Reducing the carbon impact of inhalers across the North of England

This bulletin provides baseline figures on the current Inhaler Carbon Footprint at ICS level in the North of England, in order that systems can identify the level of response to be undertaken. It examines the current carbon footprint attributed to Inhalers in the North East and Yorkshire and the North West. It also analyses the Inhaler carbon footprint by therapeutic class, Inhaler type, and the contribution of hospital admissions for asthma towards total Inhaler carbon footprint.

Respiratory System


This report looks at prescribing trends in primary care for the Respiratory System at SICBl and ICB level with particular focus on bronchodilators and corticosteroids. Prescribing data is weighted with QoF registers, and also uses HES data to measure prescribing to outcomes. The report also calculates the potential opportunity cost for respiratory drugs based on the NHS England Right Care indicators.

If you have any queries about the content of the report please contact us at



Data Period

October 2019 to September 2022

Inhaler Carbon Impact Assessment Tool


The NHS Long Term Plan outlines that 4% of the total NHS carbon footprint savings are expected to be realised through a ‘shift to lower carbon inhalers’ equivalent to a 50% reduction in the inhaler carbon footprint. 1,2 The RDTC has developed an inhaler carbon impact assessment tool in response to these targets. It is intended to be used at a commissioning level to estimate the impact of respiratory pathway choices made following a clinical decision making process.

This is not a clinical switch tool and should only be used as a calculator to estimate the impact of respiratory pathway choices already made following a clinical decision making process.

User Verification

Please note that in order to access the tool users not only require an authorised RDTC website account but additional verification details. To request inclusion as a verified user please contact us at


1. NHSE. NHS Long Term Plan.

2. Centre for Sustainable Healthcare (CSH) Networks. Inhalers and NHS Long Term Plan.

Data Period

July 2020 to June 2021



Inhaler carbon footprint; significance, focus & action

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve. PPHs use prescribing data, biomedical literature and other data sources to provide new insights.

The impact of climate change on health is increasing, as global warming continues to rise. 1 Within the health and social care sector, pressurised metered dose inhalers (pMDIs) and breath-actuated pMDIs (BA-pMDIs) have been identified as a significant contributing factor to the NHS carbon footprint.

This publication reviews current inhaler prescribing in the context of global warming potential data, and highlights interventions which should be considered by health systems.

There are three versions of this publication; please select the appropriate version for your region below.

The RDTC has also produced a carbon impact assessment tool for inhalers.