NHS Trust slashes carbon emissions amid new inhaler rollout

Oxford University Hospitals NHS Foundation Trust (OUH) made the change as part of a wider effort to reduce the environmental impact of care and support the NHS’s goal of reaching net zero.

The switch to lower-carbon inhalers was supported by changes in prescribing, additional staff training, and improved support for patients on correct inhaler use and disposal.

Sarah Poole, advanced clinical pharmacist lead in respiratory medicine at OUH, said: “This project shows that we don’t have to choose between high-quality patient care and protecting the environment – we can achieve both.

“For many patients, switching to a dry powder inhaler is clinically appropriate and significantly reduces carbon emissions.”

The trust reported an 18 per cent drop in carbon emissions from pressurised metered dose inhalers (pMDIs) in 2025/26 compared to the previous year, and a 22 per cent reduction since recording began in 2022/23.

This is estimated to equal a reduction of 300 tonnes of CO2e over 12 months, comparable to nearly 764,000 miles driven in a petrol car.

pMDIs, commonly known as ‘puffers’, contain a powerful greenhouse gas.

Though they remain essential for many people with asthma and chronic obstructive pulmonary disease (COPD), dry powder inhalers (DPIs) are suitable for many patients and have a much lower environmental impact.

Clinicians across OUH are helping patients switch to DPIs where safe and appropriate, while also improving education on correct inhaler use in line with national guidelines.

Ms Poole said: “Good inhaler technique supports better health outcomes and helps avoid unnecessary additional treatment, which also reduces our environmental footprint.”

For patients who are not suitable for dry powder inhalers, alternative and novel options are also helping to reduce emissions by using lower-impact propellants.

Proper disposal of inhalers also plays a key role in reducing emissions.

Up to 30 per cent of the original gas can remain in an empty pMDI, which can be released into the atmosphere if sent to landfill.

Patients who use pMDIs are encouraged to return used or expired inhalers to community pharmacies for safe disposal.

Medicines make up about 25 per cent of the NHS’s carbon emissions in England, with inhalers accounting for three per cent.

Lisa Hofen, chief estates and facilities officer at OUH, said: “Reducing our carbon footprint is an essential part of how we deliver healthcare now and in the future.

“This significant reduction in emissions from inhalers shows the impact that clinical leadership, innovation and patient engagement can have when sustainability is embedded into everyday care.”

OUH now plans to expand staff training, develop more patient resources, and look into reintroducing inhaler recycling schemes.