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Disclaimers & Carbon Footprint Methodology

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General Disclaimer

  • The content on this website is provided for educational, informational and quality improvement purposes only and does not constitute clinical, medical or professional advice.
  • While we make reasonable efforts to keep content accurate and up to date, we make no representations or warranties as to its accuracy, completeness or currency.
  • Users should ensure they refer to current national and local guidance and other established evidence-based sources, particularly where content is used significantly after its publication date.
  • By using this website, you do so at your own risk. To the fullest extent permitted by law, Greener Practice excludes liability for any loss, damage or harm arising from the use of, or reliance on, its content. Nothing in this disclaimer excludes liability that cannot legally be excluded.

Quality Improvement Projects

  • Our quality improvement projects are designed to support quality improvement and are not clinical guidance or protocols.
  • They must be used alongside current national and local clinical guidelines and other relevant evidence-based sources.
  • Users should ensure they refer to current evidence and guidance, particularly where content is used significantly after its publication date.
  • Responsibility for clinical decisions and patient care remains with the clinician or practice.
  • Greener Practice CIC accepts no liability for outcomes arising from the use or implementation of these projects.

Carbon Footprint Estimates

  • Carbon footprint estimates and comparisons on this website are indicative only and are based on simplified assumptions and methodologies.
  • Carbon calculations and comparisons are provided to support quality improvement and informed discussion and are not validated for use as the sole basis for clinical decision-making or prescribing decisions. Further information on methodology and limitations is provided below.

Inhaler Carbon Footprint Methodology

  • For inhaler-related projects, carbon footprint estimates are based primarily on the global warming potential (GWP) of propellants used in Metered Dose Inhalers (MDIs).
  • Dry Powder Inhalers (DPIs) and Soft Mist Inhalers (SMIs) generally have substantially lower greenhouse gas emissions because they do not rely on hydrofluorocarbon propellants.
  • The delivery device itself also contributes to carbon emissions. Generally, device-related emissions for both DPIs and MDIs are estimated to be in the range of approximately 0.5–2kg CO2e per inhaler, although this may vary depending on methodology and product design.
  • Where appropriate, inhaler comparisons may be grouped broadly into:
    • Low carbon footprint
    • Higher carbon footprint
    • Highest carbon footprint categories
  • The methodology used is informed by published NHS resources and peer-reviewed healthcare sustainability research, including sources such as:
    • Wilkinson et al.
    • Janson et al.
    • NHS and Greener NHS resources
    • British Thoracic Society/ National Institute for Health and Care Excellence/ Scottish
    • Intercollegiate Guidelines Network (BTS/ NICE/ SIGN) asthma guidance

Non-Inhaler Carbon Footprint Methodology

  • For non-inhaler medicines and interventions, Greener Practice may use:
    • Medicines Carbon Footprint (MCF) methodologies
    • Published lifecycle studies
    • Financial spend-based conversion factors
    • Other recognised healthcare sustainability methodologies
  • MCF methodologies estimate emissions using factors such as:
    • Molecular weight
    • Chemical structure
    • Process mass intensity
    • Excipients
    • Primary packaging
  • More information on MCF methodologies can be found here: https://www.yewmaker.com/mcf-classifier

Important Limitations

  • The estimates used on this website do not represent full lifecycle emissions and may exclude or simplify factors such as:
    • Pharmaceutical ingredient manufacture
    • Inhaler device manufacture
    • Transport and distribution
    • Packaging
    • Disposal
    • Healthcare utilisation impacts
    • Wider supply-chain effects
  • Carbon footprint estimates may also vary depending on:
    • Data availability
    • Pricing
    • Manufacturing processes
    • Patents
    • Inflation
    • Evolving methodologies
  • Figures and comparisons should therefore be regarded as indicative estimates rather than definitive lifecycle assessments.

Clinical Care and Decision Making

  • Sustainability considerations are only one aspect of healthcare.
  • Clinical decisions must always prioritise:
    • Patient safety
    • Clinical effectiveness
    • Individual patient need and person-centred care
    • Shared decision-making
    • Current national and local clinical guidance
  • Responsibility for prescribing and clinical decisions remains with the treating clinician or practice.

Disclaimer – CQC

  • Completion of a project or receipt of a certificate does not guarantee compliance with CQC or other regulatory requirements.

Sources and Methodologies

  • Methodologies and references used may include:
    • NHS/ Greener NHS resources
    • BTS/ NICE/ SIGN guidance
    • Global Initiative for Asthma (GINA) guidance
    • Peer-reviewed healthcare sustainability research
    • MCF methodologies
    • Published lifecycle assessment and inhaler carbon footprint studies
  • Project-specific references and supporting evidence may also be included within individual resources and toolkits.