Sweden: Reducing the carbon footprint of the health sector in Skåne - Climate friendly health and care (CLIRE)

Mitigation initiative

CLIRE mapped all resource flows (energy, materials, transport, food, laundry) in selected units, identified the highest-emitting processes, and then implemented targeted measures. It developed a stepwise “Map–Identify–Act–Evaluate” protocol.

Protocol followed in the CLIRE project. Based on [1]

For example, CLIRE translated procurement carbon factors into a digital tool to assess products’ footprints (the “PreOrder & Climate” platform), so that low-carbon alternatives could be prioritized. It built a “sustainable treatment room” with a recyclable bed, LED lighting, low-flow ventilation and locally sourced bio-based consumables. CLIRE also retrofitted a hospital building (improving insulation, installing heat pumps and replacing oil boilers) and created 100% renewable-powered primary care demonstration sites. [2]

GHG emission reduction measures  

Initiative outcomes

Evidence of Success  

The project and subsequent environmental programmes yielded measurable cuts. In the two CLIRE pilot units at Malmö’s SUS hospital, per-patient climate impacts fell dramatically by 2014: the Hand Surgery ward’s carbon footprint dropped 41% (from 25.7 to 15.2 kg CO₂e per inpatient) and its operating theatre by 33% (from 12.2 to 8.2 kg CO₂e per surgery) relative to 2010. The Urology clinic saw smaller reductions (ward –9%, OR –11%). Although exact total figures vary by source, the lean procurement and energy investments (e.g. 60 GWh wind/yr plus 22% energy savings) imply CO₂ cuts on the order of tens of thousands of tonnes at the region’s scale. Energy cost savings were also realized (e.g. one hospital reported €250,000 in annual energy savings by 2016). 

 Region-wide greenhouse gas emissions declined through renewables, efficiency, and fuel switching. By 2016, the health sector was 86% fossil-free; by 2022, all regional fleet vehicles were electric or biofuel-powered. [3] In 2023, Region Skåne cut N₂O and desflurane emissions by about 10% using new destruction units. [4] A dedicated wind farm supplies about 40% of hospital electricity, and energy-efficient systems in pilot wards cut annual energy use by ~22% between 2014–2023. 

Overall, Region Skåne met its 2020 goal of near-zero net emissions (fossil-fuel free since 2020) and is on track for its 2045 net-zero target. 

Co-benefits 

Skåne’s approach delivered health and economic gains. Crucially, streamlining care pathways produced win-wins. Reorganizing bladder-cancer diagnostics into a fast-track “one-stop” clinic halved time-to-diagnosis, cut repeat visits, inpatient stays and drug use, and saved money and resources. Enabling outpatient visits via home nurses and telehealth spared travel, boosting patient convenience while cutting ~7.5 tCO₂e/year.As the Swedish study notes, “organizing care chains, patient flows, and resource use has great potential to both make care more efficient for patients, staff, and the economy and at the same time reduce climate impact”.