Reducing our carbon footprint by introducing green inhalers
We began prescribing dry powder inhalers to eligible patients at HMP Norwich to reduce the negative impact on the environment and make improvements to patients’ treatment outcomes.
Why we decided to take action
Climate change impacts the air we breathe, affecting our lungs, and increases the risk that air pollution will worsen.
The environmental impact is an area of increasing concern and, as healthcare professionals, we recognised that we should be playing our part in evaluating practice to see how we could make a difference.
The NHS in England is responsible for an estimated five per cent of the country’s carbon footprint, which is equivalent to all the planes taking off from Heathrow in an average year.
Medicines account for 25 per cent of emissions within the NHS. Within medicines, inhalers are the single biggest contributor to the carbon footprint.
What we did
Our Medicine Optimisation Strategy sets high quality health and care standards for all, now and for future generations. This means we must respond to the health emergency that climate change brings.
Our target was to have 90 per cent of eligible patients on green inhalers at HMP Norwich to reduce the negative impact on the environment and make an improvement to patients’ treatment outcomes. In April 2023 only 10 per cent of patients were on inhalers classed as environmentally friendly.
We wanted to move away from the use of multidose inhalers (MDI), which are small and quick to use but require the patient to coordinate breath and actuation, which can be a problem for patients with low grip strength or arthritis. MDI inhalers are a poor choice for patients with low cognitive ability or difficulty actuating the mechanism. They are also the ones which have the highest carbon footprint.
Dry powder inhalers (DPI) differ from MDIs in that they are breath-actuated (breath-dose coordination is unnecessary) and easier to use.
Metered dose inhalers have estimated carbon footprints of 500g CO2eq per dose, compared to 20g in DPIs.
We switched our protocol from MDIs to DPIs for clinically suitable patients and reviewed all patients on inhalers.
All prescribers, long term condition nurse and other healthcare team members got involved in the project.
What difference has this made?
By April 2024 100 per cent of all prescribed inhalers are now classed as ‘green’.
Positive feedback from patients has included:
“This has improved my asthma control”
“I have a better understanding on how to use the inhaler”
“I am happy to use a greener option if I can.”
As a result of the change, we have decreased the carbon footprint by at least 15600kg of CO2, which is equivalent of 71,000 miles by car per annum!
This success has been shared with our teams across the country so it can be implemented in different services.
This project proves that we all can have a positive impact on our planet by making small changes.
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