Healthcare leaders from across Scotland are calling for policymakers, NHS leaders and the pharmaceutical industry to address the environmental impact of medicine prescribing, which they say must be tackled for Scotland to achieve net-zero target.

Information about the environmental impact of medicines should be made clearly available by pharmaceutical companies, the medicines gatekeeper and the body responsible for clinical guidelines in Scotland, according to a statement published yesterday.

Professional leadership bodies representing prescribers say prioritising the introduction of electronic prescribing across the NHS would allow for more sustainable prescribing and enable environmental data in medicines procurement to be more readily accessed and shared.

As much as 25% of carbon emissions in the NHS comes from medicines. Today’s statement says this and the ecological impact of drugs entering the wastewater system ‘needs to be tackled’ if Scotland is to achieve net-zero.

Currently signed by Academy of Medical Royal Colleges and Faculties in Scotland, Royal Pharmaceutical Society (RPS) and the Royal College of General Practitioners (RCGP) Scotland, the statement says they are committed to reducing unnecessary medicines prescribing among its members and promoting the use of green social prescribing initiatives as an alternative.

Clare Morrison, RPS Director for Scotland, is calling for other health professional leadership bodies to follow suit and sign up to the new national movement:

“Health professionals in Scotland have chosen to come together to create a new national movement to reduce the environmental harm of prescribing and medicines use. Now we are calling on others to join us: Scottish government, producers of NHS guidelines, the pharmaceutical industry, all health and care professionals, and of course patients.

“Every one of us needs to take action to tackle climate change. What this joint statement demonstrates is how seriously we are taking the climate crisis: we can no longer assume someone else will take responsibility, we must all play our part.

“As professional leadership bodies, we believe that by acting together and focusing on the key areas described in our statement, we can and we will make a difference that will contribute to net zero and reduce the ecological harm from medicines.”

Currently, decisions made by the Scottish Medicines Consortium (SMC) on what drugs will be made available in Scotland are predominantly influenced by financial considerations.

Attendees of NHS Scotland’s Sustainability Conference last year heard from a Joint Chair of the Royal College of General Practitioners (RCGP), Dr Chris Williams, that local medicine availability lists, or formularies, should instead be based on environmental impact.

He said: “For that to happen, there needs to be in place arrangements whereby manufacturers are supplying those sorts of details to the bodies that make those choices, to the ADTCs and beyond.”

In its NHS sustainability strategy published in November, the Scottish government says it will work to provide ‘clinicians with the information they need to consider environmental impacts when prescribing’ to support the implementation of Realistic Medicine. 

Yesterday’s joint statement echoes his request and additionally calls for “fresh thinking and innovation” within the NHS and NHS suppliers to reduce medicines waste.

Dr David Shackles, the Joint Chair of RCGP Scotland said:

“Radical action is required if Scotland is to reach its target of Net Zero and as individual prescribers, we have an important role to play in ensuring that our health service significantly reduces its carbon footprint.

“However, we can’t do this alone and we need to see bold action at a national level to embed the structures that will lead to change. The climate crisis is a public health crisis and as healthcare professionals we are committed and united in our calls for action.

“Our joint statement is a significant step forward and I very much look forward to engaging with the Scottish government and others to make progress in this important area. This is essential if we are to achieve the very best outcomes for the health of our patients and the planet.”

The Scottish government says in its sustainability charity that it is committed to developing accurate assessments of the carbon footprint of the NHS supply chain, despite acknowledging that there is a ‘a major gap’ in its understanding.

From October, each health board will report on its annual progress to cut emissions across key activity areas, including prescribing.

The document also moves forward the target for NHS Scotland to move to a net zero health service to 2040.

 

Read more: GPs call to consider climate in prescribing decisions; Promoting sustainable healthcare; The case for virus-killing uniforms

 

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