and this means a serious increase in the proportion of the NHS budget that is spent on prevention. 

We also need to see the NHS, and other public service providers, equipping people with the knowledge they need to take more responsibility for their own health, as we see them doing in most of the scenarios.

We strongly believe that this isn’t necessarily bad news. By focusing on our wellbeing and leading more sustainable lifestyles we can find the low-carbon/high quality-of-life sweet spot. That’s something not just for the NHS to consider but other organisations in the public sector, and all of us as individuals.

So, yes, we may see malaria return to our shores. But when it comes to climate change it’s the societal impacts that pose the real challenge. The NHS is uniquely positioned to play a leading role in shaping a more sustainable future for us all.

Further information is available here.