This year there is a big new NHS drive to reduce the impact of healthcare on global warming. If we don't do that then our health, and that of our global neighbours will be badly affected.

Unfortunately the most commonly prescribed style of asthma inhaler in the United Kingdom has been the "metered-dose inhaler" (MDI) - they are the ones with the metal canister that you press down and a fine spray is ejected. Some years ago the CFC's that were damaging the ozone layer were replaced with a different propellant (the chemical that "sprays" the medicine) and one manufacturer then labelled their product "Evo" to mean better for the environment. Regrettably the newer propellant is a potent greenhouse gas so it contributes to global warming. In fact the "Evo" product is said to cause the equivalent effect of the carbon dioxide released in driving a petrol car for 170 miles - that is the impact of a single inhaler. Whether the product is used or not the propellant gas will slowly leak out such that they continue to be a problem even when discarded.

Fortunately there is an answer which is vastly better for the environment and also provides the same crucial level of care for asthma control for the vast majority of patients (young children and others who need medication via a "spacer" device are the exception). Better still these alternative "dry powder" (DPI) inhalers are also easier to use than the MDI's.

For this reason please expect recommendations of inhaler switches to be widely received by our patients in the coming year. We remain just as committed to keeping your asthma well controlled and this is also vitally important to us. If you currently feel that your asthma is not well controlled then please contact us to book an appointment with one of our asthma nurse team and they will seek to prioritise your switching.

Using any inhaler device correctly requires guidance and there are helpful videos for almost all inhaler devices at www.rightbreathe.com