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Environmental Scanning of Climate Adaptation Tools in Healthcare

Submitted:

28 April 2026

Posted:

29 April 2026

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Abstract
Introduction: Extreme weather events are increasing in frequency and intensity due to climate change, contributing to substantial morbidity and mortality globally, particularly among vulnerable populations. In the UK, climate adaptation within health systems remains insufficiently developed. However, there is limited understanding of the tools currently available for the identification and management of populations at risk during extreme weather. This study aims to systematically characterise UK-based climate adaptation tools used in healthcare settings. Methods: Environmental scanning was conducted, because no centralised database exists for climate adaptation tools in healthcare, and many relevant resources are not captured in traditional academic or grey literature repositories. Structured Google searching by two independent reviewers enabled identification of publicly available and practice-oriented tools accessed in real-world settings. Eligible resources included UK-based tools designed for healthcare professionals, local authorities, or patients that incorporate meteorological data to mitigate climate-related health risks. Results: Nine tools met inclusion criteria, comprising e-learning platforms, online dashboards, integrated clinical software, and structured workflows. Most targeted healthcare professionals, with few targeting local authorities and none targeting patient self-management. Data inputs and outcomes measures were heterogeneous, spanning risks related to heat, cold, flooding, and air pollution. Reporting was inconsistent, as nearly half the tools were not publicly accessible and all demonstrated limited transparency. Conclusion: The current landscape of UK climate adaptation tools in healthcare is fragmented, with variability in accessibility, evidence, and scope. Clearer reporting and greater coordination in how such tools are catalogued may support more consistent and equitable responses to climate-related health risks.
Keywords: 
climate adaptation
;  
public health
;  
digital health
;  
healthcare tools
;  
computerised technologies
Subject: 
Public Health and Healthcare  -   Public, Environmental and Occupational Health

Background

Extreme weather events are increasing in frequency and intensity as a consequence of climate change, with heat, cold, flooding, and air pollution contributing to morbidity and mortality worldwide [1,2]. The risk of death increases by 10 to 25% for each degree Celsius rise above regional temperature thresholds [3,4], and heat-related mortality among adults aged ≥65 years has increased by 167% compared to the 1990s [5]. In addition, air pollution contributes to an estimated 4.2 million premature deaths annually [6]. These exposures are associated with cardiovascular stress and respiratory illness, particularly among individuals with long-term conditions such as chronic obstructive pulmonary disease, heart failure, diabetes, and chronic kidney disease [7]. Risks are further concentrated in underserved populations experiencing socioeconomic disadvantage, as limited access to healthcare, housing, and adaptive resources constrains the ability to respond to environmental stressors [8,9,10,11].
National policy responses emphasise the need for inclusive and locally adaptive approaches that integrate health and social care services to maintain continuity of care and reduce avoidable hospital admissions during extreme weather events [12,13]. Climate adaptation within UK health systems remains underdeveloped, with fragmented implementation and widening inequalities in exposure and outcomes. Periods of extreme weather are associated with rapid increases in healthcare demand, particularly in primary and social care driven largely by people with long term conditions, while service capacity remains constrained. Disruptions to healthcare access resulting from reduced mobility, service interruption, and displacement, further increase risk of poor health outcomes [14,15,16].
Digital- and data-enabled approaches offer potential to support anticipatory care by identifying populations at risk and informing timely intervention. Existing literature shows that many platforms do not translate meteorological data into actionable patient level or clinical decision-making [17,18]. At the same time, the current evidence base is largely derived from peer-reviewed studies, with poor visibility of tools developed and implemented in practice across healthcare organisations and local authorities. As a result, there is limited understanding of what climate adaptation tools are currently available in the UK, who they are designed for, and how they incorporate environmental risk into healthcare delivery.
Environmental scanning of grey literature is an established method for identifying practice-based tools and approaches that are not captured in academic databases, enabling assessment of responses to complex health system challenges [19]. This approach has been applied across healthcare contexts, including shared decision-making tools for stroke prevention [20], technology-enabled support for pre-visit care planning [21], human papilloma virus vaccination uptake [22], and cancer screening programmes [23]. Applying this method to climate adaptation in healthcare enables direct identification of tools as they are accessed and used in real-world settings. This study therefore aims to systematically characterise UK-based climate adaptation tools used in healthcare settings through an environmental scan of publicly accessible resources.

Methods and Materials

Environmental scanning was undertaken to characterise climate adaptation tools used in UK healthcare. This approach was selected as it allows systematic identification of grey literature and practice-based resources that are not routinely captured within peer reviewed databases, and is well suited to informing policy and service development [24]. In contrast to systematic, scoping, or rapid reviews, which focus on indexed academic evidence, environmental scanning supports broader identification of tools developed and implemented across healthcare organisations, local authorities, and service settings.
The scan was guided by the RADAR-ES framework, which synthesises methodological guidance from multiple studies to support environmental scanning in health services research [25]. This framework includes five phases: recognising the issue, assessing relevant factors, developing a protocol, acquiring and analysing data, and reporting findings. These stages are consistent with approaches described in previous environmental scans [26,27,28] and were applied to structure the identification, extraction, and synthesis of data.
Searches were conducted using Google to reflect real-world access to tools in the absence of a centralised database. Google was selected as it indexes a wide range of sources, including organisational websites, service platforms, and implementation focused resources that are often not included in academic or grey literature repositories. Searches were performed from inception to March 2026 using predefined terms including ‘healthcare weather tool NHS’ and ‘patient climate support UK’. Two reviewers independently conducted the searches and screening (LM and HS).
Eligible resources included tools based in the UK that were designed for healthcare professionals, local authorities, or patients and incorporated meteorological data to reduce climate-related health risks. Tools were excluded if they were not UK-based or did not address health risks associated with environmental exposures. Given variation in terminology, the definition of a tool was applied broadly to include digital platforms, guidance resources, and structured workflows.
Data extraction was conducted independently by two reviewers (LM and HS) using a structured approach, with findings reported in Table 1. This focused on tool aims and development, intended users, mode of delivery, environmental health data inputs, transparency of reporting, and reported findings and limitations. A narrative synthesis was undertaken due to heterogeneity in tool design and outcomes, following guidance for synthesis without meta-analysis [29].

Results

Tool development and aims
Nine tools were identified, most of which were developed by the National Health Service or UK Government (n=8; not ID9). Several also included private companies (n=4; ID1,6,7,8), with one developed by a non-profit organisation (ID3). Included tools were mostly created to educate and prepare healthcare professionals for weather events: combined events (n=4; ID1,2,3,7), heat or cold (n=2; ID4,9), and pollution (ID6). Others were created to educate and prepare local authorities for weather events (n=3; ID5,7,9), with only one targeting the public (ID8) and none targeting self-management directly or involving patients in tool development.
This included educating professionals on the impact of weather events on health and wellbeing, focusing on how the climate affects healthcare and how healthcare affects the climate (ID2,3,8). It also involved helping professionals assess climate-related health risks and intervene to mitigate these within local authorities and care settings, especially in the context of health inequity (ID5,6,7). Lastly, tools were aimed to provide direct support through alert and communication systems at hospitals and home visits (ID1,4,9).
Audience and delivery of tools
Which healthcare professionals were addressed was generally unclear, with one tool specifying targeting of emergency departments (ID1) and one of primary care practices (ID3), and none focusing specifically on social care. These objectives were often addressed through e-learning courses (n=3; ID2,3,4) and online visualisation dashboards or interactive maps (n=3; ID5,8,9), with the remainder utilising integrated software (n=2; ID1,6) or fillable workflows (ID7). While some were continuously adapted via real-time updates or artificial intelligence training (n=3; ID1,8,9), others were static and require manual adaptation once developed (n=4; ID2,3,4,7) or remained unspecified (n=2; ID5,6).
Environmental health data incorporated
In four out of nine tools, patient or healthcare data was included, ranging from demographic and social deprivation data to the location of and climate impact on NHS sites (ID1,2,6,8). However, how exactly this was used was not described and none reported the sample size, sex, age, or ethnicity of individuals. Furthermore, the conditions addressed were only mentioned in the case of asthma (ID3,6), with all other long-term conditions excluded. Personalisation of care or consideration of underserved populations was rarely mentioned, with only one addressing homelessness (ID5).
When looking at meteorological data considered, this was also highly heterogeneous. Temperature was included the most (n=6; ID2,4,5,7,8,9), followed by air quality and pollution (n=4; ID2,5,6,9), flooding and sea level (n=4; ID5,7,8,9), and precipitation and humidity (n=4; ID4,5,7,8). Droughts and wildfires were incorporated in three (ID5,7,9), seasonality in three (ID1,4,9), and wind in one (ID9). Poor housing conditions and disrupted access to healthcare, caused by cold (ID4) and flooding (ID8) respectively, were taken into account in several tools.
Tool transparency
However, three tools reported ‘weather’ or ‘weather events’ without further clarification (ID1,2,7), pointing towards a lack of transparency. Furthermore, one only indirectly described the data utilised (ID5), as it mentioned the plan it was based on which provided the information while the tool itself did not. Another did not provide any data or information on meteorological variables but only encouraged users to consider these (ID7), and one did not report any details on data used in tool development altogether (ID3). Additionally, the use of spatiotemporal data was not described in most tools (only in ID1,6,8,9), while weather is known to be rapidly changing. When localised data was utilised, this was generally on a regional level and never GPS-based, and the one address-based tool considered NHS locations and not patient locations (ID8).
Key findings and limitations reported
Pilot studies have been reported in three of the nine tools (ID1,5,7), with one still under development (ID5). Tools were often said to have led to improved prediction of healthcare demands or preparedness (n=6; ID1,4,5,7,8,9), improved identification or understanding of climate-related health risks to patients (n=6; ID2,3,4,6,7,8), and improved evidence-based decision-making for their mitigation (n=5; ID5,6,7,8,9). This included more accurate predictions of admissions to emergency departments (ID1) and identification that someone is living in a cold home (ID4). It also involved the creation of a climate crisis motion (ID3) and summaries of local risks to climate (ID7). Lastly, visualisations were successfully created across tools to monitor progress (ID5), provide a geospatial view of asthma metrics (ID6), and to depict current and projected climate risks to healthcare services (ID8).
Yet evidence was missing in all, with numbers to show uptake and efficiency or impact rarely provided, and one tool not describing any findings (ID2). Limitations were also not reported in any of the tools, further confirming a lack of transparency. Indeed, information was mostly gathered based on descriptions rather than through use of the tool itself, which was restricted to various degrees. While some were publicly accessible with (ID4) or without registration (ID2,7,8,9), almost half of the tools were not (ID1,3,5,6), and as such their applicability remained unknown.
Table 1. Characteristics of UK-based healthcare tools aimed to minimise climate-related health risk
Table 1. Characteristics of UK-based healthcare tools aimed to minimise climate-related health risk
Tool References Developers Delivery Relevant data Goals Implementation Outcomes
1. A&E Demand Forecasting Government Transformation Magazine, 2025; NHS England, 2023; OpenAccess Government, 2026; The Guardian, 2025; The Telegraph, 2025 NHS England, Faculty Continually trained AI for clinicians through NHS Federated Data Platform (not public/not accessed) Historical trends, seasonality, weather, public holidays, patient age, flu and covid spread Provide English hospitals with anticipated A&E admissions ≤3w ahead, alert to potential upcoming surges Piloted in 9 NHS organisations, used by 50, available to all with 170 active users per month
 2x more accurate at admission predictions than unspecified comparator
2. All Our Health Government UK; NHS England CARE, E-learning for Healthcare, Office for Health Improvement and Disparities E-learning and signposting tool incl. on climate change and air pollution (public/accessed) Data on greenhouse gases, air temperature, extreme weather events, outdoor and indoor air pollutants, climate impact on healthcare Help healthcare professionals understand impact of climate change and reduce effects of air pollution to prevent illness, protect health, and promote wellbeing Not reported Not reported
3. Greener Practice
 Greener Practice Greener Practice Quality improvement project tools incl. ‘Helping patients keep warm’, ‘Extreme Heat Alert QIP’, ‘Extreme Cold Weather Alert QIP’, ‘Air pollution’ for GPs (not accessed due to paid registration) Not reported Educate primary care to move towards environmentally sustainable healthcare by providing resources, convening groups to share learning, collaborating with organisations QIPs help identify high risk patients during heat/cold by encouraging use of local referral pathways Webinars attended by thousands of people, created climate emergency motion
4. Helping People Living in Cold Homes E-learning for Healthcare; NHS England Public Health England, Department for Business Energy and Industrial Strategy, National Institute for Health and Care Excellence E-learning and signposting tool (accessed after free registration) Winter air temperatures, effect of cold and damp homes on health Support healthcare professionals during home visits or patients to apply NICE guidance NG6 ‘Excess winter deaths and illness and the health risks associated with cold homes’ Not reported Users spot that someone is living in a cold home which affects their health and direct to assistance
5. Local Authority Risk and Adaptation (LARA) Toolkit: Heat Edition Government UK Centre for Climate and Health Security, UK Health Security Agency Online dashboard for councils (not public/not accessed) Not reported but based on Adverse Weather and Health Plan which focuses on heat, cold, flooding, drought, thunderstorms, wildfires, air quality Help local authorities assess heat-related health risks and plan actions to protect health by addressing leadership, local authority, care settings, home and domiciliary care, children and young people, people experiencing homelessness, homes, planning, occupation, infrastructure At pilot stage, full tool not yet published Assessed preparedness for heat-related health risks, identified improvement areas in services, assessed approaches to protect at risk groups, planned practical actions, monitored progress using visualisations
6. London Asthma Decision Support (LADS) Tool Imperial College Health Partners; Nort West London Integrated Care Systems, 2023; Asthma and Lung UK; Vizify Analytics NHS North West London Integrated Care, South East London Integrated Care, Imperial College Health Partners, Imperial College London, Vizify Whole systems integrated care platform using Tableau/SQL for population health management (not public/not accessed) Longitudinal air pollution, demographic and social deprivation data, routinely collected NHS data Help clinicians intervene earlier to improve asthma-related outcomes, help identify and investigate health inequity Not reported Provides geospatial view of asthma metrics, enhances data-driven decision-making across scales
7. NHS Climate Change Risk Assessment Tool ATACH; Healthcare Property; JBA Consulting; NHS England, 2025; NHS England JBA Consulting, NHS England Fillable Excel workflow (public/accessed) Consideration of heat, drought, cold weather, downpours and flooding from surface-water and rivers, severe weather events, coastal flooding and erosion via workshop with NHS adaptation and sustainability leads Help NHS staff identify climate-related risks and their potential impact on healthcare delivery and adaptations, progress towards net zero and maintain service continuity during climate events Piloted in unspecified number of NHS organisations with feedback incorporated Summarises local risks to climate change following implemented adaptations
8. NHS Scotland Climate Mapping Tool NHS Scotland, 2025; NHS Scotland, 2025; Sustainability Action; Scottish Government NHS Scotland, TellUs Toolkit, ARCGis Web-based Geographic Information System (public/accessed) National datasets on flood risk (SEPA), climate projection (UKCP18), NHS sites Help users visualise climate-related hazards, understand how it affects healthcare infrastructure and service continuity, and support adaptation planning Not reported Depicts current and projected risks within 1km of GP/NHS sites across Scotland related to flooding, air temperature, rainfall, sea level
9. Weather-Health Alerting System Government UK Met Office, UK Health Security Agency Real-time emails focused on heat and cold for health/social care providers, local authorities, emergency planners (alert map part of data dashboard public/assessed) Drought, air pollution,
wildfires, flooding, humidity, wind speed, event duration, spatial extent, resource availability, seasonality, temperature thresholds based on collaborative risk assessments		 Provide early warning and risk communication on climate-related health risks to help local decision-making Regionalised green (prepared), yellow, amber, red (emergency) alerts trigger advice and information to NHS and governmental workers during or prior to weather event Not reported

Discussion

This study identified and characterised nine UK-based climate adaptation tools used in healthcare through direct access to practice-facing resources. These tools spanned e-learning courses, online dashboards, integrated software, and structured workflows, and were primarily designed for healthcare professionals. Few targeted local authorities and none supported patient self-management. Across tools, environmental health data were applied inconsistently, addressing a range of risks including heat, cold, flooding, and pollution, with intended outcomes varying from service preparedness to risk identification and policy support. While some tools incorporated spatiotemporal data and continuous updating, this was not consistent, which limits their ability to respond to rapidly changing environmental exposures. A consistent finding was the limited transparency and accessibility of tools. Nearly half were not publicly available, and all provided minimal information on underlying evidence, methodological limitations, or intended populations. In addition, reporting of demographic characteristics and approaches to personalisation was largely absent. This limits understanding of whether these tools support equitable care or reinforce existing disparities, particularly among populations with the highest exposure and vulnerability. Taken together, these findings indicate that current tools do not yet reflect the aims set out in national policy for integrated, locally adaptive approaches that link health and social care in response to climate-related risks. Fragmentation in tool development, variation in scope, and the absence of a centralised database contribute to a landscape that is difficult to navigate and assess. In this context, the lack of clarity around what constitutes a “tool” further complicates identification and evaluation of available resources.
Comparison to existing literature
These findings are consistent with other literature, which also highlight a clear need for practical tools that enable healthcare providers and users to adapt effectively to extreme weather [30,31,32]. While many reviews describe that broader initiatives are required to improve preparedness, advance weather warning systems, and promote collaboration across services, the evaluation of existing practical tools designed to address these needs remains limited [33,34]. The small number of studies that do explore the applications of climate adaptation tools in healthcare also describe a range of resources, including online dashboards, e-learning modules, and structured workflows designed to facilitate risk assessment, planning, workforce management, and decision-making. However, evidence and evaluation of their practical applications or integration within organisations is again limited [35,36,37,38]. Furthermore, these confirm inconsistent use of the term “tool”, as well as a gap between policy frameworks and practical implementation due to poor operationalisation [39].
This lack of implementation and evaluation of climate adaptation tools in healthcare including primary and social settings is also evident when looking at the UK specifically [40,41,42,43], despite relatively well-developed guidance highlighting its need. While other tools exist, these do not meet eligibility criteria due to a lack of context-specific actionable steps or interactive elements, such as the Health Inequalities Climate Change Tool [44] and Flooding or Cold or Heat Health Action Cards [45,46,47]. Furthermore, healthcare tools utilising meteorological data also often address the effect of healthcare on climate change and goals of sustainable practice [48], rather than the effect of weather events on health (e.g., RCGP Green Impact for Health Toolkit [49]). While ClimApp does utilise meteorological data to inform individualised heat and cold stress guidance for healthcare professionals as well as patients, this tool remains in early development and is not yet integrated within the UK [50].
Strengths and limitations
This environmental scan provides the first synthesis of UK-based healthcare tools developed to support adaptation to climate-related health risks. Strengths include the use of a transparent and structured approach, independent screening and data extraction by two reviewers, and a systematic narrative synthesis. Inclusion of grey literature from inception to the present, rather than reliance on peer-reviewed academic publications, enabled identification of practice-based tools developed across healthcare organisations, local authorities, and service settings that are not routinely captured in indexed repositories. The use of Google searching also reflects how such tools are accessed in real-world settings, which strengthens the relevance of findings for policy and implementation.
However, the absence of a centralised database and the limited public availability of many tools means that some resources may not have been identified. Tools used within primary care, social care, or hospital systems may be embedded within internal platforms and therefore not visible through public search strategies. In addition, variation in how tools are described and labelled may have influenced identification despite the use of predefined search terms and broad eligibility criteria. Data extraction relied on information available within tool descriptions which were often limited, restricting the ability to assess underlying evidence, implementation processes, and impact. As a result, findings reflect reported characteristics rather than independent evaluation of tool performance. Finally, the heterogeneity of tools in design, purpose, and reporting limited the extent to which direct comparisons could be made across the identified resources.

Conclusions

The current landscape of climate adaptation tools in UK healthcare is fragmented, with variability in accessibility, evidence, and scope. Centralised organisation of these tools, alongside clearer standards for reporting of data sources, populations, and intended use, would support more consistent evaluation and implementation. Improved transparency and coordination may enable greater generalisability and scalability across healthcare settings, and support alignment with national policy priorities for integrated and locally adaptive responses. Strengthening the development and reporting of these tools could contribute to more effective identification and management of climate-related health risks, particularly among populations with the highest levels of vulnerability.:

Author Contributions

Conceptualisation: LVM, HDM; methodology: LVM, LS, HDM; data collection: LVM, HS; data analysis: LVM; writing and review: LVM, HS, LS, HDM.

Funding

This work was funded by the National Institute for Health Research Artificial Intelligence for Multiple Long-Term Conditions (AIM) project, “The development and validation of population clusters for integrating health and social care: A mixed-methods study on Multiple Long-Term Conditions” (NIHR202637), and the National Institute for Health and Care Research Multiple Long-Term Conditions (MLTC) Cross NIHR Collaboration (CNC) (NIHR207000). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

Data Availability

All data utilised is publicly available.

Conflicts of Interest

None declared.

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