Healthcare decarbonisation targets need clear boundaries, credible timelines and transparent reporting to turn ambition into measurable emissions reduction. Health Care Without Harm Europe, the European arm of a global not-for-profit organisation focused on reducing healthcare’s environmental footprint, sets out this approach in The Healthcare Leaders’ Handbook for Setting Decarbonisation Targets. The framework treats mitigation targets as quantified, time-bound commitments driven mainly by emissions reduction, with carbon removals limited to residual emissions.
Target Design Starts with Scope and Timeframe
Mitigation targets begin with target boundaries. Healthcare institutions need to define which activities, operations, entities and value-chain elements are covered, as well as which greenhouse gases and emission categories are included. Organisation-wide headline targets are expected to reflect the boundaries used in the greenhouse gas inventory, while sub-category targets can focus on specific areas such as waste, purchased goods and services or commuting. Combining headline and sub-category targets can give decision-makers a clearer view of overall progress and practical action areas.
Emission coverage is commonly organised through Scope 1, Scope 2 and Scope 3 categories. Direct emissions include sources owned or controlled by the institution, including boilers, vehicles, on-site waste treatment and fugitive emissions from anaesthetic gases or cooling equipment. Indirect energy emissions cover purchased electricity, steam, heating and cooling. Wider value-chain emissions include upstream and downstream sources, such as purchased medical goods, business travel, staff and patient commuting and management of used products.
Timeframe then turns ambition into a planning requirement. A base year should use reliable and representative emissions data, avoiding unusual events that would distort future comparisons. Target years provide milestones for short-, mid- and long-term progress. Target levels define the intended percentage reduction from the base year. Absolute emission targets are preferred for initial headline targets because they show whether total emissions are falling, while intensity targets can support specific operational monitoring.
Science-Based Targets Tighten Net-Zero Claims
Science-based targets apply climate scenarios and mitigation pathways to test whether a target matches climate science. Mitigation targets express ambition; science-based targets assess whether that ambition aligns with a pathway that limits warming to 1.5°C or well below 2°C. Healthcare has a dual role because it responds to climate-related health risks while contributing approximately 4.2% of global greenhouse gas emissions. In Europe alone, healthcare-related emissions are estimated to cause more than 365,000 disability-adjusted life years each year.
Target levels need to reflect fairness and capacity. Institutions with greater access to finance, technology and robust public health systems are expected to set more ambitious targets, while those expanding essential health services should do so sustainably. For headline science-based targets, coverage should include Scope 1, Scope 2 and Scope 3 emissions and cover at least 90% of total greenhouse gas emissions. A short-term target year of 2030 and a long-term target year no later than 2050 are used as minimum timeframe requirements.
Net-zero targets require deep reductions before residual emissions are neutralised. A zero-emission end state means no emissions are generated across all scopes without offsets. A net-zero target requires at least 90% reduction by 2050, with remaining residual emissions balanced by long-lived permanent carbon removals. Carbon neutrality allows a more flexible mixture of internal reductions, avoidance credits and removal credits, making net-zero targets more tightly constrained. Clinical necessity remains relevant where emitting activities are medically justified and vital for patient outcomes.
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Reporting Turns Targets into Management Tools
Target-setting does not end with the adoption of goals. Progress needs to be managed through a reporting framework that is consistent, accurate, complete and transparent. A target trajectory gives a mathematical and visual pathway from base-year emissions to the final target year. Annual allowable emissions can then be aggregated into a carbon budget, showing the total emissions permitted over the target period. Tracking the remaining budget helps prevent delayed action from undermining long-term alignment with science-based limits.
Progress monitoring relies on gross emissions and accountable emissions. Gross emissions aggregate the reporting-year emissions within the target boundary, while accountable emissions adjust that figure for the net effect of carbon removals. Comparing gross emissions with allowable emissions identifies performance gaps. The proportion of carbon removals used can also be compared with a predefined neutralisation cap, helping distinguish residual-emission management from reliance on offsetting instead of abatement.
Reporting should describe methodology, data sources, calculation approaches, uncertainties, target boundaries, emission coverage, target levels and performance indicators. It should also show how governance, accountability, equity considerations and climate strategy alignment support delivery. Recalculation is recommended when significant changes affect comparability, including improved data quality, changed methods, structural changes or discovered errors. Targets should also be updated every five years because the remaining global carbon budget changes as emissions continue. A carbon management plan then links targets with implementation, opportunity assessment and annual reporting.
Credible healthcare decarbonisation depends on targets that are measurable, science-aligned and operationally embedded. The approach centres on defined boundaries, reliable baselines, appropriate target years, transparent target levels and limited use of carbon removal for residual emissions. It also connects mitigation with health equity, local co-benefits and accountable governance. The central message is that net-zero claims require more than ambition. They require evidence, regular reporting and sustained emissions reduction across operations, supply chains and wider institutional influence over time.
Source: Health Care Without Harm
Image Credit: iStock
References:
Health Care Without Harm Europe (2026) The Healthcare Leaders’ Handbook for Setting Decarbonisation Targets: A Framework for Setting Credible, Actionable Mitigation Targets to Decarbonise Healthcare. Brussels: HCWH.
