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How respiratory healthcare could be greener


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By Carol Stonham
Executive chair of the Primary Care Respiratory Society

18 Nov 2020

In 2020 the Primary Care Respiratory Society launched the Greener Respiratory Healthcare Initiative.

Healthcare accounts for 4% of the UK’s carbon emissions and minimising the environmental impact of healthcare in general is a key goal for the NHS.1  Environmental pollution also contributes to burden of lung disease. Around one in five people in the UK are living with a lung disease and a further 10,000 people are diagnosed every week.2  For many of these people, air pollution is both a cause and an aggravating factor, making their symptoms worse and their lives more difficult. 

Our vision as an organisation is to ensure optimal respiratory health for all and our goal for the Greener Respiratory Healthcare Initiative is to enable our members to deliver healthcare that is kinder to environment. Raising awareness, providing education and advocating for proactive strategies to reduce the impact of respiratory healthcare on the environment is at the heart of the PCRS Greener Respiratory Healthcare Initiative.  

In practical terms, we encourage clinicians caring for patients with respiratory disease to educate themselves about the environmental impact of respiratory healthcare, including the carbon footprint of the inhalers used to deliver mediations for respiratory disease, and consider the environment and environmental issues in their daily lives as well as their clinical practice.  

PCRS believes that a key to greener respiratory healthcare is to ensure that patients receive early and accurate diagnosis. This is critical so that patients can receive the treatment that is right for them. Accurately diagnosed and well controlled respiratory disease is greener healthcare, as it avoids wasted medications and additional hospital visits. Embracing remote ways of working, including remote consultations for patients where appropriate has the potential to reduce air pollution associated with patient travel to and from healthcare facilities.  

Many of the medications prescribed for respiratory disease come in inhalers. The choice of inhaler should be made based first and foremost on what best controls a patient’s condition, and what the patient is able to use effectively. After that, if there is more than one inhaler that might be appropriate, the greener option maybe the one to encourage the patient to choose.  

In the future we hope that all inhalers will be kind to the environment, but for now we need to make sure that patients are educated and empowered to use their inhaler correctly every time, ensure they use every dose and that the inhaler is not discarded until it is empty and that used inhalers are safely disposed of or recycled where possible.  

A focus on working with patients to achieve control of symptoms must be at the top of the list too. Avoiding exacerbations not only improves patient outcomes: it reduces unnecessary travel to and from unscheduled care and reduces the need for excessive use of rescue medication. Overall, better respiratory care is greener respiratory healthcare.  

Healthcare commissioners also have a critical role in enabling clinicians to deliver greener respiratory healthcare that is right for individual patients without compromising on quality. We therefore encourage healthcare commissioners to consider the impact of their decisions on the environmental burden of healthcare systems and services. The environment is not simply a healthcare issue and for this reason PCRS invite partnerships and collaborations between healthcare, patient and environmental organisations to ensure the need for greener healthcare remains high on the agenda at all levels. Collaboration and partnerships with the pharmaceutical industry are also encourage to develop and deliver strategies and treatment that will ensure respiratory healthcare can be delivered in a way that is greener and kinder to the environment while providing patients with the highest quality of care. 

The Primary Care Respiratory Society (PCRS) is a UK-wide professional society for respiratory health care professionals.

References: 

1. NHS England. Delivering a ‘Net Zero’ National Health Service. Available at: https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2020/10/delivering-a-net-zero-national-health-service.pdf

2. British Lung Foundation. Lung disease In the UK – big picture statistics. Available at: https://statistics.blf.org.uk/lung-disease-uk-big-picture#numbers-developed-lung-disease-uk. Accessed November 2020.


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