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Improving sustainable respiratory care

We are coordinating a national quality improvement project which supports the switching of patients to more environmentally friendly asthma inhalers, if it is safe and appropriate to do so

Read comments 3
  • Idea
  • 2022

Meet the team


  • Dr Sarah Walpole - Infectious Diseases registrar
  • Dr Lewis Standing - Respiratory registrar
  • Alice Fitzpatrick - Physician Associate
  • Joseph Mcalveney - Medical student, Newcastle
  • Maria van Hove - Public Health Registrar

What is the challenge your project is going to address and how does it connect to the theme?

The challenge:

Metered dose inhalers (MDI) are significant contributors to greenhouse gas emissions, and make up 3% of the overall NHS carbon footprint.

The solution:

Dry powder inhalers (DPI) are less harmful to the environment, and suitable for many patients with asthma. NICE has published a decision support aid to facilitate the switch of patients from MDIs to DPIs.

What does your project aim to achieve?

We are already a team of doctors, physician associates and medical students supporting teams across the country to have a structured conversation with patients about switching to a more sustainable inhaler. We are applying for Q funding to scale up the project, and streamline the processes.

This quality improvement project supports patients to switch inhalers, if appropriate for them as an individual, whilst also collecting data from across the country about the willingness of patients to make the switch.

We would use Q funding to make a website, and to run engagement and education events on sustainable respiratory care. This will not only improve patient outcomes, but contribute to reducing the NHS carbon footprint and the commitments in the NHS Long Term Plan.

How will the project be delivered?

The team have already been delivering this project voluntarily. We would like to scale up the work we have been doing, through the allocation of Q Funding.
Being allocated Q funding will allow us to develop a website, and to run events on engagement and education for interested members of the healthcare workforce.

We will develop a website, with the resources for the quality improvement project and an opportunity to submit questions, as well as a space for teams to submit the data they have collected securely. We will offer people the opportunity to sign up to our mailing list.

How is your project going to share learning?

We will share learning by holding regular learning and education events, about the reasons for the project (sustainable inhalers) and the outcomes of the project (reasons why patients switch inhaler / don’t switch inhaler).


  1. Echoing the above poster's comment, are any of your clinical nurse specialists involved, or perhaps your lead practice nurses?

    Is this project just for adults? With good intentions, CYP are often prescribed inappropriate devices that they simply can't use, leading to higher risk of exacerbation and perhaps hospital admission which generates higher levels of polluting gases.

  2. Really important area, given the increased need for inhalers.

    I would be really interested to hear how your engagement will be taken forward & reaching seldom heard.

    I also wondered whether any of your specialist nurses are involved?

  3. This is a really importnat agenda - making sure it is safe to switch is really important especially in children many of home can't use alterantives.

    It would be good to see somehting of your small scale work done already to see teh intiatives you have used and how you will scale up


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