Greener Practice CIC partnered with N3i to develop tools to support better and greener asthma conversations thanks to funding from the Health Innovation Yorkshire Humberβs Sheep Shed green award programme.
Asthma morbidity and mortality in the UK is high despite the standard practice of annual asthma reviews. Better tools were required to support healthcare professionals and patients to consider how to improve asthma control during asthma reviews.
Visual guides would enable personalised asthma conversations at asthma review focussed on empowering patients to self-manage and improved templates support the clinicianβs completion of the review in a timely manner. These resources would integrate greener care into a focus on better care.
Greener asthma care is often centred around the environmental impact of the inhaler choice. This missed the key impact on the patient, and what may be the best choice for their asthma control.
Greener Practice wished to develop a simple visual guide to support healthcare professionals to conduct the asthma review conversation in a way that focusses on primarily improving asthma control and integrates lower carbon device choices within a conversation about the best inhaler choice for them. By empowering the patient to make the right decisions for their circumstances it was believed this will both improve care and support low carbon choices.
This success has been down to the commitment of both N3i and Greener Practice to go over and above to deliver the project. Huge shout out to Kat, Sally and Dean of N3i who have done about 10 times more work than either of us anticipated and have been absolutely fabulous collaborators.
Greener Practice worked with N3i to develop an NHS approved visual aid for clinicians and a SystmOne template for Better Greener Asthma conversations.
The visual guide aids the conversation held during asthma reviews between healthcare professionals and patients. This guide is accessible online with linked resources and is also printable for use in clinical rooms.
Alongside the visual guide a new SystmOne template was created to be completed during asthma consultations. Feedback around alternative templates was that they are too long, complicated and didnβt encourage key conversation around understanding the condition, improving adherence and choosing the best inhaler device. The new template is clinical safety checked and has received input from clinicians across the region to ensure it is fit for purpose.

The development of the resources (visual aid and asthma template) will help support healthcare professionals nationally. The project received feedback and endorsements from leading national respiratory bodies, this means that it has been approved as a Greener NHS resource and will be promoted nationally and by the NHS England respiratory team.
For the pilot site at Meridian PCN itβs calculated that there has been reduction in the carbon footprint from inhaler prescribing for the period of the project April to December 2023 compared to the equivalent period of the previous year April to December 2022.
This data has been extracted using PRESQIPP data.
The reach and use of the visual aid has been national with its publication on the 2024 QOF Guidance and the Respiratory Futures website. Future publications include The Nursing Times and the NHSE Greener NHS Website.