Prototype of an organising framework for healthcare decarbonisation research: an exploratory classification study

Abstract

Objectives: To develop an organising framework for healthcare decarbonisation research which goes beyond classification schemes based on scope 1, 2 and 3 emissions or lists of loosely connected themes and which is intended to support the coordination, funding and application of research into policy and practice. The organising framework was developed with a focus on the National Health Service (NHS) in England but enables application to healthcare systems more broadly. Design: An exploratory classification study of over 160 research questions derived from a review and data extraction of nine systematic reviews, 13 stakeholder documents, two research priority exercises and four research funder sources. A further eight systematic reviews and 14 stakeholder documents, which were not used for direct data extraction, were used to test the emerging framework and specify thematic gaps. Setting: Primarily high-income healthcare systems, with a focus on the NHS in England. Participants: Not applicable. Primary outcome: A multilevel thematic framework representing current and missing areas of research in healthcare decarbonisation. Results: The framework comprises six top-level themes: Natural resource use and sources of carbon; Healthcare settings and workflows; Solutions; Stakeholders; Organisational levers for change; and Scientific measurement and theory (the ‘NHS-SOS framework’). At levels two and three, there were 39 and 86 subthemes, respectively. Conclusions: This framework offers a structured, empirically derived representation of the emerging field of healthcare decarbonisation research. It is intended as a living tool to support shared understanding, prioritisation and action and to foster coherence in a currently fragmented research landscape.