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Respiratory - Carbon Impact dashboard

Around 3% of all greenhouse gas emissions generated by the NHS come from the inhalers prescribed for respiratory conditions.
In line with the NHS Long Term Plan, the Greener NHS programme, and to support the ambition for a net zero NHS, we’re aiming to reduce greenhouse gas emissions by 4% by 2040 through greener inhaler prescribing. This is the carbon dioxide equivalent (CO2e) of 403Kt.
Recently, there have been initiatives to choose greener alternatives when prescribing inhalers.  For example, the National Institute for Health and Care Excellence (NICE) has 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.

Dry powder inhalers (DPIs) and soft mist inhalers (SMIs) are a greener alternative to metered-dose inhalers (MDIs). MDIs rely upon an aerosol to deliver their active chemical ingredients and have a higher carbon load.

Prescribers have been encouraged to prescribe a DPI or SMI instead of an MDI, where clinically appropriate. If this is not possible, they are encouraged to prescribe a lower carbon MDI variant.

This will achieve a more sustainable approach to inhaler prescribing. It will mitigate the carbon impact of respiratory prescribing, without a negative impact on patient outcomes.

The Respiratory - Carbon Impact dashboard sits alongside the existing Respiratory dashboard in ePACT2. It is intended to provide prescribers and commissioners with the necessary insight to understand the impact of respiratory prescribing in terms of sustainability. It will also provide a way to monitor and promote better prescribing practice in the respiratory space, with the aim of reducing greenhouse gas emissions.

The dashboard shows information in 4 key areas:

  • Prescribing of DPI inhalers for short-acting beta agonist (SABA) inhalers.  SABA inhalers, also known as relievers, are used to control symptoms.  
  • Prescribing of DPI inhalers for preventers. Preventers, such as inhaled corticosteroid (ICS) or long-acting beta agonist product (LABA) inhalers, are used in the day-to-day management of respiratory conditions.
  • Prescribing of lower carbon salbutamol MDI inhalers.
  • Prescribing of high-carbon preventer inhalers.

The data is shown by month, and can be viewed at GP practice, PCN and sub-ICB location levels.

In future releases, the dashboard will display the CO2e emission values associated with each metric, along with predicted values based upon target reductions in emissions. There are further plans to introduce metrics to cover areas such as overprescribing, double and triple therapy, and branded versus generic prescribing.

The release of this dashboard allows NHSBSA to deliver on our Environment Strategy by using our interaction with the wider healthcare system to help drive change on a national level. As a Catalyst for Better Health, it is imperative that we understand how medicines are impacting our environment and what role we can play in helping to reduce that impact.

Supporting Documentation

View the Respiratory - Carbon Impact dashboard specification (Word:110KB) and appendix document (Excel: 41.1KB), where a description of the metrics and a list of the inhalers used in the dashboard can be found.

If you’re registered for ePACT2, you can access the Respiratory - Carbon Impact dashboard via ePACT2.

If you’re not registered for ePACT2, you can access the Respiratory - Carbon Impact dashboard using the Catalyst - public insight portal.