Evidence map›Paper›PMID 33581070›Full record

ArticleThe Lancet. Planetary health2021

Health care's response to climate change: a carbon footprint assessment of the NHS in England.

Imogen Tennison, Sonia Roschnik, Ben Ashby, Richard Boyd, Ian Hamilton, Tadj Oreszczyn, Anne Owen, Marina Romanello, Paul Ruyssevelt, Jodi D Sherman and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Planetary health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 339 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
339citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

339 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  15. Call to Action: A Sustainable Interventional Radiology Service.Cardiovascular and interventional radiology · 2026
    Review
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279 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Imogen TennisonNHS England & NHS Improvement, London, UK.
Sonia RoschnikNHS England & NHS Improvement, London, UK.
Ben AshbyArup Group, London, UK.
Richard BoydArup Group, London, UK.
Ian HamiltonUCL Energy Institute, University College London, London, UK.
Tadj OreszczynUCL Energy Institute, University College London, London, UK.
Anne OwenSchool of Earth and Environment, University of Leeds, Leeds, UK.
Marina RomanelloInstitute for Global Health, University College London, London, UK.
Paul RuysseveltUCL Energy Institute, University College London, London, UK.
Jodi D ShermanDepartment of Anesthesiology, Yale University, New Haven, CT, USA.
Andrew Z P SmithUCL Energy Institute, University College London, London, UK.
Kristian SteeleArup Group, London, UK.
Nicholas WattsInstitute for Global Health, University College London, London, UK.
Matthew J EckelmanDepartment of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA. Electronic address: m.eckelman@northeastern.edu.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863Wellcome Trust 209734/Z/17/Z
6 · The paper itself

Abstract

backgroundClimate change threatens to undermine the past 50 years of gains in public health. In response, the National Health Service (NHS) in England has been working since 2008 to quantify and reduce its carbon footprint. This Article presents the latest update to its greenhouse gas accounting, identifying interventions for mitigation efforts and describing an approach applicable to other health systems across the world.

methodsA hybrid model was used to quantify emissions within Scopes 1, 2, and 3 of the Greenhouse Gas Protocol, as well as patient and visitor travel emissions, from 1990 to 2019. This approach complements the broad coverage of top-down economic modelling with the high accuracy of bottom-up data wherever available. Available data were backcasted or forecasted to cover all years. To enable the identification of measures to reduce carbon emissions, results were disaggregated by organisation type.

findingsIn 2019, the health service's emissions totalled 25 megatonnes of carbon dioxide equivalent, a reduction of 26% since 1990, and a decrease of 64% in the emissions per inpatient finished admission episode. Of the 2019 footprint, 62% came from the supply chain, 24% from the direct delivery of care, 10% from staff commute and patient and visitor travel, and 4% from private health and care services commissioned by the NHS.

interpretationThis work represents the longest and most comprehensive accounting of national health-care emissions globally, and underscores the importance of incorporating bottom-up data to improve the accuracy of top-down modelling and enabling detailed monitoring of progress as health systems act to reduce emissions.

fundingWellcome Trust.

Indexed as

Climate ChangeCarbon DioxideCarbon FootprintDelivery of Health CareEnglandGreenhouse GasesHealth Care SectorHumansState MedicineTransportationCarbon DioxideGreenhouse Gases

Identifiers

PMID33581070
PMCPMC7887664

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.