Dr Matt Sawyer spent 17 years working in general practice but these days he works for what he describes as “human and planetary health” running the environmental sustainability consultancy SEE Sustainability from his North Yorkshire base.
Noting that humans are one part of the ecosystem of the natural world, the doctor has dedicated his work to helping the NHS reach its goal of being carbon neutral by 2045.
“The NHS was the first health system in the world to declare a net zero target. In October 2020 it launched the net zero ambition with timelines and said we want to be completely net zero by 2045. This is how we’re going to do it. This is our roadmap. They were absolutely ahead of the game.”
The NHS net zero challenge
It’s a mighty challenge. According to the BMA, the health service contributes around 4–5% of total UK carbon emissions and the NHS in England alone is responsible for 40% of the public sector’s emissions.
Sawyer works helping primary care providers (GPs, pharmacists, dentists and others) to identify and then act on reducing their carbon footprints. The work can take anything from a day or so of consultancy and training to many months of more in-depth work.
“It very much depends on what is being asked for. For some places it is a day or half a day, depending on what they want, but in other places, there’s some I’ve been working with for months, a year even.
“For example, north Lincolnshire, and Yorkshire wanted some more in-depth work doing and a guide producing for practices to be able to know the commonsense things that work.
“I think I’m more of an enabler. There’s a lot of practices that have already made a lot of differences.”
Due to the size of the NHS, every aspect of the change needed involves big numbers. Just looking at transport reveals an incredible 9.5 billion journeys A YEAR relate to patients, staff, deliveries and visitors.
Reducing air pollution
“We know that air pollution contributes to the deaths of between 30 and 40,000 people in the UK each year, so that’s a bit less than 10% of deaths in the UK have air pollution as a contributory factor and that is probably an underestimate.
“How can we reduce air pollution and help staff and help financially?”
Matt looked at the travel to one of the GP practices and found that four staff had slightly different start and finish times and were driving four separate cars into work each day. By tweaking their working hours, they were able to liftshare.
“Suddenly, instead of having four cars on the road, you had one car on the road with four people in it. Between them they were spending a quarter on petrol, they had more money in their pockets, the community was better off because there was a better air quality and staff morale went up because they were spending time with each and were friends outside of work. The planet got a benefit, the patients got the benefit and the staff got the benefit.”
Carbon-neutral babies
Small but impactful tweaks mean that everyone involved can play their part in the net zero journey, but some changes require structural effort. One of those has involved changing the equipment used to deliver gas and air to women in labour.
“Anaesthetic gases are particularly harmful to the environment and they are being decommissioned and phased out. Nitrous oxide (which is sometimes called laughing gas) being used in maternity, for example, for pain relief.”
The machine used to deliver nitrous oxide was previously allowing the gas being breathed out to enter the labour room and exposing midwives to high levels as well as releasing dangerous emissions to the environment.
“Now the tube that they hold and breathe in has got a one-way valve on it. So when they breathe out, it goes into a machine and it’s broken down into nitrogen and oxygen, so it’s not released. Air is 78% nitrogen 21% oxygen, so it’s just released as the gas that’s all around us. It means that patients get the same benefit, but not the planetary damage.”
This system led Newcastle hospital to declare the first carbon-neutral baby back in 2021
and now the system is commonplace.
Creating a ‘field of dreams’
As well as paying attention to supply chains and medical equipment, some premises have gone further by addressing their infrastructure.
Near Hull, the Castle Hill Hospital site in Cottingham was able to set up its own solar farm in a neighbouring field.
The project, which quickly became known as the ‘Field of Dreams’, saw 11,000 panels installed at a cost of £4.2mn in order that the Trust could begin to lower its carbon footprint and generate its own electricity. The hospital is now completely powered by solar in the summer months when sunlight days are longer.
“Now half of their total electricity is provided free over the field which means that the energy bills are lower. Financially, you realise that it’s a good move.”

Spreading the lessons far and wide
While Sawyer continues his work with individual health trusts or groups of GP practices, his ultimate aim is to get the knowledge out to the approximately 40,000 primary care practitioners in GP practices, opticians, dentists and other healthcare settings.
Co-authoring a book which can be circulated further afield is the next stage.
“It’s the recognition that actually, we can still have a very high quality of life, but we can do it in a less environmentally impactful way.”
This article was first published at The Northern Eco?