Towards Greener Prescribing in General Practice

This paper explores the challenges faced by general practice in implementing sustainable prescribing. It outlines the actions governments and other relevant bodies across the UK can take to dramatically reduce carbon emissions from primary care, which simultaneously improve patient outcomes and support prevention efforts.

Climate change has been described by the World Health Organization as ‘a fundamental threat to human health’. Whilst it has had a direct impact on individual health outcomes, it also presents a challenge for health systems which are not well-equipped to deal with the impacts of climate change. Lord Darzi’s 2024 independent investigation of the NHS in England highlights that whilst there have been some key developments in reducing emissions through addressing the carbon footprint of estates and targeting emissions from supply chains, there are still some significant challenges ahead. Substantial ambition and momentum will be needed if the NHS is to reach its goal of becoming the first net-zero health service.

The Royal College of General Practitioners (RCGP) recognises reducing NHS carbon emissions as a key strategic priority which is critical to the future of planetary health – the interdependent and interconnected health of our planet and humankind. However, greener healthcare strategies can also lead to a gold standard of care, improved patient experience and outcomes, and healthier and happier lives.

Over half of carbon emissions from primary care come from prescribing. Taking action to minimise prescriptions of ‘unnecessary’ medications is one of the most effective ways to enhance patient outcomes whilst reducing the environmental impacts from providing patient care. Enhancing preventative and alternative methods of care can reduce activities which produce higher levels of carbon emissions, while also reducing medication side effects, costs, and the complexity for patients managing multiple conditions and treatments.

Of course, some prescribing is essential and in the best interest of patients. However, its environmental impact can be reduced by improving the information available to patients and clinicians about medication options. Additionally, actions such as reviewing the entire supply-to-disposal chain, expanding access to medication recycling schemes, and raising public awareness of safe medicine disposal can further help mitigate its effects.

These positive changes, however, will only reach their potential if general practice has the time, resources and support to shift to greener prescribing. General practice is at crisis point after years of underfunding from governments across the UK and poor workforce planning, which has led to fewer fully qualified GPs working in the sector.5 This creates a challenging environment for practices to address overprescribing and polypharmacy. A system-wide strategy is necessary to support the delivery of greener prescribing.