An analysis of sustainable development across the health and care sector.This report is an important step in measuring progress, recognising achievement and identifying opportunities across the sector. We are pleased to report that the NHS has achieved an 11% reduction in carbon, exceeding the 10% target set in 2009. This is a notable achievement whilst activity has increased by 18%, even considering how this has been supported in large part by efficiency savings in the NHS and the growth in availability of cleaner energy. The action across the NHS, strong system leadership from organisations such as Public Health England (PHE) and work across local authorities have helped to deliver a 13% carbon reduction across the wider health sector. This reduction is laudable however there is still much more to be done to meet the UK targets for 2020, particularly as activity is likely to continue increasing.