This report set outs a strategy for the National Health Service (NHS) in England to become ‘carbon net zero’ by 2040 for the emissions the NHS controls directly and 2045 for the emissions the NHS has the ability to influence. It describes the modelling and analytics underpinning the NHS carbon footprint, trajectories to net zero and the interventions that are needed to achieve that ambition, including across estates, medicines, supply chain, transport and travel, care models and the workforce.