The SHC care pathway method
A structured, repeatable approach to measuring the carbon footprint of clinical care
This page sets out an overview of the method SHC developed in collaboration with NHS England, and updated in 2026. It is designed to be used by anyone - clinicians, planners, and industry teams - at any scale, and with whatever data is available. The method underpins the Patient Care Pathways Carbon Calculator, SHC's free tool for running your own assessment.
How the method works
The SHC method guides you through a full assessment of a care pathway, from initial scoping through to reporting your results.
You start by clarifying what you’re assessing and why – which patients, which condition, what setting, and what you want the findings to be used for. This defines the boundaries of the assessment and the “unit” that all your results will be measured against.
Next, you map out the care pathway in detail: every activity involved, how often it happens, and how these activities group together into simple building blocks (such as a GP appointment, a hospital bed day, or patient travel). Keeping activities distinct at this stage avoids anything being counted twice later on.
You then identify which of these activities have the biggest environmental impact, and focus your data collection there – using real-world data where it’s available, and best estimates where it isn’t. Each activity’s impact is calculated and then combined, based on how often it occurs, to give the total impact of the whole care pathway.
Finally, you interpret the results to find where the impact is concentrated, report your findings, and use them to make the case for change, whether that’s redesigning a pathway or informing a wider decision.
For more detail, please refer to the full method document
