The Clean Air Framework

Delivery of the Clean Air Framework (CAF) has positioned HI NENC as the regional facilitator for sustainability. The Framework brings together Sustainability leads within the region’s Trusts, academia and industry, to collaborate on shared issues and develop innovative solutions to reduce air pollution and achieve Net Zero by 2030. It aims to provide support across the region’s healthcare system, to embed the Integrated Care Board for the North East and North Cumbria (ICB NENC) sustainability plans by sharing best practices, encouraging the spread of innovation and amplifying sustainability messages.

Contact Details

  • Peter Lillie - Sustainability Lead
  • Health Innovation North East North Cumbria
  • [email protected]
  • Hannah Gibson - Project Manager
  • Health Innovation North East North Cumbria
  • [email protected]

Project Dates

Project Start 01/08/2022
Project End Ongoing


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Our alignment with the CAF sparked a journey of wider Collaboration, corporate accountability and personal responsibility and a drive to positively affect Health Inequalities: We are in a Climate Emergency and its imperative we have a joined-up approach to the solutions moving forward, this means shared learning coupled with individual accountability. If one solution can be copied and cookie cut into a similar environment saving time, money, resource and most importantly reducing further environmental impact and consequently reduce Health Inequalities then that must be a good thing.
Peter Lillie, Sustainability Lead, HI NENC
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The North East has the poorest health in the country, with high levels of health inequalities. Generally, air pollution is worse in more deprived communities and can be up to 20% higher. The North East has more attributable deaths to air pollution per 100,000 people than London, despite London having considerably worse particulate pollution. Poor air quality is the largest environmental risk to public health in the UK and studies have shown that long-term exposure to air pollution reduces life expectancy, mainly due to cardiovascular and respiratory diseases and lung cancer. Short term effects include exacerbation of asthma and increases in respiratory and cardiovascular hospital admissions and mortality.



Integrated Care for Cleaner Air – Tackling air pollution across the North East and North Cumbria ICS Understanding the Levers for Change – May 2022.

Health matters: air pollution – November 2018 – Health matters: air pollution – GOV.UK (

The CAF brings together Sustainability leads within the region’s Trusts, academia and industry, to collaborate on shared issues and develop innovative solutions to reduce air pollution and achieve Net Zero by 2030. This aligns with the NENC ICS Green Plan to be the Greenest and Healthiest Region by 2030.

HI NENC created a questionnaire based on the sections outlined within the CAF Trust Tracker. The questionnaire was completed by all 11 Trusts in the NENC region, during interview-type meetings. The aim of collecting this data was to identify common themes across the region and benchmark any existing sustainability progress.

It was discovered that the Trusts were encountering the same issues, but often working independently to address them. The CAF aimed to reduce siloed working and encourage the Trusts to work together to develop sustainable solutions.

In response to the data collected, HI NENC took several actions to spread awareness of the effects of air pollution and encourage collaborative working between Trusts:

  • Created and shared an informative toolkit on air pollution for Trusts to advertise on their website. This is available on the Global Action Plan.
  • Developed an e-learning sustainability module for the NENC NHS workforce and drafted a letter with the provider collaborative. The letter will be sent to the ICB to mandate the module in NENC.
  • Brokered relationships between Sustainability and Innovation teams within Trusts and brought them together in January 2024 for HI NENC’s bi-monthly Innovation Forum.

Further information on the survey, data collected and outcomes can be found here, within the found here, within the Clean Air Framework: Phase One Report


Introducing the Clean Air Framework has raised awareness of regional capabilities within the Clean Air agenda. Trusts are now further informed of the regional support available, to develop new and existing solutions that positively affect climate change.

HI NENC has been able to reduce siloed working and foster collaborations between Trusts that have a shared goal of reducing their carbon footprint.

This work is contributing to ICB NENC’s goal to be the greenest region in England by 2030 by cutting carbon emissions in regional Trusts.

The implementation of the CAF within the region’s healthcare system will help decrease air pollution in the area. This will result in long-term benefits for public health by reducing chronic conditions caused or exacerbated by air pollution, such as asthma, lung cancer, and cardiovascular disease. This will improve patient outcomes and quality of life, especially benefiting those living in areas with high levels of deprivation, who are disproportionately impacted by air pollution or have comorbidities exacerbated by air pollution.

The healthcare system will benefit from a decrease in patient numbers, alleviating the strain on NHS resources used for treating these conditions. Resources can then be deployed elsewhere in the system to provide better care for patients.

The implementation of the Clean Air Framework is expected to lead to a decrease in carbon emissions from local NHS Trusts, thereby reducing regional air pollution.

Several initiatives have emerged as a result, such as the travel and transport survey, which seeks to comprehend the commuting habits of the regional NHS workforce.

HI NENC has supported the region’s healthcare system in implementing the ICB NENC’s sustainability plans. This involved sharing best practices and using innovation to drive sustainability. The organisation has collaborated with local NHS and industry partners to address unmet needs and develop innovative solutions, to achieve Net Zero by 2030. Ongoing efforts are also being made to integrate sustainability into all of HI NENC’s work programs and to demonstrate the organisation’s impact on the clean air agenda using the ICB’s framework.

The next steps will be to establish and communicate the value of sustainable healthcare solutions set forward by the North East North Cumbria Integrated Care Board (NENC ICB). HI NENC will also run a solutions-based pilot, which tests high-impact, low-effort solutions to build an effective base for pushing further actions on the Clean Air Framework. Current work is underway to conduct a series of workshops to gather regional priorities and understand where innovation should be focused.

Our work facilitating the Clean Air Framework project aimed to provide a clear benchmark of the Net Zero progress across NHS Trusts in North East and North Cumbria. The NHS Carbon footprint is a major contributor to UK emissions and it was unclear on how this could be tackled and what had already been done. The data collected, with the support of Clare Winter and James Dixon, has been instrumental in understanding a starting point with key actions to be delivered to begin driving the Net Zero agenda in order to reach ambitious regional and national targets.
Hannah Gibson, Project Manager, HI NENC