Executive Summary
The Intergovernmental Panel on Climate Change (IPCC) concluded in 2021 that ‘it is unequivocal that human influence has warmed the atmosphere, ocean and land.’ Climate change has significant and growing impacts on human health, with the World Health Organization (2023) identifying it as ‘a fundamental threat to human health’. The intersection of climate and health policies has consequently become a subject of growing importance for policymakers, advocates and researchers.
This study investigates the extent to which and ways in which experts in healthcare, public health and climate change believe climate and health policies are, and should be, integrated in policymaking in the United Kingdom. It is part of a multinational study funded by the Wellcome Trust, including analogous research in Brazil, the Caribbean, Germany, Kenya and the U.S.
To conduct this research, we carried out 42 in-depth interviews with individuals across UK central government and related agencies, devolved governments in Scotland and Wales, local government, Parliament, as well as experts involved in advocacy, academia, advisory and consultancy roles. The interviews were conducted from February to June 2024. Our analysis has also been informed by feedback on our preliminary findings from some of our research participants and other stakeholders in the UK through an online stakeholder webinar attended by over 80 stakeholders.
The findings reflect participant views on the current national status of climate and health policy in the UK, how policy and policymaking could be improved, the barriers to achieving those improvements, and opportunities and strategies for advancing related objectives.
Current status of national climate and health policy
Despite widespread acknowledgment of the significance of climate change impacts on human health, participants observed that practical integration in UK policymaking has been limited due to siloed government departments, insufficient resource allocation, and a lack of cross-cutting / integrated policy frameworks.
The UK has played an important role in bringing health considerations into international climate negotiations, particularly through its leadership as host of the 2021 UN Climate Change Conference (COP26), and subsequent initiatives. However, there is a need for greater efforts to bridge the gap between the domestic and international policy domains to ensure that health becomes a central component of global climate strategies, and that international developments feed back into national action.
Ideals for climate and health policy
Participants widely believed that integration of climate and health policies in the UK is required and that this can be done in the most effective way by adopting a holistic, systems-thinking approach that emphasises prevention, addresses wider determinants of health, and prioritises vulnerable populations. Cross-departmental collaboration and evidence-based policymaking are essential for developing effective and efficient policies. However, there is also an increasingly pressing need to move from evidence gathering to decisive action to meet the urgent challenges of climate change.
Barriers to climate and health policy
Despite the clear need and theoretical acknowledgment of the benefits of integrating climate and health policies in the UK, numerous barriers hinder this optimal integration.
Participants most frequently mentioned chronic underfunding and limited capacity as the most significant barriers to greater climate and health policy integration. A lack of dedicated roles and budgets often results in work on climate and health being done informally, leading to inconsistencies and gaps in effort and focus.
A focus on short-term objectives and lack of long-term decision-making was identified as an impediment to consistent and sustained efforts to address climate and health issues. The health service often reacts to immediate needs, undermining efforts to address longer-term impacts.
Some participants cited resistance to change or inertia within large and bureaucratic systems and institutions, particularly the National Health Service (NHS), as another significant barrier. Such systems are designed for stability and resilience, making it more challenging to implement new policies and practices, especially where large-scale or more transformational efforts are required.
Siloed decision-making was another frequently cited barrier. Government departments (nationally and locally) tend to operate in siloes, focusing on their specific mandates without sufficient cross-departmental coordination and collaboration. Fragmentation hinders cohesive policy development and implementation to address climate and health impacts.
Participants described a variety of barriers relating to data and evidence. For example, several questioned whether conventional hierarchies of evidence, typically privileged in healthcare decision-making, are appropriate for evaluating complex system-wide changes needed in climate and health policy. Participants argued that different types of evidence may be better suited to informing transformational change and ensuring timely and effective policymaking.
Effective integration requires knowledge across climate and health domains, but some participants observed that this is rare and difficult to achieve within existing professional frameworks. Industries reliant on fossil fuels and the house-building sector, whose lobbying power can delay adoption of more ambitious and integrated policies, were also identified as significant barriers.
Opportunities to advance climate and health policy
Despite the cited barriers to better integrating climate and health policies, several promising opportunities could facilitate progress in the UK. One recurring theme amongst participants was the potential for significant co-benefits arising through increased integration. For example, action to reduce air pollution could lower healthcare costs associated with respiratory diseases as well as bring down carbon emissions.
The success of initiatives, particularly the Greener NHS programme, demonstrates that integration of climate considerations into the healthcare system is achievable. The sheer scale of the NHS – one of the largest employers and service providers in the UK – offers substantial opportunities to make impactful change. The NHS can leverage its purchasing power and influence to drive large-scale changes through efforts such as prioritising plant-based foods on hospital menus, alongside other changes including retrofitting buildings to improve energy efficiency. The high proportion of the NHS carbon footprint accounted for by medicines and medical supplies highlights how progress on a more preventionoriented approach could yield considerable emission reduction benefits.
Finally, learning from the approaches taken in the devolved governments of Wales and Scotland presents another valuable opportunity. The Wellbeing of Future Generations (Wales) Act (2015) offers a pioneering legislative framework focused on sustainable development, which facilitates stronger integration of climate and
health policies, and addresses health inequalities that are exacerbated by climate change. Scotland’s approach includes the development of a climate emergency strategy within NHS Scotland, providing lessons for capacity building and policy alignment.
Strategies to advance climate and health policy
A multi-faceted approach was promoted by many participants to advance climate and health policy integration in the UK. This includes enhanced cross-cutting coordination across government departments and with health services. Participants emphasised the need for greater interdisciplinary collaboration, with climate and health experts working closely with a variety of sectors such as housing, transport and urban planning, to ensure climate and health outcomes are consistently considered in policy development and implementation.
Establishing dedicated roles and allocating sufficient resources were also widely referenced by participants as essential for sustained focus and expertise on climate and health policy integration. Another critical strategy is ensuring that evidence used in policymaking and delivery is fit for purpose. This can include the development of robust indicators tailored to the needs of policymakers and the adoption of adaptive pathway models for more informed decision-making under uncertainty.
Engaging and empowering communities is an important consideration for advancing climate and health policy. Involving local communities in the co-production of policies ensures that efforts are tailored to the needs of those most affected and enhances public buy-in, building support for change and facilitating implementation.
Implications
The findings of this report point to several implications and opportunities for advancing the integration of climate and health policies in the UK. The scale of change required demands coordinated action across all policy sectors, ranging from healthcare and urban planning to transport and housing. Cross-national learning, both within the UK and internationally, offers valuable insights into successful approaches for achieving such coordination. There is potential for institutional and legislative reforms, such as establishing a Minister for Adaptation and Resilience or enacting a new Public Health Act that requires all government departments to consider health implications in their policies. The creation of an independent expert body similar to the Climate Change Committee could provide crucial advice on creating a healthier, climate-resilient country. The importance of the health service to the UK’s on-going climate policy commitments – lowering greenhouse gas emissions and increasing resilience to worsening impacts – certainly needs to be recognised in the government’s forthcoming 10 Year Health Plan for England.
Future research should focus on addressing evidence gaps, identifying how innovative financing mechanisms beyond traditional public funding could support integrated climate and health interventions, developing strategies to more effectively translate existing evidence into policy action, and creating robust processes for policy integration that can withstand political changes. By emphasizing co-benefits, leveraging the scale of the NHS, learning from devolved governments, and fostering greater cross-sector coordination, the UK can make significant progress in developing more integrated and effective climate and health policies. Further research could usefully clarify more precisely where evidence gaps are used to justify inaction, which of them it is feasible to fill, and in which cases a new approach to decision-making ought to be enacted in view of the urgency of action.
Citation
Rayner, T, Smith, E., Howarth, C. and Graham, J. (2025). Advancing and Integrating Climate and Health Policies in the United Kingdom: Insights from National Stakeholders. University of East Anglia and Grantham Research Institute on Climate Change and the Environment. https://www.doi.org/10.17605/OSF.IO/SQ3R7
Funding Sources
We thank Wellcome Trust for funding this research.