Medicines account for 25% of NHS emissions, a large portion of these emissions originate from a small number of medicines which can be decarbonised fairly easily.
A large portion of NHS emissions come from two groups:
- Anaesthetic gases (2% of NHS emissions)
- Inhalers (3% of NHS emissions).
The anaesthetic gas desflurane has emissions from one bottle equivalent to burning 440kg of coal. The NHS Long Term Plan commits to lowering emissions from anaesthetic gases by 40% by:
- Use of sevoflurane instead of desflurane
- Capture of anaesthetic gases
- Destruction or reuse of anaesthetic gases
- Reduction in the atmospheric release from leftover nitrous gas canisters.
Actions and interventions to accomplish the above include:
- Engagement with anaesthetists has seen a cut of 50% in anaesthetic gas use since 2018 (equivalent to saving 17ktCO2e per year)
- Further clinical engagement may reduce desflurane use as little as 5% by volume (saving a further 23ktCo2e)
- Capture and destruction of nitrous oxide could cut one third of NHS anaesthetic emissions
- Saving 90ktCO2e across 132 high impact trusts
- Also delivering 75% reduction in nitrous emissions when implemented across the NHS
- Decreasing nitrous oxide wastage by identifying new measures to recycle this
- Currently, 30% of nitrous oxide is left in canisters after use.
Emissions from inhalers largely come from the propellant in metered-dose inhalers (MDIs). The NHS Long Term Plan sets targets by moving to lower carbon inhalers such as dry powder inhalers (DPIs). Meeting these targets is possible by:
- Increasing DPI usage which is a clinical equivalent to MDIs for many patients
- A 30% uptake would result in a reduction of 374 ktCO2e per year
- Resources are available to aid this decision-making, such as the National Institute for Health and Care Excellence’s Asthma Patient Decision Aid
- Increasing the frequency of the greener disposal of used inhalers
- Supporting innovation of lower carbon propellants and alternatives.