Designing sustainable and equitable interventions across NHS Scotland

This paper describes ongoing research under the project entitled Design HOPES (Healthy Organisations in a Place-based Ecosystem, Scotland), which focuses on translating the best design-led research into sustainable and equitable real-world benefits across NHS Scotland. Health and social care systems across the world face unprecedented challenges compounded by the most significant threat face by mankind in this 21st century: the climate crisis. The effects of climate change on health will affect most populations in the next decades and put the lives and health and wellbeing of billions of people all over the world at increased risk (Costello et al., 2009). To put this into perspective, if healthcare were a country, it would be the fifth-largest emitter of greenhouse gases on the planet . The carbon footprint for healthcare is equal to the emissions of 514 coal-fired power plants, equivalent to 4.4% of global net emissions. Ignoring the climate emergency will severely disrupt care, with poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer (NHS England and NHS Improvement, 2021). At the same time, many of the actions to mitigate and adapt to climate change and improve environmental sustainability also have positive health benefits to such an extent that the Lancet Commission has described tackling climate change as “the greatest global health opportunity of the 21st century” (Wang and Horton, 2015).