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Environmentally friendly inhalers

Tags: Greener NHS

What is this measure?

Percentage of inhaler doses that are from metered dose inhalers (MDIs), excluding salbutamol inhalers.

How is it calculated?

We divide the number of MDI inhaler doses by the total number of inhaler doses and then multiply that by 100 to obtain the % each month. We do not include salbutamol inhalers in these calculations or inhalers which are used outside of the management of common respiratory conditions such as asthma or chronic obstructive pulmonary disorder.

Why does it matter?

The updated BTS/NICE/SIGN guidance on asthma management recommends basing inhaler choice on:

  • an assessment of correct technique
  • the preference of the person receiving the treatment
  • the lowest environmental impact among suitable devices
  • the presence of an integral dose counter

The NHS has committed to reducing its carbon footprint by 80% by 2028 to 2032, including a shift to lower carbon inhalers. Dry powder inhalers (DPIs) and other newer types of inhalers like soft mist inhalers are less harmful to the environment than traditional metered dose inhalers (MDIs).

The NHS England National Medicines Optimisation Opportunities for 2024/25 identify reducing carbon emissions from inhalers as an area for improvement.

NICE has produced an inhaler decision aid to facilitate discussion about inhaler options.

Which NHS Trusts are included?

Trusts are only included in this measure if they have issued any products included in the denominator for this measure.

For this measure, 222/225 Trusts are included. A full list of Trusts included is available on the Submission History page.