A series of reports measuring the carbon footprint of the NHS in England. This consumption carbon footprint includes emissions from building energy use; travel to and from sites; as well as goods and services purchased by the NHS. This hybrid approach covers scopes 1, 2 and 3 as identified by the GHG Protocol. The best available methods have been used, including directly measured data where this is available and supplemented with average carbon intensities from an input-output model. Every dataset has been updated based on the most recent Defra guidance alongside the HM Treasury Green Book supplementary guidance for greenhouse gas appraisal. These footprints form a useful understanding of both the scale and changes in emissions over time. To ensure changes to the footprint are represented accurately the whole time series has been updated.