Scottish Ambulance Service Annual Climate Emergency & Sustainability Report 2024/25

Introduction
Background
Leadership and Governance
Summary of Impacts
Climate Change Adaption
Building Energy
Our Green Champions
Sustainable Care
Anaesthesia
Travel and Transport
Sustainable Procurement, Circular Economy & Waste
Sustainable Communities
Conclusion

1. Introduction

This is the Scottish Ambulance Service’s (the Service) annual Climate Emergency and Sustainability Report for 2024 / 2025. It reports on the Service climate activities for the year 2024/25, and the future plans and actions.

The planet is facing a triple crisis of climate change, biodiversity loss and pollution as a result of human activities breaking the planet’s environmental limits.

The World Health Organisation recognises that climate change is the single biggest health threat facing humanity. Health organisations have a duty to cut their greenhouse gas emissions, the cause of climate change, and influence wider society to take the action needed to both limit climate change and adapt to its impacts. More information on the profound and growing threat of climate change to health can be found here.

2. Background

The Scottish Ambulance Service is committed to operating, delivering and developing sustainably. This means that sustainability must be at the core of all of our decision making to positively influence our policies and how we run our services.

As a national Emergency Service and NHS Board, the Service has changed how it delivers its services, providing more support, care and treatment to people in their homes, and for those patients requiring very specialist support, conveying them to hospitals.

As a frontline service with over 5,700 members of staff, we provide an emergency ambulance service to a population of over 5.5m people serving all the national mainland and island communities. Our Patient Transport Service undertakes over 400,000 journeys per year and provides care for patients who need support to reach their healthcare appointments due to their medical and mobility needs, support for discharge and transfers.

SAS continues to occupy a unique position and role within healthcare provision in Scotland with a visible presence in every community, and over the years, we have continued to innovate and demonstrate our ability to transform and deliver new and improved services.

SAS are therefore responsible for a range of services for the people of Scotland, from accident and emergency response, to delivering primary care, providing patient transport, dispatching rapid air ambulance and ScotSTAR (Scottish Specialist Transport and Retrieval Service) support for critical patients, to being a Category 1 responder for national emergencies.

The Service is delivered to a geographical area of 30,090 square miles from 142 locations from Whithorn in the south to Unst in the Northern Isles covering a building area of 52,845 square meters, utilising a fleet of 1701 vehicles, two rotary and two fixed wing aircraft and supporting the Scottish Charity Air Ambulance Service operated from Perth.

Our Current Service at a Glance

Our Activity 2024/25

Calls received: 1,552,565
Emergency calls received: 1,111,598
87% of emergency calls answered in 10 seconds
Total incidents: 831,274
Inter-hospital transfers: 36,948
Planned patient journeys delivered: 385,614
Air Ambulance/ScotSTAR missions: 4,396 (3,015 transfers and retrievals)
Emergency incidents: 724,812
24.3% of emergency patients managed at point of call (176,134)
Emergency incidents responded to: 548,678
25% of emergency patients managed on scene (181,391)
49.3% of patients managed without the need to go to hospital (357,525)
50.7% of emergency patients taken to hospital (367,287)
Special Operations Responses: 5,081
Mobile vaccination units vaccinated: 43,643 people

Our 2030 strategy sets out how we will improve our response to patients, provide them with the best possible care, and support the health and safety of communities across the country.

Strategic Roles

Saving more lives, improving clinical outcomes, and increasing healthy life expectancy.
Enhancing the health and wellbeing of our staff and citizens.
Shifting care focus from acute hospitals to people's homes and local communities.
Improving care by anticipating needs and responding quickly and safely.
Addressing root causes of health problems and tackling inequalities exacerbated by COVID-19.

Our Vision

Saving more lives, reducing inequalities, improving health and wellbeing

Our Mission

Working together with the people of Scotland, our staff and partners to deliver sustainable and effective care, experience and treatment, anticipating needs and preventing ill health.

Our Values

Care & Compassion
Equality, Dignity & Respect
Openness, honesty and responsibility
Quality and teamwork

Our Principles

Equality and human rights-based approach
Services planned, designed and delivered around people and their lived experience
Ensuring best value, good governance, joined-up working and effective management of resources
Implementation based on evidence and best practice, championing digital and innovation

Our Ambitions

Be a great place to work, focusing on staff experience, health and wellbeing
Provide compassionate, safe and effective care where and when needed
Deliver net-zero climate targets
Improve population health and tackle inequalities
Innovate to continually improve care and enhance resilience and sustainability
Work collaboratively with citizens and partners to create healthier and safer communities

Our Path to Net Zero Strategy 2030

Aligning to this 2030 Strategy, the Scottish Ambulance Service approved their 2030 Sustainability Strategy – Our path to net zero in September 2022.

Commitments

Work towards achieving NHSScotland targets through efficient use of energy and technological investment and setting our target of 2040 to be a net zero Service.
Use suppliers aligned with NHS Scotland environmental objectives.
Enhance built environment through design, repair, maintenance, and refurbishment.
Minimise waste to landfill and implement recycling and safe disposal initiatives.
Achieve continuous environmental improvement and best practice.
Engage with stakeholders, young people and citizens on climate change issues.
Ensure sustainability is a priority in all strategic and operational activities.
Provide sustainability information, instruction, and training to staff, suppliers, and stakeholders.
Develop and implement sustainability policy.
Support community environmental initiatives including biodiversity.
Support research and development to improve environmental performance.

This strategy reflects the Scottish Government ambition. It is supported by a three-year delivery plan with targets, delivery dates and outcomes, reported to the 2030 Steering Group and SAS Board.

The path to net zero is also a key connector to the Population Health Framework and Service Reform Framework, ensuring whole system approaches to reducing health inequalities and making health and social care more resilient and sustainable.

3. Leadership and Governance

To deliver the 2030 sustainability strategy, the Service has a Climate Emergency and Sustainability Organisational and Governance Structure identifying key roles, responsibilities, and lines of communication. We use this to foster sustainable practices, provide direction and influence behaviours and cultures.

Specifically we have:

Appointed our Vice Chair as our Climate Emergency and Sustainability Champion.
Appointed our Director of Finance, Logistics and Strategy as our executive lead for our Climate Emergency and Sustainability response.
Ensured that our progress in responding to the climate emergency and sustainability issues is regularly considered by our Board.
Established reporting on progress of the aims of this strategy through our 2030 governance structures, ensuring that those aims are fully integrated into all planning, management decisions and operational practices across the Service.

To deliver the action plans, we have put in place a Climate Emergency Response and Sustainability Group (CERAS) who have taken a lead role in the delivery of the strategy. Our 2022-25 3-year action plan has been updated with a new action plan 2025-2028 agreed by the SAS Board in March 2025. Progress against this is reviewed at each CERAS meeting.

The CERAS group consists of delivery leads for the different seven key work programmes defined within the Strategy:

Sustainable building and land – Estates lead
Resilience – Resilience lead
Sustainable travel – Fleet lead
Sustainable goods and services – Procurement lead
Sustainable care – Realistic medicine lead
Sustainable communities – representatives from regions and operations
Our people and culture – HR lead

The SAS Communications team and the finance team also support the CERAS group.

The Climate Emergency and Sustainability Executive lead chairs the group and the Climate Emergency and Sustainability Champion oversees the progress of these actions.

The detailed 3-year action plan also shows the ‘Impact from Planned Actions to End of 2027/28’, recognising the benefits of the actions.

The pace of change reflects the need for additional capital and revenue funding to implement some of these actions. Given the current financial challenges, there is a risk of actions progressing slower than planned. The impact and risk assessment of this is continually monitored through the CERAS group.

The NHS Scotland Climate Emergency and Sustainability Delivery Group have acknowledged the current constraints within the wider system, mirrored within the Health Boards:

Insufficient funding to support the deliverable
Insufficient staffing capacity or expertise
The need for a continually assessed revised approach to producing the deliverable compared to initial plans

On 8th March 2023, the Chair and Chief Executives of the Health Boards received correspondence from the Cabinet Secretary detailing the Triple Planetary Crisis – climate change, pollution and biodiversity. This confirmed the priority focus from Scottish Government and ensured all climate and environmental work progress is also reported through the Service Annual Delivery plan.

The Service Annual Delivery plan 24/25 reported progress on the climate change action plan. In April 2024, the SAS Board agreed to an annual reduction of 0.5% emissions per year, reflected within the Board Annual Delivery Plan for 2025/26.

4. Summary of Impacts

The Scottish Ambulance Service aims to become a net-zero organisation by 2040 for the sources of greenhouse gas emissions set out in the table below. The Service has not set specific reduction targets for individual sources; however, we have set a 5% overall reduction in our annual greenhouse gas emissions, which we achieved for 2023/24.

Greenhouse Gas Emissions 2023-2024 & 2024-2025 (tonnes CO2 equivalent)

Source	2023/24 emissions (tCO2e)	2024/25 emissions (tCO2e)	Percentage change – 2023/24 to 2024/25	2024/25 – target emissions	Percentage difference between actual and target emissions – 2024/25
Building energy	2,389	2,385	-0.1%
Non-medical F-gas	0	3	100%
Medical gases	1,272	1,076	-15%
Metered dose inhaler propellant	0.20	0.30	50%
NHS fleet travel	14,292	14,631	2%
SAS Air Ambulance & Coastguard Search & Rescue	5,130	4,866	-5%
Waste	84	46	-45%
Water	12	9.8	18%
Business travel	359	285	-21%
Total emissions	23,538	23,302	-1%
Carbon sequestration	N/A	N/A	N/A	N/A	N/A
Greenhouse gas emissions minus carbon sequestration	N/A	N/A	N/A	N/A	N/A

Noting that progress primarily in our highest emissions use of our fleet has been significant over the last few years as we transitioned to electric vehicles. Noting that this from 24/25 will stabilise until an ultra-low emission ambulance and patient transport vehicle can be brought to the market.

The table below sets out how much of key resources we used over the last two years.

Source	2023/24 Use	2024/25 Use	Percentage change – 2023/24 to 2024/25
Building energy (kWh)	11,857,433	11,795,284	-0.5%
NHS fleet travel (miles)	28,568,317	28,223,948	-1%
SAS Air Ambulance & Coastguard Search & Rescue (Litres)	2,043,686	1,931,961	-5%
Waste (tonnes)	554	482	-13%
Water (cubic metres)	41,092	40,582	-1%
Business travel (miles travelled)	828,368	724,147	-13%

Significant work has taken place within the service to reduce travel for business, noting that the majority of this travel now relates to operational shift cover in remote and rural locations. During 2024/25, this trend continues to reduce business mileage and hotel stays. As summarised in the table above, we achieved further reductions in grey mileage and hire vehicle business travel. Specifically, 588,993 grey miles in 2024/25 down from 640,640 and 135,154 hire vehicle miles down from 187,728.

5. Climate Change Adaptation

Scotland’s climate is changing faster than expected according to research published by the James Hutton Institute in December 2023. According to this research:

“Between 1990 to 2019, February and to a lesser extent April have become wetter, particularly in the west, by up to 60%, exceeding the projected change by 2050 of 45-55%.”
“Scotland is on track to exceed a 2°C increase in temperature by the 2050s, with the months from May to November experiencing up to 4°C of warming over the next three decades (2020-2049).”
“The number of days of consecutive dry weather – an indicator for drought and wildfire risk – are also expected to increase in drier months, such as September.”

Climate change exacerbates existing health risks and introduces new challenges, ranging from the spread of infectious diseases to the intensification of heatwaves and extreme weather events that will impact the health of the population, healthcare assets and services. NHS Scotland plays a pivotal role in safeguarding the life and health of communities by developing climate-resilient health systems capable of responding to these evolving threats.

The changing climate is increasing risks for health and health services. More information on these risks in the UK can be found in the UK Climate Change Committee’s Health and Social Care Briefing available here: www.ukclimaterisk.org/independent-assessment-ccra3/briefings/

The Scottish Ambulance Service has actioned the following to better understand the impact of climate change on the Service and the people and places we serve:

Completed flood risk assessments for all SAS properties
Developed a Climate Change Risk Assessment
Developed updated continuity plans for:
- Adverse Weather
- Business Continuity Frameworks
- Fuel Shortages
- Pandemic Outbreaks
- Community Resilience
- Community First Responders

The resilience lead for the Service is a key member of the Service’s Climate Emergency Response and Sustainability group.

The Service Climate Change Risk Assessment & Adaptation Plan is reviewed annually. This risk assessment aims to improve the resilience of the Service’s assets to current climate risks and future climate change, whilst also assisting in:

Protecting vulnerable sites, services & communities
Reducing the cost of service disruption
Complying with legal requirements

The Service has adopted a six-stage approach of:

Identifying climate hazards that are likely to affect our assets
Assessing the probability of the climate hazard occurring
Identifying assets that could be affected by the hazards now or in the future
Assessing the scale of the consequence for specific assets if the hazard occurred
Completing the risk assessment (probability x consequence)
Developing adaptation plans

In doing so, we have considered an appropriate management approach (Tolerate, Treat, Transfer or Terminate) to identify and have recommended adaptation measures.

The climate hazards and therefore risks that are a priority for the service for the year ahead are assessing the public, patient and staff impact on:

Higher average temperature and extended periods of hot weather
Extended periods of dry weather (including the impact of wildfires)
Heavy downpours and driving rain
Storm surge
Flooding
Cold spells
Combined climatic effects including storm, high winds, lightning, fog mist and low cloud

The action plans supporting these risks include the impact on our air ambulance service, assets and our overall healthcare service provision.

6. Building Energy

We aim to use renewable heat sources for all the buildings owned by the Scottish Ambulance Service by 2038.

The Scottish Ambulance Service has 170 individual buildings over 142 locations such as Whithorn and Stranraer in the south, Edinburgh to Ayr across the central belt, Thurso in the north and many of the surrounding western and northern isles from Arran and Islay to the Shetlands.

In 2024/25, 2,365 tonnes of CO2 equivalent were produced by the Scottish Ambulance Service use of energy for buildings, approximately 10% of our overall carbon footprint. This is an increase of approximately 1% on the year before.

In 2024/25, the Scottish Ambulance Service used 11,801,284 kwh of energy as detailed below. This is a decrease of 0.5% on the year before.

2015/16 energy emissions	2023/24 energy emissions	2024/25 energy emissions	Percentage change 2015/16 to 2024/25
Building fossil fuel emissions	1,446	1,268	1,241	-14%
District heat networks and biomass	0	0	0	0
Grid electricity	2,161	1,106	*1,124	-48%
Totals	3,607	2,374	2,365	-34%

Note – The increase is due to the increase in EV charging, supporting the successful rollout of electric vehicles.

The Service building energy use has reduced overall by 9% from 2015/16. We have also had a small reduction of 0.5% on the previous year. Noting that whilst energy use only relates to approximately 10% of the overall SAS footprint the Service continues to consider ways in which this carbon footprint.

In recognition of these challenges, work has taken place to undertake ambulance estate station audits with approximately 70% completed by March 2025. These audits determined not only the building assessments and functionality but also the current heating provision and identifying opportunities for improvement if additional funding were to become available. Work with the SAS communications team to promote the behavioural aspect of energy use in buildings, supported by the green champions appears to have had a positive impact with a continuing reduction in building fossil fuel use. A 12% reduction from 2015/16, with a 2% reduction between 2023/24 and 2024/25.

Following on from the building assessments steps, the Service has recently submitted plans for decarbonisation funding, focusing on
Replacement of gas boilers with electric boilers and air source heat pumps at a number of high impact ambulance stations they all have comparatively high levels of tCO2e emissions for the size of building.
Replacement of all fluorescent, halogen and sodium lighting with new best available technology LED lighting systems across a range of sites which have been assessed as being suitable following the recent estate wide audit. This would also generate revenue savings that would be reinvested into SAS frontline services.
Our first Green (zero emission) Ambulance Station. This would be developed as a test of change and then building upon this knowledge consider how this model could be rolled out across the country.
Further expansion of our EV Charging Infrastructure. This continues with the successful rollout across SAS

The Service hopes to receive confirmation of this funding in early 2026.

2015/16 energy use	2023/24 energy use	2024/25 energy use	Percentage change 2015/16 to 2024/25
Building fossil fuel use	7,690,239	6,934,230	6,789,667	-12%
District heat networks & biomass	0	0	0	0
Grid electricity	5,244,504	4,917,203	5,011,617	-4%
Renewable electricity	0	0	0	0
Totals	12,934,743	11,851,433	11,801,284	-9%

7. Our Green Champions

During 2023/24, The Scottish Ambulance Service launched our ‘Green Champion Network’. The purpose of this network is to engage with staff across the entire organisation to be our ‘foot soldiers’ to embed good practice across all aspects of climate impact and sustainability. We aim to utilise their enthusiasm to encourage sustainably minded workplace behaviours to reduce energy consumption, improve recycling, engage with local communities, improve biodiversity, promote sustainable travel and workplace activity-based groups.

Thus far, we have over 70 members of staff who have volunteered to be part of the Green Champion Network. They have agreed the following Green Champion Charter:

Green Champion Charter

We aim to bring people together to make enjoying nature as easy and rewarding as possible.
We aim to encourage everyone to enjoy nature for the positive mental health benefits.
We aim to raise awareness of the impact our choices have on the environment and how we can make positive changes.

Green Champion Vision

Drive adoption of change: take a lead role with your colleagues to promote the Service’s Sustainability Strategy to adopt our vision of reducing CO₂ emissions into day-day business processes.
Share Knowledge: To help disseminate information that supports the sustainability aims and encourage staff to participate in calls for sustainability related actions.
Signpost colleagues: to appropriate training and support resources.
Lead by example: to encourage colleagues on how to act sustainably, both at work and at home, by sharing actions that can be taken on by staff.
Attend events: initial on-boarding briefings, training, promotional events and periodic review meetings.
Provide feedback: be critical and give us feedback on how our support is working for you.
Take part: be an active member of the Green Champions network, engaging with and supporting other champions.

Green Champion Values

What can Green Champions help to achieve?

Identify and develop initiatives that can help reduce emissions, costs, risks and improve processes and systems.
Improve staff satisfaction by illustrating sustainability commitment that aligns with staff values.
Align with the Service’s Net Zero Plan, Sustainability Policy and Health Well-being strategy.
Utilise sustainability as a means to deliver wider improved outcomes for staff.

What can Green Champions do?

Create a network of staff who share a common interest in sustainability, and to share ideas and encourage best practice across teams.
Develop professional skills that align with departmental and corporate strategies, delivering net zero, zero waste and improving our overall sustainability.
Empower staff to promote behavioural change in the Service and deliver the Service’s sustainable policies.
To showcase and recognise staff for their work.

To support the champion network, SAS have created an induction pack, a dedicated teams channel, a data collection process to understand what activities are already taking place.

We also have in place a lead Green Champion. a Paramedic at Leverndale Station, her reasoning for taking on the role encompasses well in what we hope to achieve……

‘Faced with the biggest mental health crisis the world has ever seen, I believe there are many solutions to this, which lie in nature. We as humans are not separate from nature, we are very much part of it, but this notion has become lost over the years and I believe this sense of disconnect is a contributing factor to the dark places we often find ourselves in today. I think when people are truly connected to anything, be that political values, religion, hobbies, sports etc this inspires certain behaviours that are motivating and supportive and I think this is certainly true when it comes to nature….. As we begin to feel more connected to the natural world this can influence small changes which benefit not only our health but also the planet.’

Building upon this approach, the green champions continue to meet and have agreed a range of actions and events including:

To initiate green champion visits across stations
Undertake a Nature-Based Training course
Cooking Initiative across Stations using plant based recipes
Explore Foraging Courses, educating staff on how to support local community biodiversity projects
Identify existing Walking Groups to promote and support across the service
Explore a Cold Water Dip Event
A Step Count Competition

This is all aiming to connect staff to nature, to each other and support the SAS work on culture and staff health and wellbeing.

8. Sustainable Care

The Service continues to make progress in reducing its carbon footprint through the adoption of more sustainable care practices. The work in reducing unnecessary accident and emergency admissions has been a core priority for the Service. This has focus has been on:

The continued development of our Pathways Hub. We use this to ensure where patients do not require an ambulance response, they receive appropriate care in other parts of the system. Where we do attend but taking the patient to the hospital front door is not needed, we can find opportunities for care that save patient journeys. We are seeing a year-on-year increase in the numbers of patients going through our Pathways Hub and in Mar 24, 25% of all attended emergencies were managed without the need to convey to hospital.
Increasing the capacity and use of our Integrated Clinical Hub. We use paramedics and nurses, advanced practice paramedics and nurses and GPs to explore which patients will benefit from an ambulance attendance and which of those, will benefit from going to hospital. By managing 40% of our emergency demand without sending an ambulance resource, we reduce our carbon footprint whilst simultaneously knowing we have high rates of patient satisfaction because of this. The Integrated Clinical Hub have avoided over 55,000 ambulance journeys since April 2023. A recent test of change, which ran over a weekend in late September 2025, trialled routing NHS24 calls through the Integrated Clinical Hub (ICH) to assess patients before dispatching an ambulance. The results were very positive: over half of the 1,007 NHS24 incidents managed in the ICH did not require an ambulance, saving 520 journeys and around 700 conveyances to emergency departments were avoided thus reducing mileage travelled and associated emissions. We were also able to identify some patients who needed an immediately life-threatening response.
The drive for greater multi-disciplinary teams and blending of roles means that we can recruit from a variety of experienced healthcare professions and advance our clinical practice. A good example of this is SAS Advanced Practitioners and Paramedics in Urgent and Primary Care who rotate through various work settings as part of their role. They are skilled in finding alternatives to admission, whether by treating the patient themselves, referring to appropriate partners in the community or bypassing ED with direct admission. They provide assessment and treatment in person, by phone or video consultation remotely and when working in collaboration with primary care partners.
Creating a psychologically safe environment to make patient-centred and risk-based decisions, following the principles of Realistic Medicine. Through work with our Palliative and End of Life Care, we are teaching and supporting our crews to make individualised decisions that put patients at the centre of the process. By listening to what patients and/or their carers want, we can deliver care closer to home and often allow a calm and supported natural death that avoids unnecessary patient journeys.
Working hard with partner organisations to break down barriers to care, we can conduit care through sometimes complex systems to get the best results for our patients and their carers. One example of this is the collaborative approach working with Flow Navigation Centres, to make sure we preserve ambulance resources for those most in need, whilst maintaining the care to others as they access services.

We remain committed to advancing our delivery of sustainable care, for the benefits of our patients and our environment. This will also include consideration in how we can communicate to our patients of the improvements that small changes can make including for example the use of inhalers.

9. Anaesthesia/Analgesics

Greenhouse gases are used as anaesthetics and for pain relief. These gases are nitrous oxide (laughing gas), entonox (a mixture of oxygen and nitrous oxide) and the ‘volatile gases’ - desflurane, sevoflurane and isoflurane.

Through improvements to anaesthetic technique and the management of medical gas delivery systems, the NHS can reduce emissions from these sources.

The Scottish Ambulance Service’s total emissions from these gases in 2024/25 was 1076 tco2e, a decrease of 15% from the year before. The focus has been largely around system loss, SAS do not have any piped supply of Entonox, the primary source of loss/waste. In addition, we only deliver entonox via demand valves which only release gas while the patient is breathing in via the mouthpiece. This minimizes the release of entonox to the atmosphere.
Clinical use of entonox has generally trended down over the last 5 years. In terms of what further steps we can take:

Increased governance of medical gas cylinders with a specific focus of work already in progress as noted in more detail below
Further reduction in the clinical use of entonox may be possible with increasing the use of penthrox, there is a separate piece of work on-going looking to establish the cost impact of a full-scale rollout.
Explore alternative demand valves which claim to be much more efficient in terms of proportion of gas released on use V’s inhaled by the patient.

More detail on these emissions is set out in the tables below:

Source	2018/19 (Entonox baseline year) 2020/21 (pMDI baseline year)	2023/24	2024/25	Percentage change 2018/19 to 2024/25
Portable entonox	1336	1272	1076	-19%
pMDI - Inhalers	42 kg co2e	197 kg co2e	299 kg co2e	612%
Total	1336.04	1272.19	1076.29	-19%

The Service is also implementing a medical gases project to improve the management of gas cylinders leading to a more efficient. This project aims to:

Provide traceability of gases by implementing a smartphone app to capture the movement of cylinders from delivery to collection.
Reduce the stock holding surplus and achieve closer adherence to clinical guidance in relation to the number of cylinders to be routinely carried on A&E and PTS vehicles (as per National Clinical Bulletin 015/19).
Identify long term misplaced cylinders and return these to the supplier to be refilled to re-enter circulation and be re-used.
Improved stock control is expected to reduce ordering frequency, which will result in fewer deliveries and lower associated environmental costs. Fewer instances of gases expiring by reaching 3 years old can also be expected.

10. Travel and Transport

Domestic transport (not including international aviation and shipping) produced 28.3% of Scotland’s greenhouse gas emissions in 2022. Car travel is the type of travel which contributes the most to those emissions.

NHSScotland is supporting a shift to a healthier and more sustainable transport system where active travel and public transport are prioritised.

A key aim of our path to net zero action plan is to remove all petrol and diesel fuelled cars from our fleet. In aiming to reduce travel costs the Scottish Ambulance Service continue to:

Implement additional approvals and controls to reduce business travel
Implement the SAS Agile Working Policy
Implement the SAS business travel policy which was approved in December 2024

Significant work has taken place to continue to reduce the need for travel and accommodation and this has been driven by the Service Best Value efficiency programme, driving not only financial savings but also reduced emissions.

Supporting this more efficient working, an additional internal approval control process has been put in place with business travel and accommodation requiring to be approved by the Chief Operating Officer and/or the Director of Finance.

The Service is also working to remove all petrol and diesel fuelled cars from our fleet by 2025 and this is on track for delivery by this date. The Service is now operating over 300 zero emission vehicles. To further encourage the use of electric vehicles the lease car eligibility has been updated to have electric vehicles only unless it can be demonstrated that an individual’s role would be impossible with an electric vehicle, which must be reviewed and signed off by the Executive team. Thus far there have been no applications for combustion engine cars.

We continue to roll out the EVC infrastructure, with 61 sites with at least one vehicle charger and a further 17 locations are currently in progress. In total, there are 145 operational chargers across the estate.

In 2025, The Service took delivery of its first fully electric A&E ambulance and this is currently being tested.

The following sets out how many renewable powered and fossil fuel vehicles were in the Scottish Ambulance Service fleet at the end of March 2024 and March 2025:

March 2024

Cars – 441 vehicles with 57.8% (255) being zero tailpipe emissions vehicles
Light commercial vehicles – 65 vehicles with 53.8% (35) being zero tailpipe emissions vehicles
Heavy vehicles – 927 vehicles with 0.2% (1) being zero tailpipe emissions vehicle
Specialist vehicles – 116 vehicles with 0% being zero tailpipe emissions vehicle
Motorcycles – 10 vehicles with 0% % being zero tailpipe emissions vehicle

March 2025

Cars – 487 vehicles with 63% (306) being zero tailpipe emissions vehicles and 37% (181) being fossil fuel vehicles. 20% difference in zero tailpipe emissions vehicles
Light commercial vehicles – 87 vehicles with 40% (35) being zero tailpipe emissions vehicles and 60% (52) being fossil fuel vehicles. 0% difference in zero tailpipe emissions vehicles
Heavy vehicles – 1001 vehicles with 15% (8) being zero tailpipe emissions vehicle and 92% (993) being fossil fuel vehicles. 700% difference in zero tailpipe emissions vehicles
Specialist vehicles – 116 vehicles with 0% being zero tailpipe emissions vehicle and 100% (116) being fossil fuel vehicles. 0% difference in zero tailpipe emissions vehicles
Motorcycles – 10 vehicles with 0% being zero tailpipe emissions vehicle and 100% (10) being fossil fuel vehicles. 0% difference in zero tailpipe emissions vehicles

The following table sets out the distance travelled by our cars, vans and heavy vehicles in 2024/25. This information does not include external hire vehicles or grey mileage.

Year	Cars	Light commercial vehicles	Heavy vehicles	Specialist vehicles	Total
2024/25	3,004,239		25,219,709
2023/24	4,966,762	340,731	18,605,637	1,103,142	25,016,272

11. Sustainable Procurement, Circular Economy and Waste

Earth Overshoot Day marks the date when our demand for resources exceeds what earth can regenerate in that year. In 2025, Global Earth Overshoot Day was 24th July, 7 days earlier than 2024.

For the UK, the picture is more worrying. In 2025, the UK’s Earth Overshoot Day was 20th May, almost 2 weeks earlier than 2024. The current level of consumption of materials is not sustainable and is the root cause of the triple planetary crises of climate change, biodiversity loss and pollution.

We aim to reduce the impact that our use of resources has on the environment through adopting circular economy principles, fostering a culture of stewardship and working with other UK health services to maximise our contribution to reducing supply chain emissions to net-zero by 2045.

The Service launched its updated procurement strategy in November 2023. This continues to recognise that supply chain sustainability must be considered to help determine the extent of the associated greenhouse gas emissions and social and environmental impacts. As key member of the SAS CERAS team, the team consider the best means of minimising carbon risk, improving energy efficiency, reducing waste and promoting sustainable procurement practices.

The Service is utilising the suite of sustainable procurement tools and guidance that Scottish Government has made available to all public bodies to assess current levels of performance, helping to inform the actions required to embed good procurement practice to realise intended sustainable outcomes.

They also continue to look for opportunities to broaden access to contracts for Small and Medium Sized Enterprises (SMEs), the third sector and supported businesses.

Looking for innovation and harnessing more sustainable technologies
Encouraging our suppliers to provide more sustainable goods and services with lower carbon emissions
Expanding the use of community benefits
Embedding fair work practices
Promoting equality and tackling inequality
Inclusion of Life cycle impact mapping as part of the sustainability test

For any Procurement undertaken by the Service’s Procurement, there is a mandatory requirement for every tendering supplier to confirm their position in relation to climate change related aspects.

We continue to promote the use of items which have been designed for durability and upgradability. Tendering contracts can apply a focus on durability / upgrade ability where appropriate.

The environmental sustainability priorities of the Scottish Ambulance Service Procurement and Logistics Service’s Strategy are detailed below:

Delivering Best Value
Delivering Sustainable Procurement
Maximise Innovation and Supplier Development
Tackling Inequalities
Implementing all aspects of fair work policy

The vision, mission and role of the procurement and logistics function encompass these environmental priorities….

Our Vision

To be a high performing procurement and logistics service that delivers a legally compliant and sustainable service and provides and delivers all financial and service procurement and logistic opportunities, aligned to the Scottish Ambulance Service 2030 Strategic ambitions.

Our Mission

To provide a comprehensive sustainable procurement and logistics service that meets the needs and expectations of all service partners in support of the Service corporate, financial, social and sustainable objectives.

Ensuring the continuing development of procurement and logistics opportunities to reduce inequalities and improve community health and wellbeing and supporting NHSScotland climate change ambitions.

Our Role

Our work focuses on:

Delivering savings, efficiencies and sustainable procurements to derive social, environmental and economic benefits from public expenditure, via the purchase of the goods or services through contracting activity.
This includes collaborative working where appropriate and providing advice on public procurement to stakeholders throughout the Service.
Developing the skills and expertise of our team to deliver a high-quality service to our stakeholders.

To continue to monitor the success of this we are tracking the benefits of:

Move from single use to re-usable product (where possible and or practical)
Quantify impact of the change in
Carbon footprint baseline identification of critical and key consumables and assess alternative opportunities to reduce the carbon footprint.
Point of manufacture, to delivery to the UK and subsequent delivery to our Logistics

Internal sustainable procurement dashboards and reporting are being developed during 2024/25.

We now have a product register which identifies the country of origin and the volume of products bought from those countries. Identifying this information will allow us to review specific products and where possible find alternative suppliers within the UK first and foremost which would reduce our supply chain emissions while supporting local businesses.

Waste Management

We want to reduce the amount of waste we produce and increase how much of it is recycled.

The table below sets out information on the waste we produce and its destination for the last three years:

Type	2021/22 (tonnes)	2022/23 (tonnes)	2023/24 (tonnes)	2024/25 (tonnes)	Percentage change – 2021/22 to 2024/25
Waste to landfill	24	24	26	25	4%
Waste to incineration	N/A	N/A	N/A	N/A	N/A
Recycled waste	440	450	495	465	6%
Food waste	N/A	N/A	N/A	N/A	N/A
Clinical waste	11	13	33	0.5	-95%

We have set targets to reduce the amount of waste we produce. You can see information on our performance against those targets:

Reduce domestic waste by a minimum of 15%, and greater where possible compared to 2012/2013 – by 2025
- Target – reduce domestic waste by 7.5 (tonnes)
- Performance – domestic waste reduced by 25 (tonnes)
Ensure that no more than 5%, and less where possible, of all domestic waste is sent to landfill – by 2025
- Target – reduce waste sent to landfill by 47.5 (tonnes)
- Performance – waste sent to landfill reduced by 25 (tonnes)
- Outcome – on track
- Further reduction required – 23.5 tonnes
Baseline year of 2017/18 – 50 tonnes to landfill.
Waste to landfill in 2024/25 – 25 tonnes.
No more than 5% of 50 tonnes to landfill = 2.5 tonnes, or less to landfill by 2025

Ensure that 70% of all domestic waste is recycled or composted – by 2025
- Target – recycle or compost - 267 (tonnes)
- Performance – recycled or composted – 489 (tonnes)

% Material Diverted from Landfill

56% waste diverted offsite
39% waste diverted on-site
5% general waste

Total
481.71 tonnes

Weight Breakdown

General waste - 24.68 tonnes
Waste Diverted On Site - 186.38 tonnes
Waste diverted off-site - 270.24 tonnes

Waste Diverted Off Site

Waste Sent to a Material Recycling Facility (MRF) - 145.82 tonnes
Waste Sent to a Energy From Waste Plant (EFW) - 124.42 tonnes
Waste Sent to a Anerobic Digestion Plant (AD) - 0.41 tonnes

Total Waste Diversion

% Waste Diverted On Site - 39%
% Waste Diverted Off Site - 56%
Total % Of Waste Diverted - 95%

Carbon Saving in Tonnes

Net Benefit of Recycling Versus Landfill (Direct Carbon Saved) - 684.37

The development of our ‘Green Champion Network’ will be utilised to promote and encourage conscientious waste disposal at local levels to achieve greater waste segregation and recycling. Ongoing work within the procurement sector is also being developed with suppliers and manufacturers to reduce waste at source and updated reporting has been presented at the CERAS group.

This also included the establishment and ongoing development of the logistics hubs. Their role in reducing waste is described below:

The Scottish Ambulance Service now has three Logistic Hubs servicing mainland Scotland and the Western Isles. The aim of these hubs is to reduce the amount of stock held at individual locations and over-ordering which often reach their ‘use-by date’ and ultimately end up as waste.

12. Sustainable Communities

The climate emergency undermines the foundations of good health and deepens inequalities for our most deprived communities. The NHS touches every community in Scotland. We have a responsibility to use our abilities as a large employer, a major buyer, and one of the most recognised brands in the world – an ‘anchor’ organisation – to protect and support our communities’ health in every way that we can.

Notable initiatives within the Service for local biodiversity are community access to station green space, establishment of community gardens, encouraging the use of local flowers and vegetable to support local pollinators and ecosystems and supporting habitats linked to the work of the green champions, in connecting to nature.

Our Anchor Strategic Plan was submitted to the Scottish Government on 27 October 2023. This described four strategic priorities of:

Procurement of Goods and Services
Fair Work Opportunities
Land and Assets
Partnership Arrangements

The plan describes actions to support climate change and reducing the consequences for population health especially for those with fewer resources and less power and amplifies the existing Health inequalities. This includes:

Workforce: employability programs, living wage accreditation, diversity and inclusion accreditations, and strategies for engaging with local employability partnerships.
Procurement: focusing on spending on local businesses, SMEs, supported businesses, and third-sector bodies and assessing community benefits delivered through procurement practices.
Land and Assets: embedding anchor activities in new developments, community engagement in planning and use of developments, and current community use of land and assets including making our land and facilities available for community use. In particular our new Glasgow South Station will see the introduction of a community hub which would support access to initiatives such as food and housing services to improve community health outcomes.

Our corporate ambitions as an Anchor Institutions are aligned well to our path to net zero ambitions.

Work collaboratively with citizens and our partners to create healthier and safer communities.
Innovate to continuously improve our care and enhance the resilience and sustainability of our services.
Improve population health and tackle the impact of inequalities.
Deliver our net zero climate targets.
Provide the people of Scotland with compassionate, safe and effective care when and where they need it.
Be a great place to work, focusing on staff experience, health and wellbeing.

Our anchor plan focuses on creating fair work opportunities and adopting sustainable practices to enhance the efficiency and effectiveness of our service delivery.

By addressing health inequalities and improving the availability of services in underserved areas, the plan aims to make healthcare more accessible to all population segments.
The plan intends to improve health literacy and outcomes through strategic partnerships and a focus on public health, particularly in historically disadvantaged communities.
The commitment to understanding and meeting the unique needs of different communities supports a more personalised approach to patient care, ensuring that services are tailored to individual patient needs.
The plan supports socio-economic development by leveraging procurement and employment opportunities, improving patient health and wellbeing.
The plan's emphasis on environmentally responsible practices and the efficient use of resources ensures a sustainable healthcare system that benefits current and future generations of patients.

13. Conclusion

Recognising the financial challenges during 2024/25, and the impact in making significant progress against our climate change action plan, the annual report has seen improvements and initiatives put in place across the Service. Specifically work on the sustainable care, sustainable communities and the green champions initiative continues to show progress against the SAS path to net zero strategy.

Continued focus is to:

Further develop the green champion role
Building upon the recent decarbonisation bid, to develop an SAS investment plan for sustainable buildings
Fully assess the impact of our first electric ambulance
Continue to develop reporting on the impact of our anchor plan and sustainable communities
Building on the work of the SAS Value Based Healthcare – Medicines and Equipment group, describe further the full impact of this group in supporting the path to net zero strategy.