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Fresh air for the UK’s most polluted hospitals

by Chris Large, Senior Partner

5 March 2019

The Clean Air Hospital Framework

When the going gets tough, the tough get going. The air pollution crisis is the epitome of tough going. The air surrounding hundreds of our schools and hospitals is polluted with toxins that stunt lung growth and stop arteries moving blood properly around the body. It is especially harmful for children as both during pregnancy and after birth, it limits children’s lung function development, potentially setting them up for health problems throughout their lives. For the sake of millions of children we need to get tough on air pollution and get going quickly.  

Air pollution is also responsible for an estimated 6 million sick days every year and is expected to cause 2.4 million new cases of disease in England between now and 2035. Hospitals themselves need good air quality. It’s crucial for patients, staff and visitors. The community around them will benefit too if a hospital can minimise air pollution from traffic, boilers and building work. Hospitals becoming the leaders in tackling air pollution can show what we should expect from every workplace and those sites that cause much more pollution than hospitals. 

This is why we have created the Clean Air Hospital Framework. 

The aim is to help all hospitals in the country minimise the air pollution they cause and give vital health advice to their patients so that they know how to protect themselves.


A year ago, Great Ormond Street Hospital asked Global Action Plan the question, “what would a Clean Air Hospital look like? How would it operate, what training would it offer to staff and what advice would it give to patients?” There was no guidebook, so we agreed to put our heads together and work out the answers. A year later, and we have the answers. 215 of them to be precise. That’s how many separate steps we have uncovered for hospitals to foster clean air and advise patients. 


And because there was no guidebook, we’ve written one, so that other hospitals can create their clean air strategy in much less than a year. All hospitals are unique but share similar functions. The framework is a comprehensive list of actions, graded by the level of ambition, by which a hospital can handpick the clean air actions that fit its own unique characteristics. 

The ground-breaking effort at Great Ormond Street Hospital has been led by Nick Martin, Head of Environment and Sustainability, who has corralled the clinicians, technicians and managers to create their strategy. With just 49 of Nick’s peers using the Clean Air Hospital Framework, we could quickly see the 50 hospitals in the most polluted hotspots draw up their clean air hospital strategy. 

The change just 50 people can lead will make a real difference. 50 hospitals could provide 1.6 million patients they admit with vital air pollution advice within a year. 

Realistic operational changes could reduce NOx emissions equivalent to replacing 54 million miles of diesel and petrol driving with electric vehicles. 


There are countless people to thank for establishing the framework, especially our friends at the NHS Sustainable Development Unit, NHS Improvement, NHS England and the Department for Health and Social Care, the visionary team at Great Ormond Street Hospital and, of course the young patients at Great Ormond Street Hospital for their fantastic illustrations in the framework. 


Two more of the 50 most polluted hospitals have already asked Global Action Plan to help them set up their own clean air action plans. That’s just 47 more to go! Join the community of health professionals making clean air, by downloading the toolkit at or emailing [email protected] if you want to pick the brains of the clean air hospital team. 

Staff from the GOSH play team share some of the excellent work that GOSH patients have done on clean air
Director of Development Matt Tulley introduces why GOSH thinks the Clean Air Framework is important
Andrew Taylor, professor of cardiovascular imaging, sets out the health impacts of air pollution at the launch of the clean air hospital framework
Sonia Roshnik,director of the Sustainable Development Unit, talks about the part the Clean Air Hospital Framework has to play in wider NHS and air quality action
Nick Martin, GOSH Head of Sustainability & Environmental Management, talks about what actions GOSH already has in place, and it
Chris Large speaking at the launch of the Clean Air Hospital Framework
Senior Programme Manager Clair McCowlen showing a magnet board used to help discussions of the clean air hospital framework with staff and patients.