Primary care has the potential to become carbon neutral within 10 years, but it must undergo a series of changes, as well as build on strides made during the Covid-19 pandemic, according to the BMA. 

In a report aimed at helping the pharmaceutical sector and general practice become sustainable and environmentally friendly, the organisation laid out a 10-point plan, which it said, if adopted, could also ‘potentially improve patient health, reduce workload and save money’. 

Pharmaceuticals are the second highest contributing factor towards the NHS carbon footprint, and the largest contributor in general practice, according to the report.

It called on the pharmaceutical industry to develop an ‘independently validated’ system to ‘assess the total environmental impact of all medications’.

The BMA added that all medication should ‘clearly display their carbon footprint’, which would operate under a red, amber, green rating system and be ‘incorporated into the GP IT systems’. This would give GPs and other prescribers the option of choosing the least environmentally damaging option. 

It has also urged the Department of Health to review current regulations that prevent unopened medication that has left a pharmacy being returned and given to another patient, particularly as similar rules have already been relaxed in secondary care during the pandemic. 

It further pushed for a nationwide ‘medication returns and recycling scheme’ to be introduced, to make it easy for the public to reduce prescribing waste for items such as inhalers and devices. 

General practice should act to tackle over-prescribing and waste, which also causes a financial burden to the NHS, through discouraging stockpiling and regularly reviewing repeat prescriptions, it added. 

GP practices should have IT systems that incorporate validated deprescribing tools, as well as presenting social prescribing as a default option for management plans, the report said.

Online tools ‘could play a pivotal role’ in helping GPs and patients make decisions about reducing or stopping medication, by using an algorithm that considers a drug’s potential for improving symptoms, reducing risk of future illness and likelihood of causing harm. 

It also called for the return of reusable medical equipment, which can be sterilised onsite or by an external service, to reduce the carbon impact caused by disposable items. However, it recognised that this ‘would require significant work’, especially in light of the coronavirus pandemic. In the long-term, recyclable or biodegradable instruments could hold the solution, the BMA said. 

Social prescribing also ‘has the potential to improve patients’ health and wellbeing while also reducing practice attendances’. In some cases, it may involve nature-based health interventions, which may lead patients into better health as well as into more pro-environmental behaviours,’ the BMA suggested.  

Finally, the BMA encouraged the Government and NHSEI to support the development of the Green Impact for Health programme, which helps practices to decide and implement ‘simple’ yet ‘significant’ changes in both clinical and business areas. 

The Government should also work to encourage more carbon literacy training to support clinicians and other practice staff in making a greener practice action plan, the report said.