6045 Green asthma care – a journey to better environmental control

Objectives The innovative carbon foot-printing undertaken by the NHS ahead of the landmark 'Delivering a Net Zero Healthcare System'¹ in 2020 highlighted inhaler therapy, contributing 3% of the total NHS carbon footprint, as a key medicine target for this battle. In this work we share an ongoing journey towards establishing inhaler recycling within a single trust. We hope that sharing our methodology can help others adopt similar strategies in efforts to meet our commitments to a net-zero NHS by 2040. Methods In response to the Net Zero report our trust established a sustainability team under the umbrella of the Director of Strategy, Research & Innovation, this includes a clinician and staff network. A multidisciplinary working group, comprising individuals from paediatric and adult backgrounds, was established to tackle 'Green Inhaler Care'. Our driver diagram of the project can be seen in figure 1 with a key success being agreement of our waste contractor to provide inhaler recycling across the trust sites. An important early approach was to promote greener inhaler prescribing through word-of-mouth and teaching sessions. Staff were surveyed about their awareness of green prescribing over a two-year period. To understand the patient perspective, the paediatric team conducted an engagement exercise using electronic and telephone surveys and a focus group. We used this information to implement inhaler recycling points in the paediatric outpatient department. Initially inhalers were collected from adult inpatient wards using medicines return bags. Return rates were low so a QIP was initiated by the pharmacy team. Results Paediatric staff awareness around carbon footprint and responsible disposal of inhalers showed a modest increased by over 10% between April 2022 and October 2023. They were largely unaware of the new recycling offer but 98% of people were happy to share this information with patients with a mixed range of suggestions about how this would be best achieved. A focus group with 5 young people all felt it was important to find greener ways to deliver good asthma care. Recycling was identified as an important component of this. 13 parents answered an electronic survey; 85% of them were very likely to return their inhalers to pharmacies for safe disposal after being informed of this possibility, and none felt inhaler recycling was a bad idea. 12 patients or parents were surveyed via telephone. None had previously received information about inhaler disposal. 83% were happy to bring inhalers to outpatients for recycling. Initial inhaler returns from adult inpatient wards were low, with only 19 in 3 weeks. Following the introduction of dedicated inhaler receptacles and a pharmacy collection rota this increased by over 300%. Dedicated inhaler receptacles in Paediatric Outpatients are due to go live in November; this data will be shared at conference. Conclusion Multidisciplinary working with embedded patient involvement must form the backbone of establishing sustainable care. Here we present multiple small steps which have helped one trust start to embed inhaler recycling into asthma care. We hope sharing our process and successes will encourage others to embark on similar journeys. Reference Greener NHS – https://www.england.nhs.uk/greenernhs/wp-content/uploads/sites/51/2022/07/B1728-delivering-a-net-zero-nhs-july-2022.pdf