Sustainability
dry powder salbutamol inhalers produce the equivalent emissions of driving 4 miles. In fact, inhalers contribute to 13% of the carbon emissions in primary care. In the first three months of 2022, 22%
of salbutamol prescriptions were Ventolin Evohalers. This had a carbon footprint equivalent of driving 6,125 miles (989.1kgCO2
e). By educating
staff about the environmental harm of a Ventolin Evohaler, and that there are green alternatives available, the project aimed to change prescribing practice and reduce the carbon emissions within the service – while minimising cost and without affecting patient outcomes. A re-audit in 2023 showed that now only
10% of the Salbutamol inhalers prescribed are Ventolin Evohalers. This achieved a saving of 508.68 kgCO2
e – equivalent to 3,150 miles.
This was a great start to the improvement initiative, but Sarah has been striving to take this even further. She is currently working with the IT teams to add in a pop-up, which will challenge clinicians if they prescribe Ventolin, prompting them to think more sustainably. This will be a system-wide change and has the potential to have a far-reaching impact. “While driving change, you need to work on your leadership skills and start off small, then ‘snowball’ change. Throughout this programme, we have been able to see what a massive impact that small changes can have. But, as we grow as people, and grow in confidence, we will be able to do bigger and better things moving forward,” Sarah observed. Sarah’s employer, PHL group, learned about what she was doing and asked her to share her experience and innovation across the organisation. The organisation recently acquired another company in Scotland and Sarah’s project has inspired them to implement carbon cutting measures too. A Carbon Reduction
Committee has been established and is being tasked with reaching Net Zero within the next 20 years. “I have been bringing ideas back from the
project and it is inspiring change. Jonny and Lucy have lots of ideas on how we can move the project forward in the future. It is not just about the change being delivered as part of the project; it has been changing us as people, showing us that we do have a voice. The leadership skills that I have learnt will help me to inspire others,” commented Sarah.
‘Think before you apron’ At the celebration event, Laura Prang, a Senior Oncology Nurse at Nuffield Health at St Bartholomew’s Hospital, also highlighted her ‘Think before you apron ’ campaign. Single-use, plastic aprons are an environmental problem, and the NHS alone disposes of around 133,000 tonnes of plastic waste each year. She pointed out that one apron equals 65gCO2
e. Following a review, Laura ascertained that
plastic aprons were being overused. A survey was created of a typical patient journey for her department, involving 10 steps. Each step represented a nursing intervention where an apron may be applied. These interventions were then cross-checked against the Marsden Manual on apron indication. The survey was then administered to the nurses and HCA in the department. Based on the results, the staff were found to be using aprons more often than the indicated moments. According to the survey, there were three moments to wear an apron. Laura’s research showed that staff were wearing them at an average of seven moments. The projected environmental impact of the project is annual carbon savings of 3,769kg, and cost savings of £2,000 per year. The project will also save time in donning and doffing of the aprons. Laura now plans to survey more departments
to collect further data on apron usage throughout the organisation. This will form the basis of a wider education campaign. Other highlights included a project by Brittany
Sarah Hucker, from PHL Group (centre), who is tackling environmental harm caused by inhalers, is shown with Gemma Stacey, from FNF (Left), and Caroline Smith from Nuffield Health (right).
Laura Prang, (centre), Senior Oncology Nurse at Nuffield Health at St Bartholomew’s Hospital, has developed the ‘think before you apron’ campaign. 26
www.clinicalservicesjournal.com I August 2023
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