A record-breaking summer saw patients come to harm in every type of health and care setting, testimony from thousands of frontline nursing staff reveals.

It comes as three in four (74%) of those surveyed by the Royal College of Nursing (RCN) say they have little or no confidence that the government is taking sufficient measures to reduce the impact of climate change on health and care services.

Just days before the official end of summer, nursing staff report an “increase in deaths” in services and how patients rapidly deteriorated in "suffocating atmospheres", with those suffering from heart failure and respiratory problems among the most vulnerable.

Staff describe cancer patients dripping with sweat during chemotherapy, while others report maggots in wounds and patients with mental ill health worsening under oppressive heat.

Following revelations last month about the impact of extreme heat on nursing staff, the RCN is sharing the findings from a survey of nearly 2,500 nursing staff captured during the recent heatwaves. It says the work must start now to install cooling systems in all hospitals, care homes and other settings before next summer, which could be even hotter and see more patients come to harm.

The testimony from nursing staff shows that patients and service users were forced to receive care in uncomfortably hot facilities, regularly hitting above 30 degrees. One children's ward in Yorkshire reached 44 degrees, according to a nurse.

Nursing staff describe the combination of the heat and being cared for in corridors as causing patients to become more unwell after entering hospital. A nurse in the North West described the situation as “horrendous” with patients "suffering more from the effects of heat than the actual reason they are in hospital.”  

The difficulty of providing care in overheating corridors led to patients frequently fainting when trying to mobilise, while staff also report severe dehydration as patients, particularly older people, struggle to drink enough fluids.

A common theme from the testimony was also the impact on those with heart failure and respiratory conditions. A nurse in the East of England told of “patients with heart failure sitting in over 30-degree heat and a new ward with blocked windows.” A nurse in a hospital in the South East told the RCN of patients with “low blood pressure, increased dizziness and breathlessness with heart failure and worsening symptoms.”

Meanwhile, a nurse in Wales said: “We had two frail patients for whom the extreme heat directly impacted their deaths. Whilst it was not the only cause - if you are in respiratory failure, the heat is a death sentence.”  

Shockingly, temperatures were such a challenge in one London hospital that a nurse reported increased respiratory distress in newborn babies.

The testimony shows nursing staff taking steps to keep patients cool and prevent deterioration. A nurse at a West Midlands hospital told of an “increase in deaths in the last heatwave” and having to move “a patient out of the ward and into resus in the middle of the night to access the air-conditioning.”

One nurse working in a South East NHS hospital said that high temperatures meant “wounds heal slower, mobility declines, and the simple act of resting becomes a battle against suffocating heat.”

Another nurse in the South East said: “I have actually cried for them [patients]. It's inhumane. I don't think a veterinary surgery would be allowed to operate under such conditions.”

Some of the most shocking details shared with the RCN include the impact on some of the most vulnerable, including those with mental ill health, cancer and terminal illnesses.

Multiple nurses reported mental health patients becoming more challenging with one in the West Midlands saying it was “intolerable” and that “patients were becoming more agitated, aggressive and assaulting staff more.”

A nurse working in an emergency department in a London hospital said:"We assess mental health patients in a very small room in ED. This room has no windows and even though the ED is only 2 years old, the air-con is not good enough for this overwhelming heat. We try to assess our patients as quickly as possible so that they can go home, but some patients are too unwell to leave and are forced to stay (sectioned).”

Meanwhile, a nurse treating cancer patients in London said: "I’ve seen patients sweating and dripping due to the heat during chemotherapy. There is no air conditioning running in the unit. During one particularly hot period, patients were visibly sweating throughout their treatment. This feels like a safety concern, not just a comfort issue.”

A palliative care nurse working in a South West hospital said “we had a palliative patient with chronic ulcers on the ward. In the hospital's care, during the last heatwave, the wounds festered enough that they attracted flies and were found to have maggots. Some of his and his relative's last memories will be knowing of and, in his case, feeling maggots in his wounds.”

Staff also report how people in care homes suffered in hot conditions, with ineffective mitigations in place to keep older people and those with long-term conditions safe and comfortable.

The RCN says the "clock is now ticking" to prepare for next year and calls for heat adaptation for health and care services to receive its own ringfenced funding from government at the budget. The work must start now to ensure effective cooling strategies and facilities are in place across all of health and care in time for when temperatures rise again, the College says.

RCN General Secretary and Chief Executive, Professor Nicola Ranger, said:

“This testimony reveals the devastating impact of extreme heat on patients, with increased death, deterioration, and conditions in services which, frankly, are an assault on people's right to dignified, safe care.  

“The reality is that climate change is here, but long-term underinvestment in our health and care services has left them so unprepared. Staff did everything they could in record-breaking temperatures to keep patients safe and comfortable, but they were fighting a losing battle in buildings which often lack even the most basic cooling facilities. It's been incredibly traumatic.

“We are all aware of the pressures that winter bring, but extreme heat is here to stay, and the clock is now ticking to accelerate investment in hospitals, care homes and other settings to ensure they are prepared. This summer was our warning. By next, we need everywhere to have effective cooling facilities in place, or patients will suffer shocking harm once again."

Ends

Notes to editors

• The RCN surveyed members in Wales and England on the impact of extreme heat on their ability to provide care and the impact of the heat on the people they care for. The survey was live for about 2 weeks between 13-28 August 2026. 
• We received a very small number of insightful responses from Northern Ireland and Scotland members (below 15 in total) which have been excluded for the purpose of this briefing to ensure the results wholly reflect Wales and England. In total, 2,471 respondents participated in the survey (Wales, 189 and England, 2,282),

Key RCN survey findings

• Respondents reported a strong lack of confidence in whether their “Government is taking sufficient measures to reduce the impact of climate change upon health and care services”. Overall, the sample gave an average rating of 2.6 out of 10.0 (where 1 was strongly disagree with the statement, and 10 was strongly agree). 
• Similarly, respondents indicated a strong lack of confidence as to whether “Government is taking sufficient measures to tackle the global climate crisis”, with an average of 3.0 out of 10.0 reported.  

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