Respiratory care has some of the biggest problems (inhalers) and many good solutions for sustainable healthcare.

Carbon footprint of GSK inhalers

This isn't widely available but GSK have given it to me so I'm sharing it.

Choosing Wisely

On the 24th October 2016 the Academy of Medical Royal Colleges brought out a report

Air quality ruling

This week the High Court found the government's action on air quality to be inadequate. In the second successful case against the government

Breathing the fresh air of co-benefits

Recently it feels like air pollution's spread beyond the concern of those who care about public health to become a more mainstream issue.

Top tips for mental health teams to improve respiratory outcomes for their clients

A ten-point summary of best practice for mental health teams to improve respiratory outcomes for people with mental health problems developed by the London Respiratory Network. This matters because:

London Respiratory Network

June, 2016

Air quality posing a 'very high risk' to health at the Fort McMurray wildfire

Is Alberta another very sobering 'right now' example of climate change affecting health? See the Canadian Government's assessment of the air

Reducing the carbon footprint of hospital-based care

Nephrologist, Charlie Tomson, gives an overview of the challenge of reducing carbon in the NHS and potential solutions - from energy and waste reduction to Sustainable Care Pathways.

Tomson, C., Future Hospital Journal

February, 2015

Royal College of Physicians looking for Clinical Lead: Sustainability (part time)

Exciting developments at the RCP - and an exciting opportunity for a consultant physician...

UK health services unprepared for climate change, warns major new health alliance

UK health services are currently unprepared for the risks posed by climate change, warns a major new health alliance launching today.

Health sector hits first target in combating climate change - SDU report

The health sector is over the first hurdle in the race to reach carbon reduction targets and help limit the effects of climate change.

Breathlessness, physical activity and sustainability of healthcare - letter

Only just came across this letter by Nick Hopkinson and colleague to the European Respiratory Journal last January, highlighting the importance of

The impact of respiratory virtual clinics in primary care on responsible respiratory prescribing and inhaled corticosteroid withdrawal in patients with COPD: a feasibility study

Poster which was presented at the BTS winter meeting 2014.

King's Health Partners

January, 2015

Committee on Climate Change report and SDU call for NHS feedback on overheating in wards

The Committee on Climate Change has produced a recent report entitled 'Managing climate risks to well-being and the economy'

Respiratory fellowship plans - can you help

We (CSH) are looking for funds for a 2-year Sustainable Respiratory Care Fellow who would work with us and this Network on:

BMJ editorial - Inhaled drugs and global warming: time to shift to dry powder inhalers

As atmospheric carbon dioxide levels top 400 parts per million, an editorial in this week's BMJ draws attention to the impact of respiratory inhalers on global warming.

CleanMed 2013 - call for case studies

Plans underway for a Sustainable Respiratory Inhalers Programme

The continued use of metered-dose inhalers (MDIs) in respiratory care will have a potentially serious effect on global warming if production is not controlled, largely because these inhalers use potent green-house gas hydroflourocarbons (HFCs) as propellants. A cost-effective and safe alternative is available in the form of Dry Powder Inhalers (DPIs), and we propose a programme to change prescribing practices such that DPIs are used in preference to HFC-driven inhalers where not clinically contra-indicated.

Sustainable Respiratory Inhalers Programme - Table of Actions

Table of Actions for a Sustainable Respiratory Inhalers Programme - first created in consultation with Sustainable Respiratory Care Advisory Group in February 2013. This table can be updated as actions are completed or proposed.

Centre for Sustainable Healthcare

February, 2013

Sustainable Respiratory Inhalers Programme - briefing note

The continued use of metered-dose inhalers in respiratory care will have a potentially catastrophic effect on global warming if production is not controlled, largely because these inhalers use potent green-house gas hydroflourocarbons (HFCs) as propellants.

Centre for Sustainable Healthcare

March, 2013

Thorax editorial - Prevention is best: lessons from protecting the ozone layer

Published late last year in BMJ Thorax, editorial by Ashley Woodcock: "The Montreal Protocol was signed 25 years ago. As a result, the irreversible destruction of the ozone layer was prevented.

Ashley Woodcock

July, 2012

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UN report addresses propellant gases in inhalers

A report has just been presented to the United Nations Environment Programme (UNEP) in respect of the Montreal Prot

United Nations Environment Programme

January, 2019

Alternative to pMDI? Reduced environmental impact of a reusable soft mist inhaler

Hänsel M, Bambach T, Wachtel H M32 Reduced environmental impact of a reusable soft mist inhaler. Thorax 2018; 73:A262.

Abstract

Hansel M et al. Thorax

December, 2018

Moving beyond the air quality crisis

Realising the health benefits of acting on air pollution

This report on air pollution describes the current problem, the reasons it exists and the critical need to resolve it, and includes high level recommendations on the measures required to act on it.

UK Health Alliance on Climate Change

October, 2018

Outpatients: the future – adding value through sustainability

The Royal College of Physicians published a new report 'Outpatients: the future – adding value through sustainability' which seeks to re-evaluate the purpose of outpatient care and align those objectives with modern-day living and expectations.

November, 2018

Natural resources footprint for NHS and social care

This is the most recent carbon/natural resources footprint of health and social care in England, based on 2017 data. Of note, the greenhouse gas emissions from metered dose inhalers are estimated at 0.85 Mt CO2e, which is around 3.2% of total emissions for the sector.

Sustainable Development Unit, NHS England & Public Health England

September, 2018

Sustainable inhaler prescribing driver diagram

This example driver diagram shows how principles of sustainable clinical practice can be applied to improve respiratory inhaler prescribing. Hopefully it shows a holistic approach (MDI>DPI is not the whole story...).

Centre for Sustainable Healthcare

March, 2017

RCP video on NHS environmental impact

Short animation to raise awareness of the NHS contribution to environmental issues such as climate change and air pollution, and encourage health professionals to look for environmentally friendly ways to practise.

Royal College of Physicians

September, 2018

Making Sense of Social Prescription

The University of Westminster has published an excellent explanatory document on social prescription. It's a fantastic end to end resource with explanations of terminology, structures, different types of social prescription, and referral examples.

August, 2017

Top tips for mental health teams to improve respiratory outcomes for their clients

A ten-point summary of best practice for mental health teams to improve respiratory outcomes for people with mental health problems developed by the London Respiratory Network. This matters because:

London Respiratory Network

June, 2016

Reducing the carbon footprint of hospital-based care

Nephrologist, Charlie Tomson, gives an overview of the challenge of reducing carbon in the NHS and potential solutions - from energy and waste reduction to Sustainable Care Pathways.

Tomson, C., Future Hospital Journal

February, 2015

QI Inhaler Project in Primary Care

Hi all,

Does anyone have experience of reducing MDI prescribing/use in a community GP setting?

Inhalers and NHS Long Term Plan

The NHS Long Term Plan, published earlier this month, makes two references to inhaler climate change

Expert Working Group on reducing the climate change impact of inhalers

A national (English) working group has been formed to establish the approach and a potential target for reducing the climate change impact of

"Can a Whisper become a Roar" A call to action for the healthcare community

"As clinicians we are taught to value evidence based interventions that benefit health and wellbeing.

Calling all Q members (Health Foundation) with a passion for sustainability

Calling all sustainability friends… are you a Q member (Health Foundation)?

Sustainability in QI - the time has come!

Health systems are in constant need of improvement - and in some cases total redesign.

Air Pollution - GPs

Hello - Im a final year medical student doing a 2 week placement with CSH.

MPs call on NHS to reduce use of MDIs to tackle climate change

The Environmental Audit Committee has called on the Government, the NHS and manufacturers to reduce the production and use of metered dos

WFOT Launches Guiding Principles for Sustainability in Occupational Therapy

Last week saw the launch of the World Federation of Occupational Therapists publication ‘Sustainability Matters: Guiding Principles for Sustainabil

Call for submissions: heatwaves (adapting to climate change) select committee inquiry

The House of Commons Select Committee for the environment, the Environmental Audit Committee, is calling for evidence as part of its heatwave enqui

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Deana Gershuny posted QI Inhaler Project in Primary Care in the Sustainable Respiratory Care network

Thu, 2/14/2019 - 3:53pm

Frances Mortimer posted Inhalers and NHS Long Term Plan in the Sustainable Respiratory Care network

Thu, 1/31/2019 - 11:03pm

Jerome Baddley CEnv MIEMA created UN report addresses propellant gases in inhalers in the Sustainable Respiratory Care network

Thu, 1/31/2019 - 2:20pm

Ben Whittaker created Toasting Good Health! Monthly Sustainable Healthcare Social in Brighton in the Occupational Therapy Susnet, Commissioning Sustainable Healthcare, Sustainable Operating Theatres, Green Nephrology, Sustainable Healthcare Education, Sustainable Primary Care, Sustainable Respiratory Care, Psych Susnet, Dental Susnet, EyeHealth Susnet, and Green Nurse Network groups.

Wed, 1/9/2019 - 7:41am

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Sustainability in QI - the time has come!

Health systems are in constant need of improvement - and in some cases total redesign.

Reducing the carbon footprint of hospital-based care

Nephrologist, Charlie Tomson, gives an overview of the challenge of reducing carbon in the NHS and potential solutions - from energy and waste reduction to Sustainable Care Pathways.

Tomson, C., Future Hospital Journal

February, 2015

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Carbon footprint of GSK inhalers

Expert Working Group on reducing the climate change impact of inhalers

BMJ editorial - Inhaled drugs and global warming: time to shift to dry powder inhalers

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