Air Pollution

The benefits of this project

Opportunity for improvement

• Effects of air pollution on human health are broad, far-reaching and are not experienced equally. An estimated 36,000 deaths are caused by air pollution each year in the UK. Clinicians are not expected to be experts in the field but should be able to inform patients of the risks and explain simple ways to reduce individual exposure.   
• Cases such as those of Ella Kissi-Debrah and Awaab Ishak have brought the problem to the fore, leading to official recommendations in coroner’s reports, and bolstering guidelines from government, charities and Royal Colleges.   
• Whilst air pollution has reduced over recent decades, levels still far exceed WHO legal limits across the country, especially in areas of higher social deprivation. Long-term exposure to air pollution can cause chronic respiratory and cardiovascular conditions, as well as contribute to dementia and growth defects in utero. Short-term exposure causes exacerbations of respiratory and cardiovascular conditions and is associated with increased GP and acute hospital attendances. Despite this, “2 in 5 adults in the UK do not think that air pollution does their body any long-term harm”.
• This QIP will help clinical staff to develop their understanding of the issue, and suggest opportunities for sharing information with patients, enabling them to make healthier choices (see disclaimers). 
• You might like to create SMART goals for your project e.g. within the next month, invite all staff to participate in a staff survey on air pollution, run an education session for all staff and then re-survey staff.  

How to carry out this project

How to scale this project up or down

Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members.

Speaking to other GP registrars in your half day release sessions, sharing it with your PCN, Federation, ICB (England) or Cluster, Health Board (Scotland or Wales) or GP federation, Health Trust (Northern Ireland), so the learning can be shared and the project easily implemented by other practices too. 

Case study

In February 2024, Dr Kind, GPR ST1, gave a 10 minute presentation on air pollution and health to the local Registrars. He then decided to investigate his practice's local air quality data and the staff's level of understanding and learning needs. Clinical staff were invited to complete a six-question survery before a clinical meeting.

Results of pre-session survey

The clinical staff were generally very under-confident in discussing the health impacts of air pollution, how to reduce exposure or where to find reliable patient information. ALll staff were aware that those with chronic respiratory conditions have a higher risk of adverse health effects from exposure to high pollution levels. Not all understood that there were health implications for other groups including pregnant people and those with heart disease.

Nobody reported that they had air pollution discussions with patients routinely, a lack of knowledge was cited as the biggest obstacle. Very few appeared to be listing air pollution as a potential trigger for asthma exacerbations.

Results of post-session survey

Following the teaching presentation, discussion and guide through the new practice webpage on air pollution, attendees were asked to complete the survey a second time. All responders now felt confident or very confident discussing the health impacts of air pollution and making suggestions to reduce exposure. All were aware of reliable patient information and where to find it. Everyone understood the specific population groups at higher risk of adverse outcomes from air pollution exposure, including pregnant women and those with heart failure.

As well as a quantitative improvement in staff understanding demonstrated by the survey, plans were made to:

1. Send information alongside asthma and COPD health plans
2. Raise awareness using screen displays in waiting rooms
3. Send air pollution warnings to patients via SMS at times of high pollution (e.g. heatwaves, Bonfire Night)
4. Discourage idling in the surgery car park with the use of a sign

Staff feedback

"I have learnt so much; I was aware of dust as a trigger for asthma but had not considered other sources of air pollution"

"I had no idea about the sources of indoor air pollution like gas stoves and cleaning products"

Moatfield Surgery, East Grinstead

Have you completed this QIP?

Tell us a little about your project and enter your data in order to generate a certificate showing the probable benefits. This project may help with CQC evidence submission (see disclaimers).