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

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

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'

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

Dr Vince Mak speaks about value in respiratory prescribing

Vince Mak's talk presents an important opportunity to reduce environmental harm from use (and over-use) of respiratory inhalers, which have a huge carbon footprint due to the use of HFC propellants:

NHS London Respiratory Team Conference

October, 2012

Cradle to Gate

Greenhouse Gas Accounting Sector Guidance for Pharmaceutical Products and Medical Devices

A consortium of major global companies has been working with the NHS SDU to agree standards for reporting of carbon equivalents emissions for the manufacture of drugs and medical devices. The report was launched on Friday 30th Nov 2012 at St Thomas' Hospital in London and is a real achievement, albeit only the beginning of a lot more work.

Sustainable COPD Inhalers

The document is a framework for a review of key issues in inhaler use leading to 3 action points.

Centre for Sustainable Healthcare

July, 2012

Disruption as opportunity

David Pencheon has been quoted recently as seeing opportunity in the disruption caused by the passing of the Health and Social Care Act.

Article n the Guardian on pharmaceutical waste in the NHS

Not sure whether people have seen this article in the Guardian:

Greener Inhalers for the UK

The Centre's Sustainable Respiratory Care group will lead research on why the UK continues to use inhalers with a much higher carbon footprint than other European countries.

Following the Montreal protocol banning the use of CFC gases in 1987, many countries moved directly to a new technology for inhalers based on Dried Powder (DPIs) while the UK still prescribes a majority of metered dose inhalers (MDIs) which use powerful greenhouse gases.

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Greener AHP Hub

The Greener AHP Hub is a resource for Allied Health Professionals. It provides information and clear actionable steps which AHPs can take to improve their own environmental sustainability. The hub complements the

NHS England

October, 2021

Remote Consultations: Do they reduce Greenhouse Gas Emissions? Your Guide to calculating the Answer

This guide and carbon calculator have been developed by the Centre for Sustainable Healthcare in collaboration with PD Transformation and funded through Q by the Health Foundation and NHS England and NHS Improvement.

September, 2021

framework for sustainable inhaler practices in GP

SSC report + recorded workshop
- background/context of sustainable respiratory care
- summary of interviews with practice patients
- framework for action/SusQI projects in GP

May, 2021

The carbon footprint of waste streams in a UK hospital

This article by CSH's Sustainable Surgery Fellow, Chantelle Rizan, and co-authors, provides greenhouse gas emission factors for the different healthcare waste streams in the UK.

Highlights:

Journal of Cleaner Production

December, 2020

Environmental impact of PPE in the first six months of the COVID-19 pandemic

Article: Environmental impact of Personal Protective Equipment supplied to health and social care services in England in the first six months of the COVID-19 pandemic.

Chantelle Rizan, Malcolm Reed, Mahmood F Bhutta

Journal of the Royal Society of Medicine

December, 2020

Inhalers poster

We are using this poster to inform improved inhaler prescribing at Newcastle Hospitals

December, 2020

The environmental footprint of health care: a global assessment

Background: Health-care services are necessary for sustaining and improving human wellbeing, yet they have an environmental footprint that contributes to environment-related threats to human health.

July, 2020

Blue, brown and now green

Useful information resource / infographic about different inhalers and the main differences between them - including environmental impact.

Could be helpful in teaching...

The Pharmaceutical Journal

June, 2020

Recording: National Allied Health Professions Sustainability Webinar

This is a recording of the AHP Sustainability webinar from June 18th 2020, part of the National Allied Health Professions fornightly webinar series.

June, 2020

Millions of Nurses Call The World To Action #HealthyRecovery

From the Alliance of Nurses for Healthy Environments, this a short video (see link below) which accompanies the

May, 2020

Greener AHP Hub launched

Yesterday saw the launch of the Greener AHP Hub. This was

URGENT - COP26

I wanted to say Hello! I'm Hayley Pinto - I have just joined CSH as the new Education and Training lead.

CFMS HEART: NATIONAL REPORT ON PLANETARY HEALTH EDUCATION 2021

The Canadian Federation of Medical Students Health and Environment Adaptive Reponse Task Force recently released this report:

Climate Change Urgency and Action webinar series

The Intensive Care Society has a fantastic lineup of speakers for a weekly lunchtime (one hour) webinar series called Climate Change Urgency and Ac

A Simple Sustainability Audit - would you like to join us?

Dear Colleague,

CSH is hiring! Specialities Lead & Networks Coordinator

We are creating two new roles in my team at CSH - if you would like to help us work with clinical specialties and/or develop our online networks, please get in touch!

Oxygen waste

Here’s a very short but useful article about oxygen waste from turning the flow all the way up to the top (past 15 l/min) which is commonly done:

Sustainable Spirometry?

Hi all,

Sustainable Healthcare Reading List

Hi all, I work in the sustainability team for my Trust and I'm collaborating with our libraries to curate a sustainable healthcare reading list for

GREEN-ICU study seeking volunteers for survey and online interviews

The GREEN-ICU research study is seeking views o

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Remote Consultations: Do they reduce Greenhouse Gas Emissions? Your Guide to calculating the Answer

September, 2021

New GP contract incentivises lower carbon inhalers

The new GP contract published last week includes a new incentive to encourage lower carbon inhalers.

Green Inhaler website

This patient- and clinician-facing website gives guidance on choosing inhalers with lower environmental impact - something which is now included in the BTS asthma guidelines.

Dr Alex Wilkinson

September, 2019

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