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The UK's primary care sustainability network

High Quality and Low Carbon Asthma Care

A toolkit to support quality improvement in primary care

Introduction to Toolkit

This toolkit is designed to help UK general practices improve asthma outcomes whilst also reducing carbon emissions. It will help practices in England achieve the IIF respiratory indicators.

It contains step-by-step QI projects. Project resources include downloadable searches, educational videos, templates and patient information. Watch this video to learn more.

This toolkit is supported by the guide How to reduce the carbon footprint of inhaler prescribing? A guide for healthcare professionals.

The guide sets outs key principles such as optimising asthma care first and using a shared-decision making with patients to choose the most appropraite inhaler for them.

It has a frequently asked questions section and a very handy table of inhalers by carbon footprint category for use alongside your local formulary.


We would love to hear what is working and not working in the toolkit and how we can improve it for practices. If you have tips for what has worked or not worked in this project please get in contact.

This toolkit has been developed for Greener Practice and has been reviewed and approved by the NHS England and NHS improvement inhaler working group. It was written by Dr Aarti Bansal (GP), Dr Sarah Wikeley (GP) and Dr Tamsin Ellis (GP). Thanks to Carol Stonham (Nurse Specialist), Ravijyot Saggu (Clinical Pharmacist) and Dr Katherine Hickman (GP) for review and development of the project.

We would like to thank the Health Foundation for helping to fund the toolkit and website, Primary Care IT for developing the IT resources and Humber and North Yorkshire Health and Care Partnership for funding of the educational videos. Many thanks to the numerous Greener Practice clinicians who have also reviewed the material.