Climate change working group - about our advocating for change workstream

Our overall aim is for RCPCH to be at the forefront of taking action on climate change and promoting sustainability within healthcare and act as an example for other medical Royal Colleges. We outline the background, aims and actions of this workstream of our climate change working group focused on advocating for change.


Climate change is the biggest global health threat of the 21st century and the defining challenge of our generation. The effects of a warming planet will be a huge burden on our young people and detrimental to health, security and prosperity of future generations: the World Health Organisation estimates that 88% of the global health burden of climate change now falls on children under 5 years old. The IPCC 2021 report is clear: urgent and rapid decarbonisation is required as a coordinated worldwide effort in order to preserve a habitable planet.

The detrimental effects of climate breakdown on children are multitude. Prenatally, exposure to extreme heat is associated with an increased risk of pregnancy complications and birth defects, and infants and young children are vulnerable to morbidity and mortality from dehydration, heat stress and malnutrition. The combustion of coal produces mercury, a potent neurotoxin that can affect cognitive ability and motor function in the developing foetus. Studies have revealed associations between extreme heat and increasing antibiotic resistance, worsening mental health, challenges with epileptic seizure control, and impaired cognitive function. Worldwide, climate-sensitive infections are on the rise due to the spread of insect vectors beyond their original geographic habitat.

The NHS is responsible for 22.7 million tonnes of carbon dioxide emissions per year. It is also responsible for 5% of all road traffic in the UK. Air pollution - largely, vehicle emissions related - contributes to an estimated 40,000 deaths each year in the UK, which means that the NHS directly contributes to 2,000 air pollution deaths. As paediatricians we are acutely aware of the death of Ella Kissi-Debrah linked to illegal levels of air pollution. Paediatricians do not want to work within a system which neglects its responsibility to address the impact it has on the environment – much less a system which may be actively making children unwell.

RCPCH is one of the leading voices on child health in the UK and worldwide, and as such has a significant opportunity to positively influence the public discussion around climate change, and to model responsible organisational behaviours as a medical Royal College.

This workstream will be the anchor of the College’s work in this field, by focusing on the thing that matters most in mitigating the worst effects of climate change: dramatic and rapid decarbonisation of healthcare and the economy. This is the only way children around the world can be spared a future that, above 1.5 degrees of heating, is bleak beyond belief.

Our aim and areas of focus

Our overall aim is for RCPCH to be at the forefront of taking action on climate change and promoting sustainability within healthcare and act as an example for other medical Royal Colleges. 

Our areas of focus are as follows:

  1. Strengthening our links with other organisations and within the paediatric community to share resources and empower greater advocacy
  2. Working with the RCPCH policy and public affairs teams to be vocal advocates on national climate and sustainability policy which affects children
  3. Using our collective voice to support national campaigning on climate change and how it will affect children and young people’s health
  4. Amplifying youth voices in our advocacy work

Our actions for 2021/22

We have committed to the following activity in our first year:

  • Use existing national campaign days relating to climate change as an opportunity to amplify the voices of paediatricians and to advocate for change to improve child health 
  • Offer to meet with identified key organisations and stakeholders to discuss the importance of working together in this area and to promote and share resources developed across the CCWG
  • Work with the RCPCH &Us group to include young people’s voices in our advocacy work, and amplify their voices wherever possible
  • Work with members, RCPCH teams and other Colleges on impactful national policy and public affairs activity relating to the impact of climate change on children and young people  
  • Work with the RCPCH public affairs and media teams to develop a stakeholder matrix, including spheres of influence, for climate change advocacy 
  • Work with the support for members workstream to create materials to support paediatricians with: 
    • talking about the impacts of climate change on child health and advocating for change in their Trust
    • sharing key climate change messages with CYP and families
  • Host a climate and sustainability engagement stand at RCPCH conference
  • Work with the RCPCH Press Panel to recruit and train a group of expert members to be able to speak to media on climate and environmental issues
  • Create resources to support regional climate advocacy, so that members are empowered to support action in their local area (eg schools, planning meetings, local MPs) and how to hold people at different levels to account

Looking ahead to 2023/24

We hope to go on to do the following in our second and third years: 

  • Work with the RCPCH policy and research teams to include data on climate change and its effects on children in ‘State of Child Health’, including (if possible): air pollution; mental health; extreme weather 
  • Create a national network of RCPCH climate and sustainability champions in every hospital / region
  • Undertake a piece of work to broaden the diversity of voices involved in climate action (working with RCPCH &Us to do the same for young people) 
  • Work with RCPCH to create a Climate and Sustainability subcommittee, led by an Officer for Environment and Sustainability, with elected representatives (and representation from RCPCH &Us)
  • Evaluate the impact of our campaigning and use lessons learned to inform future RCPCH advocacy relating to climate change and child health


  • Wang H, Horton R. Tackling climate change: the greatest opportunity for global health. The Lancet, June 2015. 
  • Salas R et al. The Case of Juliana v. U.S. — Children and the Health Burdens of Climate Change. The New England Journal of Medicine, May 2019. 
  • WHO. Global Climate Change and Child Health – training for the health sector. PDF 
  • IPCC Report 2021. 
  • MacFadden et al. Antibiotic resistance increases with local temperature. Nature, June 2018. 
  • Padhy S et al. Mental health effects of climate change. Indian Journal of Occupational and Environmental Medicine. 2015. 
  • Royal College of Physicians. Every breath we take: the lifelong impact of air pollution. 2016, PDF.