Climate change is the biggest global health threat of the 21st century. The more we ignore the climate emergency the bigger the impact will be on health and the need for care with poor environmental health contributing to major diseases, including cardiac problems, asthma and cancer. Many of the actions to mitigate and adapt to climate change and improve environmental sustainability also have positive health benefits; the Lancet Commission has described tackling climate change as "the greatest global health opportunity of the 21st century". The challenges faced present an incredible opportunity to do things differently - to take a design-led approach in designing and making through high-reward demonstrator projects to help transform the health ecosystem. Through wider public engagement we aim to advance societal understanding of design's impact, and the opportunities, barriers, behaviour changes and tools needed to transition to a green approach. This research will unite a wide range of disciplines, research organisations, regional and local industry, and other public sector stakeholders, with policy-makers. The Design HOPES Green Transition Ecosystem (GTE) Hub will sustain a phased long-term investment to embed design-led innovation, circularity, sustainability and impact for the changing market, across product, service, strategy, policy and social drivers to evolve future design outcomes that matter to the people and planet. Our research is organised around seven core Thematic Workstreams, based on the NHS Scotland Climate Emergency and Sustainability Strategy (2022-2026). Design HOPES will be delivered and managed by interdisciplinary teams with significant expertise in design and making, co-creation, health and social care, with professionals with a sustainability remit, and businesses working in the design economy. Design HOPES encompasses a rich disciplinary mix of knowledge, skills, and expertise from a range of design disciplines (i.e., product, textile, interaction, games, architecture etc.) and other disciplines (computer science, health and wellbeing, geography, engineering, etc.) that will be focused on people and planet (including all living things), from the micro to macro, from root cause to hopeful vision, from the present to the future, and from the personal to the wider system. Design HOPES will design and make things and test them to see how they work, which will help more ideas and things emerge. The Hub will be an inclusive, safe, collaborative space that will bring in multiple and marginalised perspectives and view its projects as one part of a wider movement for transformational change whilst not overlooking existing assets and how we can re-use, nurture and develop these sustainably. Design HOPES aims to be an internationally recognised centre of excellence, promoting and embedding best practice through our collaborative design-led thinking and making approaches to build a more equitable and sustainable health and social care system. We will create new opportunities to support both existing services and new design-led health innovations in collaboration with NHS Boards across Scotland, the Scottish Government, patient and public representatives, health and social care partners, the third sector, academia and industry. Our seven Thematic Workstreams and associated projects will deliver a rich mix of tangible outcomes such as new innovative products, services, and policies (e.g., sustainable theatre consumables, packaging, clothing, waste services, etc.) during the funded period. With award-winning commercialisation and entrepreneurial support from the collaborating universities, we will also look to create new "green' enterprises and businesses. We will achieve this internationally recognised centre of excellence using design-led thinking and making to build a more equitable and sustainable health and social care system.