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Clinical Resources

Inhaler prescribing

One of the largest areas of the carbon footprint in primary care is Meter Dose Inhaler (MDI) prescribing. In comparison to European data, there is scope to significantly and safely reduce this through moving patients onto dry powder inhalers. 

  • Four indicators in the Investment and Impact Fund (IIF) support a reduction in carbon emissions from inhalers.Two indicators are live (from October 2021) and two will follow in April 2022. More details can be found here and in the " Tools & Resources " section of the Greener NHS programme's FutureNHS workspace. (log in required)

  • Greener Practice, with review and endorsement by the NHS England and NHS Improvement Inhaler Working Group, Asthma UK, and the British Lung Foundation, have produced a comprehensive guide, How to Reduce the Carbon Footprint of Inhaler Prescribing. The guide can be found here.

  • Further information and resources regarding inhalers can be found on the Greener Practice website  

  • The Vale of York inhaler formulary for asthma provides information on accessible prescribing with indicators of the lower carbon impact inhalers. a link is available here.
  • The Bradford District and Craven inhaler formulary is available here  

  • Right Breathe is a useful website that classifies inhalers by drug group / device plus pathway.

  • NICE is encouraging the use of greener asthma inhalers and has useful information on their website, including a new patient decision aid , produced to facilitate discussions about inhaler options.

  • The AHSN Network is hosting a series of sharing and learning events that aim to share best practice innovations and initiatives to support the delivery of a net zero NHS.  A virtual event taking place on 8th February 10:30 - 12:00 will focus on reducing the environmental impact of asthma inhalers.  Topics covered include clinical decision-making and encouraging patients, where appropriate, to adopt environmentally friendly inhaler use. Policy, education and training will also feature. Click here for further details


  • Prescribing contributes by far the largest carbon footprint of all activities in General Practice. The Greener Practice website  includes a page with a range of information on Prescribing and De-Prescribing.

  • Every month, NHSE provides anonymised data about the prescribing patterns of GPs on Open Prescribing . This can be used as a reference point to track how your practice/PCN prescribes and benchmark against others.

December 2021

The voice for NHS GPs and Practice Teams across North Yorkshire, the City of York, Bradford, Airedale, Wharfedale & Craven districts.