The Health Service Executive (HSE) Climate Action and Sustainability Office and the National Clinical Programme in Emergency Medicine in RCSI are celebrating a major milestone in healthcare sustainability, as four Irish emergency care sites have now achieved Bronze status in the Royal College of Emergency Medicine’s (RCEM) GreenED Accreditation Programme.

The four participating sites – University Hospital Waterford, Galway University Hospital, Mayo University Hospital and Bantry General Hospital Injury Unit – have completed Phase One of the GreenED accreditation programme, implementing practical measures to reduce the environmental impact of emergency department (ED) and injury unit (IU) operations while maintaining or improving standards of patient care.

The GreenED Framework, developed by RCEM, empowers ED staff to lead sustainability improvements within their departments, even in high-pressure clinical environments. Through this programme, staff have introduced targeted interventions to reduce energy use, waste and emissions, while maintaining safety, efficiency and quality of care.

This achievement marks the successful progression of Ireland’s Green Emergency Medicine (GreenEM) initiative, launched in partnership with the HSE Climate Action and Sustainability Office and the National Clinical Programme for Emergency Medicine (NCPEM) in RCSI. Supported by SPARK Innovation Funding, the project demonstrates the HSE’s commitment to reducing healthcare’s environmental footprint while maintaining the highest standards of patient care.

Minister for Health, Jennifer Carroll MacNeill said: “As our healthcare services evolve and expand to meet increasing demand we must prioritise sustainability and reduce our environmental footprint. It was a privilege to be invited to speak recently at the launch of this Green Emergency Medicine Framework alongside the Emergency Medicine Programme Model of Care 2025. This year alone there have been over 1.3 million attendances across our EDs nationally. Delivering safe, quality services to such high volumes is resource intensive so targeted interventions to reduce energy use, waste and emissions are vital. Thank you to all the healthcare staff who have placed a focus on delivering safer, greener and more resource-efficient care, I very much welcome and endorse this initiative.”

Dr Sandy Robertson, Chair of RCEM’s Environmental Specialist Interest Group (ESIG) which oversees the GreenED programme, said: “A huge congratulations to all the sites in Ireland that have achieved a bronze accreditation through RCEM’s GreenED programme. Behind each award is a team of dedicated clinicians who have successfully implemented a range of environmentally sustainable practices to reduce emissions, waste, and costs to tackle the climate crisis.

“By doing so, they are creating a greener future – not only for the health of our planet, but the health of our patients and we are proud to support them in their environmental mission. We are delighted to collaborate with HSE and RCSI to enrol these sites to take part in the programme and we look forward to continuing our partnership so more emergency care sites can start their GreenED accreditation journey.”

Roisin Breen from the HSE Climate Action and Sustainability Office commented: “EDs are resource-intensive and fast-paced environments. Despite these challenges, the teams have shown that meaningful sustainability improvements are achievable through small, focused changes in daily clinical practice. These Bronze awards recognise their leadership and commitment to improving environmental sustainability without compromising patient care.

“Padraig Kelly from RCSI added: “This achievement aligns strongly with RCSI’s sustainability strategy and builds on the momentum created by initiatives such as the Sustainable Surgery Report and Green Surgery e-learning course. It shows how collaboration and innovation can drive real environmental progress across healthcare.”

Key outcomes

• Carbon measurement and reduction: Using RCEM’s GreenED carbon calculators, teams measured and began reducing emissions from heating, lighting and medical supplies.
• Collaborative action: Multidisciplinary staff at each site engaged in locally led interventions guided by GreenED Framework.
• Education and knowledge-sharing: An eLearning module, informed by the experiences of these pilot sites, is in development to support other EDs and IUs in starting their sustainability journeys.

The success of these four sites demonstrates the scalability and impact of the GreenEM approach and represents an important step toward embedding environmental sustainability into emergency care across Ireland.

In addition, the NCPEM have just launched the Green Emergency Medicine Playbook: a national quality improvement guide supporting EDs, IUs and urgent care centres to start their sustainability journey. The Playbook out a scalable approach using a tiered structure of 'Must do, should do and could do' interventions and lays the groundwork for sites to effectively progress towards RCEM’s GreenED accreditation.