Background The health sector will play a crucial role in reducing the impact of climate change on health. However, the impact of hospitals themselves on the climate and the environment is not being adequately addressed by the EU. Hospitals and other healthcare units are energy and resource intensive, which indirectly affects human health by contributing to climate change. The healthcare sector in Skåne is responsible for CO2 emissions of more than 73 000 tonnes/yr. This suggests that the healthcare sector in the EU is responsible for millions of tonnes of CO2 emissions every year. Objectives The CLIRE project brings together many different actions to show ways of dramatically reducing the carbon footprint of the health sector in Skåne. These actions will be in line with EU objectives in relation to climate change, in particular the objectives of increasing the contribution of renewables to 20% of total energy supply and reducing carbon dioxide emissions by 20%, both by 2020. Specific objectives of the project include: To improve the procurement system so that products with a low carbon footprint will have a better chance of winning public tenders; To establish a demonstration facility (the sustainable treatment room) and a working methodology that can be employed by health clinics; To increase the use of energy from renewable energy sources and refurbish a hospital building using climate-smart technology; and To transform a number of buildings used for primary healthcare into demonstration sites. Actions will be implemented in order to reduce energy demand and the heating systems will be transformed so that each building will use locally-produced renewable energy sources.Expected results: Testing and demonstration of a climate-smart procurement model; The creation of a climate-smart treatment room and adoption of climate-smart work practices; A reduction in the carbon footprint of a hospital building by 50%, by reducing the consumption of energy from fossil fuels and increasing energy efficiency; Improved work practices and physical investments as a result of the climate-smart primary healthcare demonstration unit; A primary healthcare unit supplied with 100% renewable energy sources; and A reduction in the carbon footprint of each of the participating healthcare units by 50%.