NHS Scotland - climate emergency and sustainability: annual report 2021 to 2022

Report for 2021 to 2022 providing information on; greenhouse gas emissions arising from the operations of NHS Scotland, actions which have been taken or are underway to reduce NHS Scotland’s greenhouse gas emissions and environmental impact, and actions to adapt to climate change.


Annex - National Sustainability Assessment Scores

Table 1: National Sustainability Assessment Tool Scores, 2021/22, Source: NHS National Services Scotland
NHS Board1 2020/21 Score (%) 2021/22 Score (%)
NHS Ayrshire & Arran 71% 55%
NHS Borders 32% 15%
NHS Dumfries & Galloway 29% 39%
NHS Fife 59% 39%
NHS Forth Valley 48% 56%
NHS Grampian 41% 50%
NHS Greater Glasgow & Clyde 39% 48%
NHS Highland 30% 48%
NHS Lanarkshire 57% 67%
NHS Lothian 67% 68%
NHS Orkney 77% 76%
NHS Shetland 49% 52%
NHS Tayside 52% 41%
NHS Western Isles 63% 30%
NHS Golden Jubilee 32% 22%
The State Hospital 30% 15%
Public Health Scotland - 18%
Healthcare Improvement Scotland 40% 49%
NHS National Education Scotland 51% 55%
NHS National Services Scotland 57% 67%
NHS 24 45% 47%
Scottish Ambulance Service 52% 25%

1) Health Boards highlighted in green had their 2020/21 scores reviewed. The remaining Health Boards opted for self-assessment in 2020/21 and had their 2021/22 scores reviewed.

Building Energy Emissions

Table 2 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2016/17 2017/18 2018/19 2019/20 2020/21 2021/22 Change 15/16 to 21/22
Building fossil fuel use emissions 310,944 296,808 319,482 300,682 321,266 323,097 313,164 + 0.7%
District heat networks and biomass emissions 9,045 7,693 3,975 3,233 3,734 3,212 3,196 -65%
Electricity emissions – generation, transmission, distribution 271,301 231,391 185,420 144,723 126,089 114,184 105,824 -61%
Total 591,290 535,892 508,877 448,638 451,089 440,493 422,184 -29%

NHS Greater Glasgow and Clyde

Table 3 - Building Energy Use Emissions ( tCO2e)
Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 78,153 74,167 -5.1%
District heat networks and biomass emissions 5,559 16 -99.7%
Electricity emissions 83,061 31,571 -62.0%
Totals 166,773 105,754 -36.6%

NHS Lothian

Table 4 - Building Energy Use Emissions ( tCO2e)
Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 46,878 48,484 3.4%
District heat networks and biomass emissions 0 72
Electricity emissions 41,755 17,635 -57.8%
Totals 88,633 66,191 -25.3%

NHS Grampian

Table 5 - Building Energy Use Emissions ( tCO2e)
Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 43,083 44,983 4.4%
District heat networks and biomass emissions 1,444 484 -66.5%
Electricity emissions 22,740 6,030 -73.5%
Totals 67,267 51,496 -23.4%

NHS Tayside

Table 6 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 32,179 39,314 22.2%
District heat networks and biomass emissions 0 0
Electricity emissions 23,358 4,564 -80.5%
Totals 55,537 43,878 -21.0%

NHS Lanarkshire

Table 7 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 18,820 18,458 -1.9%
District heat networks and biomass emissions 0 0
Electricity emissions 16,975 7,346 -56.7%
Totals 35,795 25,804 -27.9%

NHS Highland

Table 8 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 21,718 20,391 -6.1%
District heat networks and biomass emissions 650 975 49.9%
Electricity emissions 13,645 6,232 -54.3%
Totals 36,013 27,598 -23.4%

NHS Ayrshire and Arran

Table 9 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 14,848 13,994 -5.8%
District heat networks and biomass emissions 445 512 15.2%
Electricity emissions 14,685 6,067 -58.7%
Totals 29,977 20,573 -31.4%

NHS Fife

Table 10 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 16,027 14,899 -7.0%
District heat networks and biomass emissions 368 167 -54.6%
Electricity emissions 11,969 5,329 -55.5%
Totals 28,364 20,395 -28.1%

NHS Forth Valley

Table 11 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 11,999 10,966 -8.6%
District heat networks and biomass emissions
Electricity emissions 12,340 5,467 -55.7%
Totals 24,339 16,433 -32.5%

NHS Dumfries and Galloway

Table 12 - Building Energy Use Emissions ( tCO2e), Source: NHS National Services Scotland - National Energy Management System
2015/16 2020/21 2021/22 Change, %
Building fossil fuel use emissions 7,399 11,453 54.8%
District heat networks and biomass emissions 193 145 -24.9%
Electricity emissions 6,274 3,024 -51.8%
Totals 13,865 14,623 5.5%

Medical Gases

Table 12 - N20 emissions (including Entonox) by Health Board, tCO2e, Source – Scottish Government
Health Board 2018/19 (baseline) 2020/21 2021/22
National Waiting Times Centre 192 315 91
NHS Ayrshire and Arran 1344 1480 1257
NHS Borders 632 489 548
NHS Dumfries and Galloway 722 500 565
NHS Fife 1493 1542 1465
NHS Forth Valley 1199 1188 1090
NHS Grampian 4112 3337 3985
NHS Greater Glasgow & Clyde 6448 5524 5065
NHS Highland 1191 885 1258
NHS Lanarkshire 2409 1943 2016
NHS Lothian 4608 4179 4272
NHS Orkney 90 69 109
NHS Shetland 114 75 100
NHS Tayside 2259 2237 2231
NHS Western Isles 127 111 202
Scottish Ambulance Service 1336 1133 1211
Total 28,274 25,009 25,466
Table 2: Volatile gas (desflurane, sevoflurane and isoflurane) emissions by Health Board, tCO2e
Health Board 2018/19 (baseline) 2020/21 2021/22
National Waiting Times Centre 23.9 19.4 22.1
NHS Ayrshire and Arran 569.2 104.8 77.6
NHS Borders 48.6 10.7 15.5
NHS Dumfries and Galloway 74.1 21.7 27.2
NHS Fife 123.4 55.8 49.9
NHS Forth Valley 171.1 38.2 40.9
NHS Grampian 1,014.60 209.2 222.3
NHS Greater Glasgow & Clyde 2,885.40 497.4 393.7
NHS Highland 154.4 35.9 43.3
NHS Lanarkshire 901.3 84.3 77.3
NHS Lothian 1,175.10 288.8 307.7
NHS Orkney 18.2 21.3 10
NHS Shetland 15.1 15.5 14
NHS Tayside 231.5 98.1 55.4
NHS Western Isles 17 0.9 8.7
Total 7,423.00 1,502.00 1,365.50
Desflurane emissions by Health Board, tCO2e, Source: Scottish Government
Health Board 2018/19 (baseline) 2020/21 2021/22
National Waiting Times Centre 5.4 6.3 5.4
NHS Ayrshire and Arran 508.2 78.6 34.8
NHS Borders 33 3.6 6.3
NHS Dumfries and Galloway 51.8 5.4 7.1
NHS Fife 67.9 25 8.9
NHS Forth Valley 115.2 8 0
NHS Grampian 896.6 145.6 151.8
NHS Greater Glasgow & Clyde 2,498.80 274.2 111.6
NHS Highland 100.9 0 0
NHS Lanarkshire 795.7 33.9 8.9
NHS Lothian 913.6 126.8 158.1
NHS Orkney 16.1 19.6 7.1
NHS Shetland 11.6 13.4 10.7
NHS Tayside 150 47.3 -5.4
NHS Western Isles 13.4 -0.9 5.4
Total 6,178.20 786.8 510.8
Negative numbers represent pharmacy returns
Piped Nitrous Oxide emissions by Health Boards, Source: Scottish Government
Health Board FY 18-19 FY 19-20 FY 20-21 FY 21-22
Golden Jubilee 180 130 290 -
NHS Ayrshire and Arran 538 558 699 542
NHS Borders 241 344 251 241
NHS Dumfries and Galloway 231 118 98 157
NHS Fife 188 316 393 217
NHS Forth Valley 246 447 197 64
NHS Grampian 1,601 1,687 981 1,310
NHS Greater Glasgow & Clyde 2,509 2,263 2,106 1,706
NHS Highland 359 364 251 403
NHS Lanarkshire 733 320 256 192
NHS Lothian 1,750 1,566 1,238 971
NHS Orkney 30 54 39
NHS Shetland 30 10 10 30
NHS Tayside 895 1,095 932 716
NHS Western Isles 59 113 64 128
Grand Total 9,586 9,385 7,764 6,717

Metered dose inhaler propellant

Emissions from MDI propellant prescribed and dispensed in primary care, Source – Scottish Government
Health Board 2018/19 2020/21 2021/22
NHS AYRSHIRE & ARRAN
MDI Total inhalers 341,496 321,008 331,386
CO2 Equivalent (tCO2e) 5,892 5,526 5,700
NHS BORDERS
MDI Total inhalers 106,595 106,784 108,238
CO2 Equivalent (tCO2e) 1,840 1,840 1863
NHS DUMFRIES & GALLOWAY
MDI Total inhalers 162,086 167,497 170,445
CO2 Equivalent (tCO2e) 2,885 2,961 3,002
NHS FIFE
MDI Total inhalers 308,573 315,323 335,584
CO2 Equivalent (tCO2e) 5,431 5,511 5,828
NHS FORTH VALLEY
MDI Total inhalers 214,866 222,993 235,084
CO2 Equivalent (tCO2e) 3,926 4,079 4,272
NHS GRAMPIAN
MDI Total inhalers 393,733 388,356 401,897
CO2 Equivalent (tCO2e) 7,380 7,377 7,626
NHS GREATER GLASGOW & CLYDE
MDI Total inhalers 1,059,467 1,063,050 1,101,702
CO2 Equivalent (tCO2e) 18,202 18,244 18,894
NHS HIGHLAND
MDI Total inhalers 251,466 238,109 239,913
CO2 Equivalent (tCO2e) 4,432 4,208 4,232
NHS LANARKSHIRE
MDI Total inhalers 560,124 570,072 589,763
CO2 Equivalent (tCO2e) 9,691 9,832 10,156
NHS LOTHIAN
MDI Total 705,366 684,477 697,476
CO2 Equivalent (tCO2e) 12,042 11,684 11,905
NHS ORKNEY
MDI Total 17,209 15,495 15,810
CO2 Equivalent (tCO2e) 319 297 304
NHS SHETLAND
MDI Total 19,407 18,297 18,810
CO2 Equivalent (tCO2e) 361 352 361
NHS TAYSIDE
MDI Total 386,520 376,492 391,383
CO2 Equivalent (tCO2e) 6,741 6,551 6,794
NHS WESTERN ISLES
MDI Total 22,594 22,862 23,747
CO2 Equivalent (tCO2e) 391 398 414
Annual Total CO2 Equivalent (kg) 79,535 78,860 81,351
Table 8: Emissions from MDI propellant prescribed and dispensed in secondary care, Source: Scottish Government
Health Board 2021/22
NHS AYRSHIRE & ARRAN
MDI Total inhalers 7,892
CO2 Equivalent (tCO2e) 135
NHS BORDERS
MDI Total inhalers 2334
CO2 Equivalent (tCO2e) 40
NHS DUMFRIES & GALLOWAY
MDI Total inhalers 3665
CO2 Equivalent (tCO2e) 63
NHS FIFE
MDI Total inhalers 7451
CO2 Equivalent (tCO2e) 128
NHS FORTH VALLEY
MDI Total inhalers 6483
CO2 Equivalent (tCO2e) 113
NHS GRAMPIAN
MDI Total inhalers 7003
CO2 Equivalent (tCO2e) 124
NHS GREATER GLASGOW & CLYDE
MDI Total inhalers 38899
CO2 Equivalent (tCO2e) 664
NHS HIGHLAND
MDI Total inhalers 4359
CO2 Equivalent (tCO2e) 75
NHS LANARKSHIRE
MDI Total inhalers 14208
CO2 Equivalent (tCO2e) 244
NHS LOTHIAN
MDI Total 21887
CO2 Equivalent (tCO2e) 373
NHS ORKNEY
MDI Total 265
CO2 Equivalent (tCO2e) 4.7
NHS SHETLAND
MDI Total 298
CO2 Equivalent (tCO2e) 5.2
NHS TAYSIDE
MDI Total 10082
CO2 Equivalent (tCO2e) 173
NHS WESTERN ISLES
MDI Total 465
CO2 Equivalent (tCO2e) 7.9
STATE HOSPITAL
MDI Total 203
CO2 Equivalent (tCO2e) 3.5
GOLDEN JUBILEE
MDI Total 526
CO2 Equivalent (tCO2e) 9
Annual Total CO2 Equivalent (kg) 2,162

Travel and Transport

Table 5 – Health Board fleet greenhouse gas emissions, Source – Health Board Annual Climate Emergency and Sustainability Reports 2021/22
Amount of greenhouse gas (Tco2E) Percentage change since 2019/20
Health Board 2019/20 2020/21 2021/22
Ayrshire and Arran 797 665 712 -10.66%
Borders 220 265 248 13.08%
Dumfries and Galloway 321 275 317 -1.00%
Fife - - - -
Forth Valley 379 453 296 -21.79%
Grampian 1026 941 1084 5.69%
Greater Glasgow and Clyde - 4,628 1,365 -
Highland - - - -
Lanarkshire 756 739 600 -20.63%
Lothian - 1402 1327 -
Orkney 66 67 46 -30.87%
Shetland - - - -
Tayside 769 754 767 -0.35%
Western Isles - - - -
State Hospital - 8 19 -
Scottish Ambulance Service 20,557 17,956 19,791 -3.73%
Health Improvement Scotland 20 N/A - offices closed Fleet reduced to zero -100%
Golden Jubilee - - - -
NHS 24 12 - - -
National Services Scotland 1583.6 1585.6 1737 9.69%
Public Health Scotland n/a n/a n/a -
National Education Scotland n/a n/a n/a -
Table 6 – Health Board business travel greenhouse gas emissions, Source: Health Board Annual Climate Emergency and Sustainability Reports
Amount of greenhouse gas (tonnes of CO2 equivalent) Percentage change since 2019/20
Health Board 2019/20 2020/21 2021/22
Ayrshire and Arran 1,886 870 1,182 -37.33%
Borders 586.33 358.35 376.05 -35.86%
Dumfries and Galloway 713.7 458 485.4 -31.99%
Fife - - -
Forth Valley 601.7 419.8 438.5 -27.12%
Grampian - - - -
Greater Glasgow and Clyde - - 2873.2 -
Highland - - - -
Lanarkshire - - - -
Lothian - 1172 1334 -
Orkney - - - -
Shetland - - - -
Tayside - - 877.8 -
Western Isles - - - -
State Hospital - - -
Scottish Ambulance Service 637 473 363 -43.01%
Health Improvement Scotland 132 - -
Golden Jubilee - - -
NHS 24 118 - -
National Services Scotland 974 98.5 148 -84.80%
Public Health Scotland Not applicable – organisation formed April 2020 2.9 5.1
National Education Scotland 163.4 17.7 23.9 -85.37%
Composition of NHS Fleet by Health Board, October 2022, Source: NHS National Services Scotland (National Fleet Management System), NHS Ayrshire and Arran, Scottish Ambulance Service
Health Board Class EV Fossil Fuel/Hybrid Total % EV
Ayrshire & Arran Cars 10 203 213 5%
Light Commercial Vehicles 8 98 106 8%
Heavy Vehicles 0 2 2 0%
Borders Cars 11 19 30 37%
Light Commercial Vehicles 6 33 39 15%
Heavy Vehicles 0 1 1 0%
Dumfries & Galloway Cars 1 91 92 1%
Light Commercial Vehicles 2 33 35 6%
Heavy Vehicles 0 1 1 0%
Fife Cars 4 47 51 8%
Light Commercial Vehicles 24 48 72 33%
Heavy Vehicles 0 0 0 0%
Forth Valley Cars 18 40 58 31%
Light Commercial Vehicles 25 50 65 38%
Heavy Vehicles 0 0 0 0%
Grampian Cars 2 173 175 1%
Light Commercial Vehicles 5 104 109 5%
Heavy Vehicles 0 18 18 0%
Greater Glasgow & Clyde Cars 31 94 125 25%
Light Commercial Vehicles 64 313 377 17%
Heavy Vehicles 5 94 99 5%
Highland Cars 43 346 389 11%
Light Commercial Vehicles 9 219 228 4%
Heavy Vehicles 0 3 3 0%
Lanarkshire Cars 0 11 11 0%
Light Commercial Vehicles 15 42 57 26%
Heavy Vehicles 0 9 9 0%
Lothian Cars 104 256 360 29%
Light Commercial Vehicles 56 109 165 34%
Heavy Vehicles 0 29 29 0%
National Services Scotland Cars 0 21 21 0%
Light Commercial Vehicles 3 40 43 7%
Heavy Vehicles 0 14 14 0%
Scottish Ambulance Service Cars 61 158 219 28%
Light Commercial Vehicles 42 243 285 15%
Heavy Vehicles 0 868 868 0%
Motorbikes 0 3 3 0%
Shetland Cars 11 33 44 25%
Light Commercial Vehicles 6 11 17 35%
Heavy Vehicles 0 0 0 0%
State Hospital Cars 1 0 1 100%
Light Commercial Vehicles 2 5 7 29%
Heavy Vehicles 0 0 0 0%
Tayside Cars 65 61 126 52%
Light Commercial Vehicles 22 51 73 30%
Heavy Vehicles 1 15 16 6%
Orkney Cars 14 17 31 45%
Light Commercial Vehicles 5 0 5 100%
Heavy Vehicles 0 0 0 0%
Western Isles* Cars N/A N/A N/A N/A
Light Commercial Vehicles N/A N/A N/A N/A
Heavy Vehicles N/A N/A N/A N/A
Total Cars 366 1577 1943 19%
Light Commercial Vehicles 273 1411 1684 16%
Heavy Vehicles 6 1054 1060 1%
Motorbikes 0 3 3 0%
Table 8: Bike Use in NHS Scotland Health Boards as at December 2022, Data from Sustrans Workplace Engagement Programme and Board returns from the NHS Scotland Sustainability Assessment Tool (except Ayrshire and Arran; Borders; Tayside; Western Isles)
Health Board Bikes on personal loan to staff Pool bikes Cargo bikes Bikes for Patient Use
Dumfries and Galloway 27 14 1
Grampian Bike initiative in place 35
Highland 13 3
Shetland 14
Lanarkshire 68 Bikes provided (quantity not available)
Greater Glasgow and Clyde Bike initiative in place
Forth Valley Bike initiative in place Bike initiative in place
Lothian 24
Fife Bike initiative in place
Orkney Bikes provided (quantity not available)
NHS Tayside 12
Table 9 – NHS Greenhouse gas emissions from waste disposal, Source: Health Board Annual Climate Emergency and Sustainability Report 2021/22
Amount of greenhouse gas (tonnes of CO2 equivalent) Percentage change since 2019/20
Health Board 2019/20 2020/21 2021/22
State Hospital 38 44 37 -1.58%
Scottish Ambulance Service 13 22 24 84.62%
Health Improvement Scotland 6 Not applicable – Offices closed - -
Golden Jubilee - - - -
NHS 24 11 - - -
National Services Scotland 28 31 47 71.01%
Public Health Scotland Not applicable – formed April 2020 - - -
National Education Scotland - - - -
Ayrshire and Arran 325 389 384 18.15%
Borders - 27. 37 -
Dumfries and Galloway 235 200 176 -25.37%
Fife - 715 847 -
Forth Valley 271 650 233 -13.95%
Grampian 590 624 545 -7.72%
Greater Glasgow and Clyde 148 351 1766 1095.60%
Highland - - - -
Lanarkshire 54 51 652 1107.78%
Lothian - - 892 -
Orkney 48 39 42 -12.42%
Shetland - - - -
Tayside 1242 188 557 -55.13%
Western Isles (clinical waste only) - 2 1 -

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