Cultivating Environmentally Sustainable Emergency Departments with GreenED

Collective leadership within healthcare is critical if we are to deliver on net zero targets and provide high-value, low-carbon care to our patients. However, driving change in systems under considerable strain from crowding, limited resources, and increasingly complex caseloads can be a daunting task and often feels out of reach. In July 2023, the Royal College of Emergency Medicine (RCEM) launched a sustainability initiative to support environmentally sustainable healthcare within emergency departments (ED). This 12-month support and accreditation scheme centers around a framework of 36 actions and has been designed to make sustainability interventions accessible to staff, enabling individuals, groups, and networks to become leaders within their own spheres of influence and elicit measurable changes. The objective of this study was to evaluate the impact of the accreditation scheme over a 2-year period.

The primary outcome measures were the financial and carbon savings made by participating sites. Secondary outcome measures were derived from a thematic analysis of written submissions, undertaken to identify co-benefits and generate qualitative insights into both barriers to, and enablers of, environmental sustainability interventions within EDs.

Five sites were successfully accredited for Bronze and Silver awards in 2024, and 10 sites for Bronze, Silver and Gold awards in 2025, with combined projected annual savings of £351,366 and 157,724 kg of carbon dioxide equivalent.

To our knowledge, this is the first time that a collaborative, structured, dynamic, and scalable approach to sustainable healthcare in emergency medicine has been used worldwide.