Sustainability is a complex, multifaceted concept that continues to evolve depending on the perspectives of different sectors and professions and their respective expertise and interests. Fundamental in all conceptualisations, though, is the challenge to shift thinking away from humans and nature being separate in the world, and their activities and effects being compartmentalised.

Transforming the health system for sustainability requires consideration of the systemic and complex nature of climate change as a determinant of health, for today's and future generations. This will require attention to both patient level processes and different framework requirements at each level of the health system. 

The strategic framework for value-based health care transformation provides a guide for supporting the consideration of climate change and its impacts on health and health care.