Climate change and other environmental impacts contribute to acute and longer-term adverse impacts on human health and wellbeing, and yet the healthcare sector itself is a key polluter.

“Data shows that if the world’s healthcare sector was a country, it would be the fifth largest contributor to climate change,” says Gillian Leng, chief executive of the National Institute for health and Care Excellence.

Indeed, the latest data from the Royal Pharmaceutical Society (RPS) says around 25% of NHS carbon emissions are from medicines, with the majority of these resulting from the manufacture, procurement, transport and use of medicines (20%), 5% specifically from inhalers (3%) and anaesthetic gases (2%).

It is good news, then, that the Greener NHS programme is working on reducing the health service’s impact on public health and the environment, alongside a pledge to reach net zero carbon emissions by 2045 – with many community pharmacies keen to play their part.

 

Electrifying deliveries in Scotland

 

Dears Pharmacy in Edinburgh and Fife has introduced three NIU electric mopeds to its delivery fleet, in a bid to offer a more efficient and greener service for customer deliveries and surgery collections.

Mahyar Nickkho-Amiry, Dears managing director and superintendent pharmacist, explains: “Parking and congestion was making it increasingly difficult to deliver prescriptions on time.

“We chose electric mopeds rather than vans, as they are an ideal fit for our inner-city locations, making it much quicker for our drivers to move around and to park more easily, especially in GP surgeries.

“The NIU version we went for has a range of 40 miles and can be charged in around four hours using a three-pin plug hook up,” Mr Nickko-Amiry adds. “At the moment we are using three of them – two in Edinburgh and one in Dunfermline – and this is just the start of our move to electrify our whole delivery fleet by 2025.”

Mr Nickko-Amiry says the pharmacy chain is making a number of changes to help cut down on its environmental impact, including installing solar panels and getting rid of plastic carrier bags.

“As an environmentally aware business, we feel we have a duty of care to look after the planet,” he tells C+D.

 

Bursting the bubble (wrap) for global deliveries

Landys Chemist in Finchley Road, north London – winner of this year’s C+D Independent Pharmacy of the Year Award – has supported its local community for 40 years, as well as serving customers across the world via its website. With a sharp focus on sustainability and responsibility to the next generation, it recycles the vast majority of its waste and instigated plastic-free packaging for online orders in 2016.

Mitesh Desai, Landys head of e-commerce, says: “We have a very busy online business shipping around the world. “About five years ago we realised this sea of plastic packing in our stockroom had to stop – but how do you send vitamins in glass bottles without them getting broken?,” the team pondered.

 

“A sustainability consultant connected us with a company which provided a perforated paper packing material which creates a lattice as it stretches to protect whatever is wrapped inside, and we were one of first companies in the UK to adopt it,” Mr Desai explains.

Admitting that it is “much more expensive – in fact we spend twice as much on packaging as we used to”, Mr Desai adds: “I’d argue any remotely socially conscious company can’t get away with using bubble wrap as what that says to customers is all you want to do is minimise your costs and maximise profits.”

 

A breath of fresh air for inhaler recycling

 

Despite NHS England’s announcement that it is delaying incentives for GPs in England to switch patients to more environmentally friendly inhalers until later this year, pharmacies are well placed to continue diverting these polluting plastic cases and gas cannisters from landfill.

Last February, Satyan Kotecha – chair of West Midlands pharmacy local professional network and owner of the K&K Healthcare group of three pharmacies in the Midlands – joined 90 pharmacies in Leicester in the Take Action for Inhaler Recycling (or Take AIR) pilot, which provides pre-paid envelopes and in-store bins so patients can recycle their used inhalers.

Run by pharmaceutical company Chiesi and supported by University Hospitals of Leicester NHS Trust and Leicestershire and Rutland local pharmaceutical committee (LPC), the inhalers are sent to Grundon Waste Management for recycling and appropriate disposal. The scheme is over halfway through the pilot period and Chiesi says there have been nearly 7,000 inhalers diverted from municipal waste and recycled so far.

Mr Kotecha agrees the pilot has been a huge success: “At Leicester, Leicestershire and Rutland (LLR) LPC’s AGM in September, audit data showed we have saved the carbon footprint impact of inhalers equivalent to 250 jumbo jet flights from London to New York, just in LLR, from inhaler recycling.”

 

 

 

A shot in the arm for plastic injector pens

 

Another green-minded pilot, launched in November, is Novo Nordisk’s PenCycle initiative, enabling pharmacies across Leicestershire & Rutland, Greater Manchester and Glasgow to recycle Novo Nordisk’s FlexPen and FlexTouch pre-filled plastic injection pens.

The scheme aims to recycle more 1.1 million pre-filled plastic injection pen devices by the end of 2022, diverting over 56 tonnes of plastic waste from UK landfill.

Andrew Cowan (pictured above, centre), pharmacist at Lloydspharmacy in Baillieston, Glasgow – which is taking part in the scheme – explains: “Patients who use pre-filled injection pens – for instance, those who live with diabetes, obesity, and growth disorders – can conveniently drop off their used pens when they visit us to collect prescriptions.”

It’s not just the pharmacy team that benefits from being more green-minded, Mr Cowan tells C+D: “We were really keen to be involved in the pilot because it makes us as a store, and as a company, more sustainable by diverting plastic away from UK landfills. It also helps our customers, patients and our community to be more environmentally friendly, too.

“It is early days but, so far, the response from our customers has been a positive one, and over the coming months we’re looking forward to seeing the impact the scheme has had.”

 

The ABC of 3D printing

 

Alphabet Pharmacy in Stretford has used its Automedi 3D printer to take the lifecycle of clinical materials to the next level – recycling facemasks, inhaler casings and medicine pots into 3D printed consumables for use in the pharmacy and local GP surgeries.

Alphabet Pharmacy’s superintendent pharmacist Alpa Ghelani (pictured below, right) says: “We got the Automedi 3D printer on a short-term contract during the pandemic to print visors, pill splitters and bottle collars.

 “It proved so useful that we put in an application to the NHS Innovation Fund so we could get it back again, and started the Remasked campaign with Automedi to collect and sterilise waste items from GP practices across Greater Manchester.

“Bits like the metal strips from face masks get sent to artisan bakeries to use as bread bag ties, and the ear loops from masks can be used by local knitting groups as elastic in socks. The remainder gets shredded and made into printer filament by Automedi, which we can then turn into 3D printed items for us – as well as items that local surgeries can order from the Automedi catalogue that we print out and deliver to them.

“At the moment, this is a trial through the NHS Innovation Fund to see if can be scaled up and rolled out through whole NHS estate, and any pharmacies or surgeries who want to get involved can find out more on our Remasked Facebook page,” Ms Ghelani explains.

 

 

Pharmacy’s future is green

 

The RPS says: “As experts in medicines, pharmacists have a professional responsibility to take a leading role in reducing the environmental impact of medicines use.”

But, as evidenced above, individual pharmacies are taking it upon themselves to tackle more than medicines waste and are investing time, money and effort into reducing their carbon footprint across the whole of their estates.

With national incentives as well as many organisations actively becoming more environmentally conscious, the NHS’s goal of reaching carbon net zero seems a more than reachable task, and community pharmacies are playing their part with exciting initiatives to make this happen.