Carbon measurement in the NHS: Calculating the first consumption-based total carbon footprint of an NHS Trust.




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Peer reviewed


In January 2009 a national NHS England carbon reduction strategy (SDU, 2009a) was launched. It is believed to be the first public sector organisation worldwide to publish a carbon strategy based on the embedded emissions of all its activities: a consumption-based approach. The strategy sets a target for 2015 to reduce NHS England’s total consumption-based emissions from travel, building energy and procurement sectors to 10% below the 2007 level of 20.0MtCO2 (SEI and Arup, 2009a).

At the local level, NHS Trusts currently measure building energy emissions and in some cases staff travel emissions, but do not include procurement. This omission is important, as procurement is estimated to account for 60% of NHS England emissions. Therefore, as none of the NHS Trusts in England have undertaken a consumption-based footprint, they have no means of baselining all emissions and checking individual progress towards the national target. A gap therefore exists between NHS England targets and the measurement tools available at an NHS Trust level.

This research seeks to explore this gap. Firstly, the consumption-based carbon footprint of Cambridge University Hospitals NHS Foundation Trust was calculated, and determined to be 168,902tCO2 in 2007. A similar methodology was used to that developed for the NHS England carbon footprint study (SDC, 2008), except importantly bottom-up data was obtained directly from the NHS Trust. By reviewing the results, and comparing them to those for NHS England, the footprinting technique appears technically viable for use at an NHS Trust level.

Secondly, the applications and benefits of this technique were examined. At a Trust level, there are clear benefits in establishing and monitoring baseline emissions, and comparing progress to NHS England targets. In addition, wider use could accrue benefits via inter-Trust and regional NHS benchmarking.

Lastly, this technique could in future be applied to the development of ‘low carbon pathway’ models of care, by mapping carbon emissions to patient costing systems.


Paul Brockway of ARUP completed his MSc in ‘Climate Change and Sustainable Development’ at the Institute of Energy and Sustainable Development (IESD) in 2009, resulting in this dissertation. He is currently working with Leticia Ozawa-Meida at IESD ( or 0116 257 7962) on calculating the university’s carbon footprint. Paul is a Senior Sustainability Consultant at ARUP and can be contacted on 0191 261 6080 or .


energy, carbon, emissions, healthcare, hospital, NHS, trust, footprint, baseline, reduction, methodology, buildings, travel, procurement, waste


Brockway, P. (2009) Carbon measurement in the NHS: Calculating the first consumption-based total carbon footprint of an NHS Trust. Unpublished Thesis (MSc), De Montfort University.


Research Institute