The Royal College of Physicians has published updated guidance to help doctors deliver more sustainable care, responding to growing concern among clinicians about the impact of climate change on patient health.
A recent RCP member survey found that 75% of 490 physicians were worried about the effects of climate change on health, while 69% expressed concern about the environmental impact of clinical practice.
The updated Green Physician Toolkit, developed by a multidisciplinary working group including clinicians, academics and patient representatives, sets out practical actions for reducing healthcare’s environmental footprint. Recommendations include:
- Prescribing lower-carbon medicines such as dry powder inhalers, reusable insulin pens and oral medications where clinically appropriate.
- Optimising medicines use through routine medication reviews and appropriate deprescribing.
- Delivering more efficient care via same-day services, integrated multispecialty clinics and streamlined pathways.
- Adapting care plans to account for environmental risks, such as adjusting heat-sensitive medications or incorporating air quality alerts for respiratory patients.
- Supporting prevention and healthier living, offering tailored advice on diet, exercise, smoking cessation and signposting to relevant services.
The toolkit also features real-world examples from clinicians leading the way, from promoting reusable insulin pens to adapting care plans during heatwaves. It consolidates evidence on the health impacts of the climate crisis, which doctors are already witnessing – including 10,781 excess deaths in England from heatwaves between 2020 and 2024.
The NHS contributes around 40% of public sector emissions, exacerbating risks such as extreme heat and air pollution. The RCP welcomed the 10 Year Health Plan commitment for the NHS to achieve net zero by 2040 for direct emissions and by 2045 for indirect emissions.
However, the RCP warns that clinicians need time, training and organisational support to embed sustainability into everyday practice. While 61% of surveyed doctors already consider environmental impact in clinical decisions, others cited lack of time and awareness as barriers.
The RCP’s special adviser on healthcare sustainability and climate change, Dr Mark Harber, said:
“Doctors are deeply concerned about how climate change is affecting their patients and the nation’s health. This toolkit equips physicians with simple, practical steps to improve patient outcomes and reduce the environmental impact of healthcare. Even under high clinical demand, prioritising sustainable care now will ultimately reduce future strain on the NHS.
“What physicians need is adequate time, resources, as well as backing from system leaders to make sustainable healthcare a reality. Without this support, clinicians cannot contribute to delivering the net zero ambitions for the NHS set out in the 10 Year Health Plan. Sustainable healthcare to protect patients from the growing health harms of climate change must be recognised as an integral part of good medicine – not an added extra.”
The RCP is urging NHS England, DHSC, and integrated care boards to make sustainability a core part of good clinical practice, ensuring doctors can play their part in tackling the climate crisis.
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