One-fifth of NHS Trusts Lack Plans to Reach Net-Zero

NHS net zero plans and why recent findings matter for the wider business community

New research has found that around one fifth of NHS Trusts in England still lack a long term plan to reach net zero. Some also do not have basic systems in place to measure their emissions. This comes despite the NHS making repeated public commitments and clear progress since 2020.

For many business owners, this may seem like an internal issue for the health service. However, the NHS is the UK’s largest public sector organisation and one of its biggest buyers of goods and services. What it does sets expectations for thousands of suppliers, many of them small and medium sized businesses.

The NHS spends tens of billions of pounds each year on estates, energy, clinical supplies, logistics, food, IT, and professional services. Its approach to carbon reporting and net zero delivery shapes tender rules, contract terms, and reporting requirements. As a result, gaps in NHS planning create uncertainty across supply chains.

At the same time, progress within most Trusts shows how fast standards are rising. Board level accountability, mandatory reporting, and clear interim targets are now normal in much of the NHS. That direction of travel is unlikely to reverse, even if some organisations are behind.

This article explains what the research found, how it fits with the NHS’s formal net zero commitments, and why it matters to UK businesses that sell to or work with the health sector.

The NHS commitment to net zero and how it is meant to work in practice

The NHS first set out its net zero ambition in 2020. It committed to becoming the world’s first net zero national health service. This ambition was later embedded in law through the Health and Care Act 2022, which gave the targets added weight and permanence.

Two separate targets sit behind the headline commitment. The first covers emissions the NHS controls directly. This includes its buildings, vehicles, energy use, and anaesthetic gases. For these emissions, the NHS aims to reach net zero by 2040. It also set an interim target of an 80 percent reduction by the period from 2028 to 2032, using 1990 as the baseline.

The second target covers emissions the NHS can influence rather than control directly. This includes most of its supply chain, commissioned services, staff commuting, and patient travel. These emissions make up the largest share of the NHS carbon footprint. The target here is net zero by 2045, with an 80 percent reduction by the period from 2036 to 2039.

To deliver this, NHS England requires every Trust and Integrated Care System to appoint a board level Net Zero Lead. Each organisation must maintain a Green Plan that sets out how it will cut emissions, manage climate risks, and report progress. These plans follow central guidance issued by NHS England, with the most recent update published in 2024.

Trusts must also report data to the Greener NHS team on a quarterly basis. This includes energy use, emissions, and progress against key actions. Some early national requirements were introduced quickly, such as a move to 100 percent renewable electricity in April 2021 where possible.

In parallel, the NHS began pushing its suppliers to disclose emissions and set their own net zero targets. Around 500 of the NHS’s largest suppliers were asked to report emissions data in the early stages. The intention was to use buying power to drive change well beyond the organisation itself.

What the latest research says about planning and measurement gaps

The recent findings come from research published by Schneider Electric in February 2026. The research reviewed the state of net zero planning and data maturity across NHS Trusts in England.

It found that while many Trusts have made tangible progress, around 20 percent still lack a long term climate roadmap. Some also do not have systems in place to measure carbon emissions in a consistent and reliable way. Without these basics, it is difficult for those Trusts to plan investments or track improvement.

According to the research, this gap presents a clear risk to the NHS achieving its 2040 and 2045 targets. Even if most organisations are on track, a significant minority falling behind can slow overall progress. In a system as interconnected as the NHS, weaker performance in one area can affect others.

The timing of the research is notable. It comes six years after the original net zero commitment and four years after the targets were written into legislation. By this stage, expectations from NHS England are clear and well established.

The research does not suggest a lack of effort across the system. Instead, it points to uneven capacity, competing operational pressures, and differences in access to skills and capital. Some Trusts have benefited from strong estates teams and successful funding bids. Others have struggled to move beyond short term fixes.

Schneider Electric summarised the position by saying that Trusts are making tangible progress overall, but that critical gaps remain. Those gaps sit mainly around long term planning and robust data, rather than a lack of awareness or intent.

Funding, targets, and examples of progress across the NHS

Alongside the gaps, there is clear evidence of progress across much of the NHS estate. Since 2020, more than £1.4 billion of capital funding has been allocated through the Public Sector Decarbonisation Scheme. This funding supports energy efficiency, low carbon heating, and on site renewables.

According to government data, this funding has supported over 100 NHS related projects. Together, they have cut emissions by more than 125 kilotonnes of carbon dioxide equivalent. Many projects have also reduced energy bills, which is increasingly important given high and volatile energy prices.

Some Trusts illustrate what structured action looks like in practice. West Suffolk NHS Foundation Trust, for example, has appointed a board level Net Zero Lead and built a network of Green Champions across departments. It has decommissioned nitrous oxide use where clinically appropriate and introduced reusable packaging for some supplies.

The Trust has also set out further plans, including heat decarbonisation, water efficiency measures, and adoption of net zero building standards by 2029. This shows how early actions can sit within a longer term framework.

University Hospitals Birmingham has made multi million pound investments in decarbonisation projects across its estate. It has also expanded virtual care models and supported sustainable travel options for staff and patients. Its estates net zero strategy is due by March 2026, with Public Sector Decarbonisation Scheme projects completing later that year.

At system level, Lancashire and South Cumbria Integrated Care System has embedded sustainability into HR processes and developed a green champions network. It aims to train half of its staff on sustainability by 2027 and see 40 percent of GP practices operating under green plans.

Nationally, NHS England has stated that the service remains on track to achieve its interim target of an 80 percent reduction in direct emissions by 2032. Recent years have seen investments in solar panels, battery storage, and basic energy efficiency such as insulation and LED lighting.

These examples reflect what NHS England often describes as no regrets actions. They reduce emissions while also cutting running costs and improving working environments.

How NHS progress and gaps affect UK suppliers and contractors

For UK businesses, especially SMEs, the significance of this story lies in procurement and compliance. The NHS is increasingly explicit about its expectations of suppliers on carbon reporting and net zero alignment.

NHS England has stated that before the end of the decade it will no longer purchase from suppliers that do not meet or exceed its commitment to net zero. In practical terms, this means emissions data, reduction plans, and credible targets are becoming standard tender requirements.

When a Trust lacks a clear plan or data, it can create inconsistency in how these requirements are applied. One contract may ask for detailed Scope 1, 2, and 3 emissions, while another may barely mention them. This inconsistency can be frustrating for suppliers trying to invest sensibly.

However, the overall direction is clear. Most Trusts and Integrated Care Systems are tightening their expectations. Many now include supplier net zero key performance indicators in contracts, as encouraged by the latest Green Plan Guidance.

For SMEs, this has cost implications. Measuring emissions takes time and resource. Implementing reductions may involve capital spend or changes to operations. However, these efforts increasingly affect whether a bid is competitive, not just how green it appears.

There is also a risk dimension. Suppliers without basic carbon data may find themselves excluded from certain frameworks or filtered out early in procurement processes. This can happen quietly, without a clear explanation beyond failing to meet minimum requirements.

On the other hand, suppliers that invest early often find the process less painful over time. Once emissions data systems are in place, annual reporting becomes routine. Many then identify genuine cost savings through reduced energy use or waste.

The Schneider Electric research highlights that parts of the NHS still lack measurement systems. That should not be read as a signal to delay action. Instead, it suggests that when lagging Trusts catch up, requirements may tighten quickly to align with the rest of the system.

Links between NHS net zero delivery and wider commercial risk

Beyond procurement, NHS net zero performance has broader commercial implications. Energy costs are a clear example. Trusts that have invested in efficiency and on site generation have been better insulated from recent price shocks.

Those benefits are also relevant to suppliers operating on NHS sites or under long term facilities contracts. Where energy costs are shared or built into service pricing, efficiency measures can support more stable margins.

There is also a resilience angle. Climate risks such as heat, flooding, and supply disruption affect healthcare delivery directly. Trusts are encouraged to address these risks within their Green Plans. That, in turn, affects property standards, logistics planning, and service continuity expectations placed on contractors.

From a reputational perspective, the NHS remains one of the most trusted institutions in the UK. Businesses closely associated with it are increasingly expected to reflect similar standards on environmental responsibility. Failure to do so can carry brand risk beyond the value of any single contract.

It is also worth noting that NHS standards often influence other parts of the public sector. Local authorities and universities often look to NHS guidance when shaping their own procurement rules. As a result, aligning with NHS net zero expectations can have benefits beyond healthcare.

While current gaps within some Trusts may slow progress in places, they do not change this wider context. The legislative basis for NHS net zero remains in place, and central guidance continues to evolve.

Key points from the research and current NHS position

• Around 20 percent of NHS Trusts in England lack a long term net zero plan or consistent emissions measurement systems.
• The NHS is legally committed to net zero by 2040 for directly controlled emissions and by 2045 for emissions it can influence.
• All Trusts and Integrated Care Systems must appoint a board level Net Zero Lead and maintain a Green Plan.
• More than £1.4 billion has been invested through the Public Sector Decarbonisation Scheme, cutting emissions and energy costs.
• NHS England expects suppliers to align with its net zero commitment, with stricter procurement rules coming before 2030.
• Inconsistent planning within some Trusts creates short term uncertainty, but the overall direction of travel is clear.

What SMEs should be considering now based on NHS experience

From our work with SMEs, the NHS story offers several practical lessons. First, formal commitments tend to translate into operational requirements faster than many expect. Once targets are written into law and backed by central reporting, they rarely disappear.

Second, planning and measurement matter more than perfect performance. Many NHS Trusts that are seen as leaders did not start with low emissions. They started with clear plans, named responsibility, and basic data.

For SMEs working with the NHS, having a credible carbon footprint and reduction plan is becoming a minimum requirement. This does not mean a complex or expensive consultancy exercise at the outset. It does mean knowing your main sources of emissions and how they are likely to change.

Third, cost control and carbon reduction often align. The NHS examples of LED upgrades, insulation, and waste reduction show this clearly. Similar principles apply in most commercial settings.

Finally, uneven progress across the NHS should be treated as a warning, not a comfort. Organisations that are behind will face pressure to catch up. When they do, expectations on suppliers may tighten quickly.

At SBS, we see many SMEs leaving this work until a tender forces the issue. That often leads to rushed data gathering and reactive decisions. A steadier approach gives more control over cost and timing.

For businesses unsure where to start, our SBS support for carbon reporting compliance explains what is typically required. We also publish guidance on sustainability requirements in public sector tenders, including healthcare.

Authoritative sources for further detail and verification

Readers who want to explore the NHS position in more detail can refer to official guidance and published updates. The Greener NHS programme provides updates on policy, reporting, and case studies.

The government sets out funding and delivery mechanisms through schemes such as the Public Sector Decarbonisation Scheme. This includes details on past and current funding rounds.

Broader context on how the NHS approach fits into national policy can be found in the government’s net zero strategy and coverage by outlets such as BBC News climate reporting.

Together, these sources show a system that has made real progress but still faces practical delivery challenges. For UK businesses, the key message is preparation. The NHS direction of travel remains clear, even if progress is uneven.