We find that the NHS must transform itself into an efficient, low-carbon operation in order to provide the best quality healthcare. It emits 18 million tonnes of CO2 each year - the largest carbon footprint of any public service provider in Europe – and high carbon prices will squeeze its budgets unless it changes its practices.

But the NHS also has a key leadership role to play in creating a more sustainable society. Its massive size and reach mean that it can have a great influence on society as it transforms itself into a low-carbon service

Fit for the Future sets out four scenarios for the healthcare system in England in 2030 and makes recommendations to guide development of the NHS. The report marks the first time the NHS has studied the long-term measures required to maintain a quality health service in the face of climate change.

How the NHS will use the report

Commenting on the report, the Chief Executive of the NHS David Nicholson said “Faced with the real environmental challenge of climate change, the NHS is determined to provide the best healthcare in a sustainable way which reduces our carbon footprint. We are sending Fit for the Future to every NHS organisation, to help us turn our commitment to delivering sustainable healthcare into real action.”

Fit for the Future offers a set of robust scenarios which managers and clinicians can use to test strategy. Its recommendations include radically increasing the amount spent on the prevention of disease, promoting low-carbon living to make people healthier and happier, helping people take greater responsibility for their own health, and making greater use of information technology.

Scenarios for 2030

We were asked by the NHS Sustainable Development Unit  to develop a set of scenarios for healthcare in England in 2030. Although each is radically different, there are common strategic implications across all the worlds, which form the basis of our recommendations.

We took our Climate Futures scenarios as a starting point, which look at the social, political, economic and psychological consequences of climate change, and interviewed prominent health thinkers to understand their implications for health in the UK.

We also performed desk research to assess the current trends in health issues and healthcare from around the world.  We brought the findings from this research and the interviews to two workshops with healthcare professionals from across different fields (such as NHS trusts, a patient association, and the Department of Health) to develop and adapt the scenarios.

Fit for the Future illustrates the scenarios with storyboards showing how a diabetic would access treatment and support for their condition in each of the worlds.  These help the reader to directly compare some of the implications of each world. 

For further information, contact Helen Clarkson

Watch a video of the Fit for the Future launch event here

Media coverage

Fit for the Future? - National Health Executive, April 2011

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