WHAT IS THE CLIMATE AND HEALTH SCORECARD INITIATIVE?
The scorecard initiative was set up in response to the climate and ecological emergency; the most significant health threat of our time. The climate crisis affects health in a myriad of ways, disproportionately impacting vulnerable communities who have done the least to cause it. Tackling the climate crisis requires health systems to acknowledge and address the drivers of planetary destruction, including neo-colonialism, an extractive economy in pursuit of limitless growth, and militarism. The health sector has a crucial role to play in changing the climate trajectory. We must work collectively to make it happen.
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This initiative focuses on bringing about justice-driven change within health organisations, focusing primarily on professional bodies. In 2019, we began writing a checklist of achievable climate actions that we wished health organisations would take. We involved a range of experts from environmental finance consultants, to climate educators at the Centre for Sustainable Healthcare, to Medact climate campaigners. Together we developed the scorecard which breaks down climate action into manageable steps.
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OUR GOALS
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Support health organisations in moving towards a just, healthy and sustainable world at the rate and scale required to ensure a liveable planet for all.
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Enable health professionals to know what climate action has been taken by their membership organisation
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OUR STRATEGY
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A framework of achievable yet ambitious actions is used to score organisations across four domains.
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Cross-organisational learning is facilitated by sharing examples of good practice.
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Progress is monitored by repeating the scorecard biennially.
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The next round of the scorecard will be assessing climate action over the two year period of 1 January 2024 to 31 December 2025. The 2024-2025 results will be published in early 2026.​
METHODOLOGY
1. CONSTRUCTING THE QUESTIONNAIRE
A working group of experts in the field of climate, nature and health developed a framework of climate actions that were considered ambitious yet achievable for health organisations. Four core domains were identified: internal operations; finance; education and delivering green care; and advocacy. Read more below. ​​​​​​Questions were written to cover the highest impact areas. We involved a range of experts to maximise the content validity.
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Weighting was determined according to the estimated impact of each question on mitigating the climate and ecological emergency. Questions considered to have the greatest impact have the most points attached. There is no gold standard way to do this, so we consulted many resources and external experts in order to identify the key areas and weight them accordingly. The scores were refined through an iterative process.
2. ORGANISATIONS ARE INVITED TO PARTICIPATE
We invite UK-based health professional bodies (medical, nursing, allied health, pharmacy and psychology).
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3. QUESTIONNAIRES ARE REVIEWED AND SCORED
Health organisations complete the questionnaire. The questionnaire is self-reported and includes suggestions of evidence which helps verify the answers. The questionnaire is then marked by the scorecard team. During the marking process, organisations may be contacted to seek clarification on some answers. Finalised scores are shared with the organisation.
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4. FINDINGS ARE SHARED
We group organisations into categories according to size and nature, and present their scores for each domain, ranking them by their total score. We also publish individual reports for each organisation, outlining actions taken and next steps.
Domains
Internal operations
This domain focuses on the work health organisations are doing to minimise their carbon footprints and waste production. Not only do these actions reduce greenhouse gas emissions, but it demonstrates positive leadership and indicates to members and the public that climate change is an important health issue on which everyone should act. ‘Getting one's house in order’ is a crucial step.
Finance
This domain focuses on organisations divesting their financial assets from investments in fossil fuels as well as banking with green banks and using green insurers. Moving the collective funds of the medical, nursing and allied health colleges and regulatory bodies makes a social and political statement which stigmatises fossil fuels and contributes to uncertainties around the long-term viability of this harmful industry. This is a critical action for breaking society's dependence on fossil fuels.
Education
& Delivering green care
Education holds a critical role in building a climate-resilient health sector. Climate-informed health professionals can engage in public health promotion and prevention as well as integrating sustainable practice into their workplaces. This domain reviews actions taken by organisations to prepare their members for clinical practice in a climate-changing world.
advocacy
The root and remedy of illness is political. Health organisations have a responsibility to advocate for population health. This means calling for an end to fossil fuel exploration and for bold climate policy. Health organisations should challenge global and intergenerational inequity of the climate crisis, as well as the underlying drivers of capitalism, limitless growth, colonialism and militarism.
OUR TEAM
CORE TEAM
Dr Eleanor Cooke and Dr Amelia Cussans
Co-founders and Directors​
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Dr Will Nash
Researcher
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Sadie Pinkney
Researcher
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Charlotte Francis
Researcher​
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WIDER TEAM
We are immensely grateful to everyone who has given their time to link between the scorecard initiative and their health organisation:
Alan Barnes, Heather Baid, Laura Burton, Isobel Braithwaite, Cara Campbell, Charlotte Cheeseman, Matthew Clarke, Rosemary Lugg, Jenny Girdler, Anya Gopfert, Sivan Greene, Natasha Guildford, Hilde Gundersen, Sara Harford, Alice Harpur, Karen Herndon, Jo Hindley, Charlotte Hurry, Kamilla Kingsley, Gareth Morgan, Will Nash, Jack Oliver-Blaney, Thomas Payne, Alexander Robertson, Andrew Savill, Aimee Serisier, Sarah Sheard, Natalie Smith, Timothy Spruell, Will Stableforth, Victoria Stanford, Andrew Stevenson, Olivia Stevenson, Mike Tomson, Louise Weissel.
We also thank the following people, whose skills and expertise has been instrumental in the development of the initiative:
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Rob Abrams, Nick Bailey, Matt Beresford, Yaso Browne, Chester Cornford, Alice Clack, Ben Eder, Nuala Hampson, Richard Hixson, Terry Kemple, Tracy Lyons, Joel Moreland, Frances Mortimer, Elaine Mulcahy, Elizabeth Robertson, Richard Smith.
ENDORSEMENTS
The Climate and Health Scorecard Initiative has been endorsed by the following organisations: ​
MEASURING IMPACT
ANONYMOUS FEEDBACK:
​After the second round (2022-23), all participating organisations were invited to give feedback. 15 responses demonstrated that:
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93% of respondents found that participating in the CHSI helped their organisations identify areas where they can improve their environmental practices.
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75% of organisations reported making changes as a result of participation in the CHSI
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73% reported that receiving scores encourages climate action
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87% reported that receiving individualised report cards is valuable in developing their organisation’s climate strategy
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Reported changes as a result of the scorecard initiative included: carbon footprinting the organisation; changing banks and pension providers; advocacy; and gaps within action plans; establishing an environmental group.
COMMENTS FROM PARTICIPATING ORGANISATIONS :
"The report cards are so clear and easy to engage with, enabling us to give positive recognition across the organisation of actions have already completed. At the same time, it clearly sets out what more needs to be achieved. Having the achieved actions and next steps alongside each other, makes this process feel manageable."
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"The scorecard has allowed us to develop an action plan and identify easy wins."
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“This and the results of the previous iteration which were published earlier in October have generated useful discussion in our own college about what further action we can take in this area, and it has been very helpful to learn from activities happening in other healthcare organisations across the UK.”
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"It [the survey] was a good exercise and has given us food for thought from which we have developed a set of actions."
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“This report is extremely useful for our strategic motives moving forward and I’m sure will help influence what steps we make next.”
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"I think that the scorecard is going to be used as a template for change. It breaks up the multitude of actions into manageable portions."
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"We plan to use this as a baseline for future work. There is much to do!"
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"Thank you for organising this initiative, and being so helpful throughout the process. We really felt listened to, and appreciate the opportunity to participate and develop our action plan. Well done for producing some excellent outputs!"