Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he made of the implications of reliever inhalers for the carbon footprint of propellant inhalers when establishing the metric in the Primary Care Network Contract to tackle that footprint; and for what reason reliever inhalers were excluded from that metric.

We are informed by NHS England and NHS Improvement that carbon impact of reliever inhalers was reviewed when establishing the proposed indicator as part of the Investment and Impact Fund in the Network Contract Direct Enhanced Services (DES). The final version of the Network Contract DES did not include the Investment and Impact Fund proposals for the first six months of the 2020/21, to ensure Primary Care Networks were able to focus on the COVID-19 pandemic.

The original proposal provided an opportunity to encourage a move towards lower carbon inhalers, where clinically appropriate and as part of regular medicines review, within the evidenced range of existing local prescribing practice. Reliever (SABA) inhalers were not included in the proposals at this stage, given the clinical evidence that an MDI inhaler may remain more appropriate where used for exacerbations (such as asthma attacks). However, NHS England and NHS Improvement are simultaneously pursuing a variety of strategies to also support a shift away from high-carbon SABA options where this can be done in a safe and clinically appropriate way.