Lancaster researchers are leading two projects worth a combined £2.2 million exploring how the NHS can cut greenhouse gas emissions while maintaining high standards of care.
The studies, funded by the National Institute for Health and Care Research (NIHR), have been awarded under a new NIHR funding opportunity which aims to help the health and social care system achieve net zero.
"Assessing the impact of virtual wards on decarbonising acute care" is a £1.2 million project to assess the impact of 'virtual wards' on the carbon footprint of acute care. It will examine whether digital-enabled care at home can reduce the environmental impact of acute care for people with acute respiratory infections, heart failure and exacerbations of frailty, while maintaining good outcomes for patients.
Acute care is one of the biggest contributors to NHS emissions. Virtual wards offer one possible way to reduce this by allowing some patients to receive hospital-level care at home through remote monitoring and clinical support.
The research will take place across three Integrated Care Board (ICB) areas in Northern England: Lancashire and South Cumbria, Cheshire and Merseyside, and North-east and North Cumbria. It will use workshops with professionals, a mixed-methods survey of NHS staff, an energy use survey with patients and carers, and service use data from participating ICBs. It will also examine whether environmental impact is important to patients and carers, and how that information can be communicated in ways that support informed choice.
Professor Heather Brown, the study's principal investigator from Lancaster University's Division of Health Research, said: "This is a great opportunity to think about how we can develop a sustainable health care system for the 21st century and support implementation of the NHS 10-year plan. We will generate evidence on the staff training needed to move to digital and carbon minimising care, carbon emissions of care in the community compared to care in hospital, patient perceptions of digital care and the environmental impact of care, and how scarce health care resources should be allocated so that we can deliver high quality care that is environmentally sustainable."
This ambitious and methodologically robust study will provide critical insights into how virtual wards can deliver clinically effective, environmentally sustainable, and socially equitable acute care. The research will run from April 2026 to March 2029 and will involve collaboration with Lancaster University Management School, and externally with the University of Cumbria and the University of Lancashire.
Professor Amanda Taylor-Beswick, co-investigator from the University of Cumbria said: "This project offers a vital opportunity to understand more about how digitally enabled care can support both better outcomes and a more sustainable NHS. Virtual wards represent a significant step in reimagining where and how acute care happens. I am delighted to be working with Professor Brown and colleagues to offer evidence that can further guide this NHS practice transformation."
Childbirth, choice and climate change is a £1 million project exploring how the NHS can reduce its carbon footprint by addressing waste associated with 'gas and air' in maternity services, without restricting access to pain relief and while recognising the importance of meaningful choice in childbirth.
'Gas and air' is a mix of nitrous oxide and oxygen, commonly used for pain relief during labour. Nitrous oxide is a potent greenhouse gas which contributes significantly to climate change. It is therefore vital to reduce unnecessary waste. It is also important to make sure that women have access to the pain relief they need during labour.
The study will involve NHS Trusts and bring together several different types of research. This includes interviews with new parents, midwives, doctors and engineers, observations of clinical practice, and innovative approaches to measure gas and air use and waste. This will help researchers understand how much waste there is, where it comes from, and how and why it happens. The project team will then work closely with people involved in maternity care to develop and test practical ways to reduce gas and air waste. Working alongside maternity staff, professional organisations and national bodies, the learning from the project will help shape national guidance and contribute to reducing greenhouse gas emissions across the NHS.
The project will run from April 2026 until August 2028 and includes partners from Manchester University, Worcestershire Acute Hospitals NHS Trust and University College London Hospitals NHS Foundation Trust.
Dr Charlotte Hadley, the study's principal investigator from Lancaster Medical School, said:
"This project offers an important opportunity to help reduce the NHS's carbon footprint and support the NHS's 2040 net zero target by reducing waste from gas and air used in maternity care. From what we know so far, gas and air waste is shaped by many factors, including the equipment involved and the everyday routines of care. Achieving lasting reductions in waste requires working closely with pregnant women and clinical, technical and operational teams to understand how gas and air is used in practice and I'm pleased to be co-leading this work with Cliff Shelton to generate practical insights that can support more sustainable care across the NHS."
Cliff Shelton, the study's co-principal investigator from Lancaster Medical School who is a consultant at Wythenshawe Hospital, said: "As an obstetric anaesthetist, I spend a lot of my professional life making sure that people get the pain relief they need in labour - this project offers an exciting opportunity to promote excellent quality healthcare while reducing waste and helping us to move towards a net-zero health system."
Together, the two projects show how Lancaster University is developing a growing reputation for research at the intersection of high-quality care and environmental sustainability, building on its strong foundation in climate change research.
Dr Sophia Lentzos, NIHR Head of Climate, Health and Sustainability, said: "Reducing the environmental impacts of the health and social care system, through cutting waste and using resources wisely, is not only one of our top priorities, but it also represents a significant opportunity as the NIHR reaches its 20th year. Through targeted investment we can improve services and support long-term economic growth. We are determined to play a key role in building the evidence, partnerships and momentum needed to go further in the years ahead."
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