The NHS is unprepared to cope with the extreme heat that is becoming our new reality
During June's record-breaking heatwave, NHS staff resorted to cooling themselves with gloves filled with water, a doctor described performing CPR in a poorly ventilated room as "almost impossible", and many reported feeling unwell because of the heat.
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These accounts come from a survey of more than 1,100 healthcare workers by the Doctors' Association UK, carried out as the UK recorded its hottest ever June day at 37.7C. Among reported indoor NHS temperatures, the median was 33C and the highest 45C.
Ninety-four per cent of respondents stated they had no or partial air conditioning, and over two-thirds said patient safety had been affected. In some hospitals, the heating was still running as the radiators were too old to turn off.
This was no isolated event. For the first time on record, the UK has reached 35C in May, June and July of the same year.
Heatwaves are becoming more frequent, intense and prolonged as a result of the climate crisis. Their consequences are measured in heatstroke and dehydration, disrupted care, an overwhelmed health service and, during the May and June heatwaves, an estimated 2,700 heat-related deaths in England and Wales alone - 42% of which were attributable to climate change specifically.
The NHS is unprepared to cope with this new reality.
First, much of the NHS estate was designed for a cooler climate and prioritises retaining heat in winter. Sealed windows, extensive glazing, poor ventilation, ageing systems and heat-generating medical equipment can make buildings dangerously hot in summer.
Scanners, fridges and technological infrastructure have been failing in high temperatures, meaning that patients are left waiting for critical operations and care, placing pressure on an already stretched system.
Second, heat impacts staffing, impairing concentration and decision-making, driving fatigue, causing staff illness, and further reducing the capacity of the system to respond to the increased needs during a heatwave.
Third, heat increases demand. Alongside heat exhaustion, heatstroke and dehydration, high temperatures worsen cardiovascular, respiratory and renal illness and interact dangerously with some medicines.
The greatest risks fall on older people, babies and young children, people with chronic conditions and certain workers.
The response to extreme heat needs to start before people arrive at the clinic.
Protecting health means retrofitting housing, expanding shade and green space in the neighbourhoods that need it most, and strengthening early warning systems so vulnerable people are reached before temperatures peak.
It requires public education, because many do not know that common medications, from diuretics to antipsychotics, impair the body's ability to handle heat.
Britain has no legal maximum working temperature: that must change to protect all workers, including in the NHS, backed by investment in cooling, ventilation and insulation so buildings stay safe in summer and efficient to heat in winter.
Above all, we must tackle the cause of worsening extreme heat by rapidly cutting fossil fuel emissions. The scale of future warming will be determined by political choices made now.
With global fossil fuel emissions reaching another record high last year, every delay means more preventable illness and premature death.
NHS staff should not have to improvise with water-filled gloves while delivering critical care.
The government must establish enforceable heat standards, fund the infrastructure required to ensure a safe NHS service under extreme heat, protect communities with preventative and anticipatory action, and ensure we tackle the underlying drivers of the climate crisis.
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Dr Rita Issa is an NHS GP and researcher on the health impacts of climate change at the University of East Anglia.
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