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Author: Lisa Plotkin, FNF Head of Policy, on behalf of FNF Sustainability Subject Expert Group

Last week, most of the UK’s major political parties unveiled their manifestos. While the Florence Nightingale Foundation (FNF) scrutinised each one, our focus was also drawn to a different manifesto: the Manifesto by Nurses. Published by the Nursing Times, this manifesto addresses the critical issues that matter most to the nursing workforce, such as staff shortages, health inequalities, and the urgent need for social care reform. 

We were particularly pleased to see that the role of nurses in driving forward environmental sustainability made the cut as an issue of critical importance to the profession It’s easy to overlook, amidst the daily acute pressures, that climate change presents a ‘fundamental threat to human health’ and plays a major role in the development of communicable and non-communicable diseases – often disproportionately amongst global majority and deprived communities. That’s why combatting climate change is one of the UN’s Sustainable Development Goals, recognised as critical to reducing disease, poverty, insecurity, and injustice.  

But what can nurses do about any of this? Well, the NHS contributes around 4% of England’s total carbon footprint and 40% of all public sector emissions. As the largest clinical profession, nurses are essential to achieving the NHS’s net-zero goals and, in turn, helping the UK reduce its emissions overall.  


Nurses Leading the Sustainability Agenda 

The Manifesto by Nurses includes a call from FNF’s Sustainability Subject Expert Group (SEG) to enhance nursing capability in environmental sustainability. This involves integrating planetary health into nursing and midwifery curricula at all levels, from undergraduate to doctoral studies. Evidence from the USA suggests that this integrated approach is more effective than standalone courses, preparing future generations of nurses and midwives. Our SEG believes that this should be embedded in the Nursing and Midwifery Council (NMC) education standards as a core competency and included in the NMC code as a domain of practice. The Medical Schools Council has already endorsed a similar move for medical education. 

The inclusion of environmental sustainability in the Manifesto by Nurses and in the Chief Nursing Officer for England’s vision for the profession highlights a growing recognition of the importance of environmental health. This not only enhances patient care but also reconnects nurses with their passion for the profession.  


Healthcare sustainability in the political manifestos  

 So, how do the political party manifestos measure up when it comes to healthcare sustainability? Regarding the NHS, Dr Jennifer Dixon at the Health Foundation highlights a ‘striking’ similarity across the main parties: commitments to increase workforce numbers, reduce waiting lists, move care into the community, and leverage technology (albeit vaguely defined) to drive reform and boost efficiency. 

On public health there is more daylight between the main parties, with the Liberal Democrats pledging to increase the ring-fenced public health grant to local authorities with targeted funding for areas with the worst health inequalities. Positively, all the parties commit to tackling smoking and restricting the advertising of junk food, although in different ways.  

Some of these measures, particularly shifting care out of hospitals and delivering more services remotely, could help reduce the carbon emissions associated with healthcare services. Additionally, public health initiatives like those announced reduce the NHS’s carbon footprint by preventing diseases and promoting healthy lifestyles, which decrease the demand for energy intensive medical treatments and hospital visits. But while there is ample mention of net-zero targets generally across all the manifestos (more on that below), no party commits to supporting a net-zero NHS. This is not surprising as this level of granularity was not expected at manifesto level.  

It’s important to note that the move towards a net-zero NHS, initiated by the NHS Long Term Plan in 2019 and reinforced by the 2020 ‘Delivering a Net Zero National Health Service’ report, was not mentioned in the 2017 or 2019 manifestos of any major political parties. Rather, that shift was part of a much wider move championed in all manifestos towards reaching a net zero economy and sparking a green industrial revolution.  


Environmental sustainability in the political manifestos  

The environment features prominently across party manifestos. Under the Conservatives the UK has cut its emissions faster than any other G20 country, and Tory support for offshore wind, renewables, electric vehicles, and to achieve net zero by 2050 remain unchanged in this manifesto. However, Sunak’s party commits to what it terms a ‘pragmatic and proportionate approach’ to climate change measures, which sees the party commit to annual licensing rounds for North Sea oil and gas and a moratorium on new green levies.  

The Liberal Democrats and Labour diverge notably in tone from the Conservatives with their manifesto green pledges, with the former pledging to appoint a Chief Secretary for Sustainability in the Treasury to ensure the UK economy is zero carbon and resource-efficient. And while much has been made about Labour scaling back on its £28 billion green policy, Starmer has committed to an ambitious Green Prosperity Plan which includes, among other pledges, achieving clean power by 2030.  


What next? 

It’s encouraging to see climate change and sustainability feature so prominently in this election campaign. This heightened focus from political parties bodes well for the NHS to accelerate its own green agenda and leverage the wider environmental momentum across the UK. Nurses have a pivotal role to play in shaping a sustainable healthcare system that aligns with society’s transition to a low-carbon future. 

During this election period, we must push all parties to explicitly support the Greener NHS programme with robust policy commitments and funding. This includes backing sustainable care models, green facility upgrades, and workforce training and education on environmental stewardship.