Unlocking green investment for GP practices

Primary care is responsible for around 25% of the NHS’s carbon emissions. As such, with the NHS committed to becoming the world’s first net zero health service, the RCGP is calling on the government to unlock green investment for GP practices to ensure general practice can play its full part in delivering a sustainable NHS. 

Many GP premises were built decades ago and have seen little meaningful capital investment since. Poor insulation, inefficient heating systems, and outdated infrastructure are common, leading to high energy bills and uncomfortable working environments for staff and patients. 

RCGP polling shows that GP practices want to act: 65% of GP partners report having taken steps to improve sustainability in the past five years. However, these efforts have largely been limited to small, incremental changes, such as recycling initiatives or switching energy tariffs. 

The same polling identifies the key barrier: 69% of GP partners cite a lack of capital funding as the main obstacle to making more substantial improvements to their premises. It’s clear that in the context of rising operational costs and ongoing workforce pressures, many practices simply do not have the financial headroom to invest in measures such as insulation, heat pumps, or solar panels without external support. 

Despite government assurances that GP practices would be able to access national decarbonisation funding, many are still excluded. RCGP research has found that since its launch in May 2022, only five GP practices in England and Wales have been able to access the Boiler Upgrade Grant scheme. Similarly, the vast majority of GP practices are unable to benefit from the Public Sector Decarbonisation Scheme — including around 1,500 practices managed by NHS Property Services. Unlike hospitals, GP practices are also excluded from GB Energy, a government-backed company established to accelerate use of renewable energy, lower energy bills and support the UK’s net zero ambitions. 

The College is addressing this paradox head on. In a public letter to Secretary of State for Energy Security and Net Zero, Ed Miliband, Professor, RCGP Chair Professor Victoria Tzortziou Brown, has emphasised that this is not only an environmental concern. 

“The climate emergency is a health emergency,” she says. “The NHS has made a bold commitment to become the world’s first net zero health service. But this simply won’t be achievable unless general practice – the part of the health service responsible for around a quarter of emissions - is properly supported to decarbonise.” 

In her letter, Prof Tzortziou Brown makes the point that targeted investment in GP premises would deliver multiple benefits, including cutting carbon emissions, reducing long-term energy costs, and improving working conditions for staff and patients. Lower running costs could also help free up resources that can be redirected into frontline patient care. 

The RCGP is calling on the Government to explore how GB Energy’s investment model could be opened up to GP practices, alongside improvements to access existing decarbonisation schemes. It says that extending GB Energy investment to primary care would provide a practical, cost-effective way to future-proof GP estates, while ensuring that general practice is not left behind as hospitals receive support to modernise and decarbonise. 

“If we are rightly investing in making hospitals greener and more energy efficient,” Prof Tzortziou Brown notes, “it makes sense to extend this support to GP practices — or we risk leaving the job unfinished.” 

Alongside its influencing work, the RCGP continues to support practices to reduce their environmental impact through initiatives such as its Net Zero Hub, which provides GP teams with guidance, tools and practical actions to deliver more sustainable healthcare. 

However, Prof Tzortziou Brown makes clear that while these resources are ‘valuable’, they ‘cannot substitute for the capital investment needed to address longstanding infrastructure challenges across the GP estate.’ 

“If the NHS is to meet its net zero commitments, general practice must be enabled, not excluded, from the funding mechanisms designed to deliver them,” she says.