Towards greener prescribing in general practice

RCGP's first planetary health policy report 'Towards greener prescribing in general practice' explores the challenges that general practices face in implementing sustainable prescribing practices and outlines actions for how Governments and other bodies across the UK can drive meaningful change to significantly reduce carbon emissions from primary care, whilst simultaneously improving patient outcomes and supporting prevention efforts.

Towards greener prescribing in general practice report (PDF file, 1 MB)

In support of these ambitions, this paper provides specific recommendations for policy action focusing on the following key areas:

• Reducing overprescribing and implementing ‘realistic medicine and prudent health principles’:
  1. Governments and NHS bodies across the UK should adopt the principles of realistic medicine and prudent health to promote shared decision-making between healthcare staff and patients, and to minimise unnecessary medical interventions.
  2. Governments and health system leaders should provide the support and resources needed for trained primary care teams to carry out ‘Comprehensive and Structured Medication Reviews’ (CMR & SMR) for every patient in need, improve quality of prescribing and improve patient safety and outcomes. This should help to ensure medications are effective and necessary, and that suitable alternatives or dosage reductions are considered where appropriate.
• Expanding effective non-medical and nature-based interventions:
  3. NICE and SIGN should update their guidelines to incorporate non-medical and nature-based interventions as a specialised category, where evidence of benefit is available.
  4. Governments across the UK should ensure sufficient long-term investment in voluntary and community services which can provide access to evidence-based non-medical and nature-based interventions, with a focus on areas of high deprivation.
• Reducing the environmental impact of prescribing:
  5. NICE and SIGN should include information about the environmental impact of medicines in their guidelines and publications.
  6. The ‘Joint Formulary Committee (JFC)’ responsible for the content of the British National Formulary (BNF) should support methods to include more information on the environmental impact of different medicines.
  7. All NHS medical procurement processes should include an environmental impact assessment, requiring the pharmaceutical industry to provide standardised environmental impact information.
  8. Medicines recycling and re-use schemes, with a particular focus on inhalers, should be expanded across the UK.
  9. Electronic prescribing should be expanded across all UK NHS settings to reduce the use of paper prescriptions and unnecessary patient travel.
• Supporting general practice to address green prescribing:
  10. Governments across the UK should adapt existing GP funding incentive schemes to encourage a stronger focus on delivering quality improvement approaches to sustainable healthcare.
  11. Health research funders and relevant NHS bodies should invest in research and evaluation of interventions aiming to reduce the environmental impact of prescribing.
  12. Education and training providers that support staff working in primary care should develop more training on environmental sustainability.
  13. Governments across the UK should allocate dedicated funding to support the recruitment of sustainability leads at practice network or cluster level.

By taking these actions to support the adoption of more sustainable prescribing, general practice can play a key role in addressing the climate crisis and supporting patients to stay healthier for longer with less reliance on medications.