Healthcare - the environmental impact

Healthcare has a significant environmental impact and the Gloucestershire Respiratory team, working within the Integrated Care System are aware that our decisions about patient care, and other activities, can be an important means to reduce our environmental burden. This is particularly important for Respiratory disease, which is likely to be increased in incidence as a result of climate change, and also increases in air pollution will lead to worsened health for those with lung disease.

The medicines we use have a significant impact, as inhalers using propellant gases are amongst the highest contributors to climate change, representing 4% of NHS greenhouse gas emissions. Alternative, propellant free inhalers have dramatically lower environmental impact.

We recognise that prevention of ill health and early, accurate diagnosis and treatment will reduce future need for healthcare, and therefore is a powerful means by which we can impact positively on the environment. We are seeking to expand and improve provision of tobacco dependency treatment for smokers across all parts of the health system.

We have also begun work to improve access to tests to diagnose lung disease accurately, making sure that the right patients receive the right treatments.  Mis-diagnosis leads to significant waste, particularly where inhalers are used inappropriately, where they are unlikely to improve the health of patients.

We have also redesigned the information given to healthcare professionals around starting treatments when lung diseases have been diagnosed.  It is important that the choice of inhaler is best for a given individual, but involving patients in decisions when such medicines are started, with greater awareness of the environmental impact of inhaler choice has the potential to reduce the impact of Respiratory disease on the climate.

We have highlighted “greener” choices throughout our guidance to healthcare professionals, and as a county have seen falling rates of propellant gas inhaler use over the last few years.

• Inhaler guidelines
• Inhaler guidelines - adults

Finally, people who use inhalers, particularly those with propellant gases, can be encouraged to take matters into their own hands to improve their impacts. We have been seeking to promote and improve the uptake of inhaler disposal schemes via pharmacies, while also advocating for recycling schemes for inhalers, which have unfortunately not been widely supported beyond a few industry sponsored pilot programmes.

We wish to encourage patients to return their used/unwanted inhalers to their community pharmacy for destruction. When returned to pharmacy they are incinerated and residual hydrofluorocarbon propellants are destroyed rather than eventually being released into the atmosphere if disposed of into landfill.