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Concerns about the environmental impact of the propellant gases used in pressurised metered dose inhalers (pMDIs) and the plastics used in all single-use inhaler devices have made them an important focus for efforts to reduce the environmental impact of the NHS. Patients themselves may also be concerned about the environmental impact of their inhalers and express a preference for alternatives. PCRS do not support ‘blanket switching’ of patients from one inhaler type to another.

According to the Global Initiative for Asthma (GINA) asthma control is assessed in two domains: symptom control and risk of adverse outcomes.  Poor symptom control is budensome to patients and increases the risk of exacerbations, but patients with good symptom control can still have severe exacerbations.[1]

The PCRS Greener Respiratory Healthcare Quality Improvement (QI) toolkit has been developed to support HCPs working in the primary care setting to understand and evaluate the environmental impact of their clinical practice, identify ways to reduce this impact, set goals and priorities and evaluate progress. The toolkit has been designed around the PCRS Greener Respiratory Healthcare Pathway which signposts the user to a curated suite of resources and materials to guide and support HCPs in their journey towards sustainable respiratory healthcare.

This pragmatic guide has been developed based on the work of the PCRS Greener Healthcare Working Group. In 2020, the PCRS Greener Healthcare Initiative brought together respiratory healthcare professionals working in primary and secondary care setting, public health specialist, patient advocacy organisations, patient representative, policy influences, service users and decision makers as well as representatives from the pharmaceutical industry.

In this article authors Daryl Freeman and Noel Baxter discuss some top tips you can implement locally to make the case for and influence others positively in support of greener respiratory healthcare.

In this article we discuss how to incorporate environmental considerations when selecting inhaler devices for patients newly diagnosed with respiratory disease. We also consider how to safely change to inhalers with a lower environmental burden when clinically appropriate and how to support patients in making the decision to change.  

As of April 2021, regional health and care needs in England will be coordinated through Integrated Care Systems (ICSs) (https://www.england.nhs.uk/integratedcare/what-is-integrated-care/).

An estimated 1.2 million people are living with COPD in the UK1 and research suggests that this number is growing (BLF 2020). Both external and internal environments can be implicated in the aetiology and control of respiratory conditions and people living with COPD are especially vulnerable to exacerbations brought on by poor air quality. PHE estimates that between 28,000 and 36,000 deaths in the UK are thought to be attributable to human-made air pollution (PHE 2019).

PCRS support initiatives to improve air quality and minimise short- and long-term damage to the environment, particularly those with an impact on climate change resulting from greenhouse gases.