Sheffield’s children’s NHS foundation trust - Reducing the use of medications which affect the environment

Case study submitted as part of Lancet Commission call for case studies.

Team members / location: Sophie-Mai Wilde / Yorkshire, England 

Issue: Often some medication can be over-used leading to huge impacts on supply chain demand, once these medicines become back in-stock AHP’s and other medical professions feel the need to use them even though it’s possible to use a more sustainable alternative showing there’s no awareness on sustainable impact.  

Intervention: AHPs may prevent this by advising patients against unnecessary prescriptions and enforcing behaviours which reduces the risk of hospital admission. Also, extra training to be given out to prevent the overuse of certain drugs were not medically necessary. ODPs especially could advise clinical staff about the harmful effects of Desflurane and Nitrous gas to the atmosphere and how it could affect patients health risks in the future which could lead to further admission  

Outcomes:  

• Environmental impact: Will help the NHS become more sustainable by limiting medications including nitrous gases, improving patient health and less admissions. 
• Social: ODPs could advise clinical staff improving their knowledge about the harmful effects of Desflurane and Nitrous gas to the atmosphere and how it could affect patients health risks in the future. Could result in dispute between health care professions if they feel as if patient care isn’t optimized.  
• Financial: Responsible use of medications will reduce any additional costs associated with unnecessary prescriptions and overuse of medication. Time of the training of AHP’s requires them to take time out of their current positions to complete training meaning extra staff on shifts will be required. Restricting some medication may lead to a more expensive alternate and could increase the demand on services if improperly managed.  
• Clinical - Patient outcomes: Some patients may not receive this well and may not like to hear small changes they can make to improve their health in the future however as a long term effect it will improve their health. Population outcomes: It will increase the populations health as less hospital admissions leads to less ambulance journeys which contribute to air quality and less medication will be needed leading to less greenhouse gas production.  

Key learning point: 

• This needs to be approached by demonstrating that environmental factors will impact everyone’s future so it will improve long term health and therefore falls under patient care.