Abstract Issue Health and social services cause significant environmental impacts. In Finland, national steering towards environmentally sustainable health and social care has been lacking. Description of the problem A multidisciplinary research project (EKO SOTE 2022-2023) was designed to investigate aims and steering mechanisms for environmentally sustainable social and health care in Finland. The project aimed to propose national steering and monitoring mechanisms for stronger environmental sustainability within the sector. Data for the proposal was collected from literature, review of national legislation, interviews, surveys, and co-development events. The project also aimed to calculate the carbon footprint of Finnish health and social care with the EEIO model ENVIMAT. Results It was estimated that health and social care contributed to 6.5% of Finland’s national carbon footprint in 2019, of which the share of health care was 4.2%. The new goal ‘Social and health care is carbon neutral and minimizes the environmental burden by 2035’ was proposed to be incorporated in the national strategic steering. Wellbeing service counties (WSC) as public care providers were suggested to be included as responsible actors in the Finnish Climate Act. National networks and targeted project funding for WSCs were found important. Three sets of indicators were designed for monitoring environmental sustainability: minimum indicators for all WSCs for national monitoring, voluntary indicators for regional monitoring, and indicators for advanced regions to pioneer best practices. Lessons According to the informants, national steering for environmentally sustainable health and social care is urgently needed. The national goal should be ambitious, wide-ranging, and feasible, and cover environmental aspects broadly. The steering requires multiple mechanisms: normative, strategic, informational, and economic. WSCs should be empowered to develop suitable means to achieve the national goal. Key messages • The project provided an ambitious, feasible, and comprehensive national goal and steering model for reducing the environmental impact of health and social care in Finland. • Collaborative efforts and joint steering model could advance environmental sustainability in health and social care.