This document describes a process for establishing a decarbonisation roadmap for healthcare systems. Methods were developed to align with the principles set out in the Paris Agreement. The responsibility for addressing healthcare’s significant GHG emissions is often devolved to individual healthcare providers, however, reducing these emissions, is a collective effort that requires strategic direction and support from the top. By utilising this approach, national and regional health authorities can calculate their collective healthcare carbon footprint, identify relevant hotspots, and set a common pathway for decarbonisation.