Organisation
King's College Hospital
Theme
Waste, consumption & food
Start Date
Feb 2024
Goals
Waste
In 2022, King’s College Hospital made a bid to the Greener NHS Healthy Futures Fund for an inhaler recycling pilot at King's.
The Greener NHS team supported the idea for the project and asked for expansion across the South East London Integrated Care System.
Secondary care sites working with community pharmacies encourage patients to return their used or expired inhalers to pharmacies. These inhalers are then sent to specialist waste facilities to recycle all inhaler components.
The Challenge
Inhalers make up 3% of NHS England’s total carbon emissions. The most polluting inhaler propellants are 3,300 times more potent than CO2.
When prescribed, inhalers are disposed of in a landfill, and the remaining gases are released into the atmosphere. One standard blue salbutamol inhaler has a carbon footprint equivalent to driving 175 miles in an average-sized petrol car.
The South East London Integrated Care System is working with NHS England, pharmacy teams, and primary care teams to deliver a six-month inhaler recycling pilot scheme. Four acute trusts and 20 community pharmacies are taking part in the pilot, working with specialist waste management facilities to recycle the inhaler's plastic outer layer, aluminium canister, and gas inside—which can be reused in fridges and air conditioning units.
The project aims to increase awareness of the appropriate disposal of inhalers among staff and patients across trusts and the wider. They will also use the information learned from the pilot to help promote prescribing more low-carbon inhalers such as Dry Powder Inhalers (DPIs).
pharmacies participating in the pilot.
Action Taken
The project working group, which includes staff from King’s College Hospital, SEL ICB, primary care, and NHS England (Greener NHS), focused on conveying the message to patients about the inhaler recycling scheme. Posters and labels have been designed to raise awareness of the pilot, and these have been placed in pharmacies, wards, clinic areas, and other patient-facing departments.
This has proven successful, with 20 community pharmacies (5 in Lambeth) now participating in the scheme and the four acute hospital trusts in South-East London. The first recycling site went live at King’s College Hospital in February 2024.
The scheme encourages patients to return their used or expired inhalers to pharmacies in southeast London before they are sent to specialist facilities at Grundon Waste Management for recycling, recovering, and repurposing a substantial portion of these harmful gases.
This six-month pilot scheme is part of a wider array of pilot schemes to assess the feasibility of a national recycling scheme. The pilot team has carefully mapped out the logistics to ensure the project's minimal carbon footprint, including transport and delivery to and from Grundon waste management. The inhaler recycling pilot working group has developed a website where you can learn more about the pilot by clicking this link (opens in a new window).
Call to Action
Laura Stevenson, Pharmacist at King’s College Hospital who was nominated for the HSJ Towards Net Zero Award 2023 and submitted the initial project bid, said:
“Medicines make up 25% of the NHS carbon footprint, which is a staggering statistic! The climate crisis is a health crisis, and we need to take decisive action to ensure we minimise our environmental impact; returning your inhaler to your local pharmacy or hospital can play a huge part in this. We can reach Net Zero by 2050 with these important actions and we need your help to do it, recycle your inhalers and help us create a greener NHS.”
Dr. Laura-Jane Smith, Consultant Respiratory Physician at King’s College Hospital, who is also part of the project team, said:
“We know how worried people are about the health effects of climate change, especially as people with respiratory disease are more vulnerable to heat and air pollution. By taking the simple step of returning inhalers to local pharmacies and hospitals instead of putting them in home waste, patients can ensure the NHS can recycle the inhalers and avoid them going to landfills. Working together, we can create powerful solutions.”
Patients prescribed metered dose inhalers can also speak to their clinicians about trialling greener inhalers to help reduce carbon emissions. Improving inhaler techniques with a suitably chosen inhaler can improve lung health and reduce the risks of asthma attacks.
Here's a map of all pharmacies participating in the recycling scheme (opens in a new window). The project team is also surveying public views about returning inhalers; have your say here. (opens in a new window)
*Currently, only pressurised metered dose inhalers can be recycled. All other types of inhalers are incinerated through appropriate clinical waste routes. But please return all your inhalers to your local pharmacies – they should not be disposed of at home.
