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Project Outline

This innovative project consists of a baseline environmental impact study of the NHS using resource flow and ecological footprint analysis methodologies.

Project boundaries

The NHS is a huge and complex organisation with many functions.  It was not possible, within the scope of this project, to investigate the entire organisation (administrative agencies and trusts). Instead, the project focused on the following:

1.  an overall estimation of environmental impact of NHS England & Wales (including all departments - administrative and Trusts), and

2.  estimate in detail the environmental impact of NHS hospitals and GP surgeries, using recommended case studies.

The ecological footprint analysis homed in on those impacts to which the NHS staff and patients were responsible - an application of the responsibility principle.

Data collection

The first phase of the project gathered data for the resource flow analysis on direct energy, materials, waste, food, transport, water and built land. 

Data was collected by both Best Foot Forward and the Stockholm Environment Institute (York University), using data specs developed by BFF and SEI, in conjunction with NHS Estates and NHS PASA. 

High level data was obtained, where available, from current NHS databases.  Data which was not available was gathered from case studies.   Best Foot Forward were responsible for this primary research. 

Data analysis

Resource flow analysis

Once all data was gathered, it was processed and aggregated as appropriate to produce a resource flow analysis of NHS facilities within England and Wales.  Data analysis was undertaken by both BFF and SEI.

Ecological footprint analysis

Following the completion of the resource flow analysis, BFF undertook the calculation of the ecological footprint - with support from SEI..


Scenarios are an important part of this project, and are based on quantitative trend and projection data.  They were developed in consultation with the Advisory Group and presented in the final report.

Final report

The final report is now available in hardcopy although the primary distribution channel is intended to be via his website in electronic format.  Raw data sheets and supplmentary materials are also being made available in electronic form only.

The project outcomes are compatible with current Biffaward funded mass balances and the footprint analysis is consistent with the methodology used in the WWF's Living Planet report.  Data from this report will be entered into Forum for the Future's Mass Balance UK project. 

For further information contact Nicola Jenkin, Best Foot Forward, Tel:  01865 250818 or e-mail:  nicola@bestfootforward.com

For further information about Material Health, contact Nicola Jenkin, Best Foot Forward, Tel:  01865 250818 or e-mail:  nicola@bestfootforward.com