Effectiveness of different approaches to reduce Scope 3 emissions associated with medicines and medical equipment

The NHS must cut its carbon footprint by 75% from medicines and medical equipment alone to meet its 2045 net zero target, but no one knows which interventions actually work. This systematic review tackles a blind spot in the NHS net zero strategy. While the health service accounts for roughly 4% of England’s total carbon emissions, three-quarters of that comes from Scope 3 sources—the goods and services it buys. Medicines and medical equipment make up about 30% of those Scope 3 emissions. Yet no comprehensive synthesis exists of what hospitals and health systems have actually tried to reduce those emissions, how much those efforts cost, or whether they succeeded. If the review finds effective, low-cost interventions, it could reshape NHS procurement policy and supply chain management. Trusts might shift prescribing practices, alter purchasing contracts, or redesign how equipment is used and disposed of. The impact would be invisible to patients but measurable in the NHS’s carbon accounts—and replicable by health systems worldwide facing the same procurement emissions problem.