Person standing outside and holding a blue inhaler

New dashboard launched to help reduce CO2 emissions from inhalers

NHS Business Services Authority has launched a new dashboard to help prescribers to reduce the high carbon impact of inhalers.

Estimates suggest that around 3% of total NHS carbon emissions can be attributed to the prescribing of respiratory inhalers, primarily metered-dose inhalers (MDI) which rely on an aerosol propellant to deliver their active chemical ingredient. 

Prescribing of lower-carbon inhalers (dry powder inhalers (DPI) or soft-mist inhalers (SMI), or lower-CO2 MDI variants, is recognised as a more sustainable approach and a way to mitigate the carbon impact of respiratory prescribing, without a harmful impact on patient outcomes.  

Working with clinicians from Guy’s and St Thomas’ NHS Foundation Trust and Imperial College Healthcare NHS Trust, the new 'Respiratory - Carbon Impact Dashboard' was built to provide prescribers and commissioners with the insight to understand the impact of respiratory prescribing in the context of sustainability. It is a means to monitor and promote better prescribing practice in the respiratory space, with the aim of reducing CO2 emissions.

The dashboard contains data that is easy to understand. For instance, it allows viewers to see the levels of higher carbon-producing inhalers prescribed versus the lower carbon inhalers. Data is shown for different types of inhalers, such as relievers (used to treat symptoms of respiratory conditions when they occur) and preventers (used for ongoing management of respiratory conditions). Data can also be viewed at practice and Primary Care Network (PCN) level, as well as within Sub Integrated Care Board Locations (SICBL).

Michael Brodie Chief Executive of NHS Business Services Authority said: “According to the Greener NHS programme, inhalers account for about 3% of total NHS carbon emissions, which is a substantial amount when you consider transport and other sources of carbon emission.

“Across the NHS, there is a drive to reduce CO2 emissions produced by the prescribing of inhalers for respiratory conditions - in line with the NHS Long Term Plan, Greener NHS initiative, and to support the ambition for a net zero NHS.

“So we hope that our new Carbon Impact dashboard can help prescribers and commissioners to see the great benefits of moving to lower carbon alternatives.”

Sam Schofield, Environment Coordinator at NHSBSA added: “High levels of air pollution cause asthma in both children and adults. In the UK alone more than 12 million people are affected by lung conditions – with over 60 million inhalers prescribed every year. Swapping to a more environmentally friendly inhaler helps to reduce the contribution to climate change and in turn prevents worsening air pollution.”

To access the new dashboard on our public insight portal ‘Catalyst’ go to https://www.nhsbsa.nhs.uk/access-our-data-products/catalyst.

NICE has also produced a decision aid to help people with asthma make informed decisions about their choice of inhaler in relation to its contribution to climate change.

Contact Information

Sahdia Hassen

NHSBSA

sahdia.hassen@nhs.net

Notes to editors

The Greener NHS programme works with staff, hospitals and partners. It builds on the great work being done by trusts across the country, sharing ideas on how to reduce the impact on public health and the environment, save money and reach net carbon zero. For more about Greener NHS go to: https://www.england.nhs.uk/greenernhs/

According to Greener NHS:

  • Inhalers account for 3% of the total NHS carbon emissions. The majority of the emissions come from the propellant in metered-dose inhalers (MDIs) used to deliver the medicine, rather than the medicine itself.
  • More than 12 million people in the UK are affected by lung conditions –with over 60 million inhalers prescribed every year, and up to 4 million people currently receiving treatment for asthma.
  • 85% patients & carers think asthma patients should be encouraged to use more environmentally friendly inhalers (Asthma UK).
  • Lowering the emissions from inhalers focuses on, where appropriate: moving away from MDIs (to dry powder inhalers, or lower-carbon MDI devices where a dry powder inhaler is not suitable for the patient), appropriate disposal of inhalers (i.e. not landfill) and the innovation and adoption of lower carbon inhalers.
  • This approach is also supported by patterns observed in other countries: in 2017, a study found that 13% of all inhalers prescribed in Sweden were MDIs, compared to 70% in England.
  • There is a relationship between increased inhaler use contributing to climate change and in turn worsening air pollution, causing more asthma. 36,000 deaths are caused by air pollution each year in the UK, this is set to increase dramatically due to climate change. 2020 saw the first UK cause of death due to excessive levels of air pollution in a 9-year-old girl.