Written question WQ86659

Table 1. Inhaler quantity number by health board in Wales for financial years 2017/2018 to 2022/2023 (incomplete)

Health Board

2017/2018

2018/2019

2019/2020

2020/2021

2021/2022

2022/2023

(April to August)

Aneurin Bevan

MDI quantity

560,140

558,102

627,537

636,256

612,383

283,320

Total quantity

855,805

841,621

937,417

944,498

905,800

425,127

% of Total

65.5%

66.3%

66.9%

67.4%

67.6%

66.6%

Betsi Cadwaladr

MDI quantity

760,656

759,632

869,707

891,353

869,202

401,251

Total quantity

1,019,202

1,019,568

1,162,798

1,183,903

1,147,696

538,035

% of Total

74.6%

74.5%

74.8%

75.3%

75.7%

74.6%

Cardiff And Vale

MDI quantity

369,620

359,195

407,782

412,755

397,441

177,383

Total quantity

553,533

549,546

629,572

636,833

614,829

284,257

% of Total

66.8%

65.4%

64.8%

64.8%

64.6%

62.4%

Cwm Taf Morgannwg

MDI quantity

481,851

479,688

543,849

554,522

534,677

244,876

Total quantity

773,488

764,106

854,916

856,691

812,217

373,645

% of Total

62.3%

62.8%

63.6%

64.7%

65.8%

65.5%

Hywel Dda

MDI quantity

370,146

365,023

406,945

402,848

378,471

172,145

Total quantity

555,413

550,968

616,420

612,643

581,666

269,699

% of Total

66.6%

66.3%

66.0%

65.8%

65.1%

63.8%

Powys

MDI quantity

130,754

132,612

152,767

159,802

152,986

70,007

Total quantity

183,664

183,206

207,871

216,003

206,478

97,049

% of Total

71.2%

72.4%

73.5%

74.0%

74.1%

72.1%

Swansea Bay

MDI quantity

395,710

393,772

449,990

470,535

453,776

208,923

Total quantity

567,248

566,020

643,989

663,888

634,952

292,595

% of Total

69.8%

69.6%

69.9%

70.9%

71.5%

71.4%

Wales

MDI quantity

3,068,877

3,048,024

3,458,577

3,528,071

3,398,936

1,557,905

Total quantity

4,508,352

4,475,036

5,052,983

5,114,459

4,903,638

2,280,406

% of Total

68.1%

68.1%

68.4%

69.0%

69.3%

68.3%

Please note:

MDI are metered dose inhalers; these are sometimes referred to as the aerosol type. Total is made up of MDIs, plus DPIs (dry powder inhalers) and SMIs (soft mist inhalers).

Numbers presented are for primary care items only i.e. do not include secondary care data.

The NHS Wales Decarbonisation Strategic Delivery Plan (gov.wales) outlines the key actions identified to help NHS Wales reach the ambitious target of net zero by 2030. One target is to shift away from MDI inhalers (or aerosol type inhalers) so that 80% of total inhalers prescribed in Wales are those with a lower Global Warming Potential (GWP).

I expect doctors in primary care to prescribe medication and devices using clinical judgement, taking account of national guidance.

All Wales adult asthma management and prescribing guideline This guideline aims to reduce variation in inhaler prescribing in the management of adult asthma.

All Wales COPD management and prescribing guideline This guideline aims to reduce variation in inhaler prescribing in the management of chronic obstructive pulmonarydisease (COPD).

GPs in Wales have taken part in a Quality Improvement (QI) project linked to inhaler prescribing during 2021/22, with the aim of:

• optimising asthma and COPD patient care;

• using dry powder inhalers or soft mist inhalers as first-line treatment options where clinically appropriate;

• if metered dose inhalers are needed, then using a brand and dosage regime with care to minimise carbon footprint.

Guidance for a phase 2 QI project linked to decarbonisation and All Wales Medicines Strategy Group Key Prescribing Indicators for 2022/23 https://awttc.nhs.wales/files/national-prescribing-indicators/national-prescribing-indicators-2022-2023-v3-pdf/ , will be made available to GP practices in the coming weeks.

GP practices are supported by pharmacy teams across primary care, with many health boards having respiratory leads working with practice teams and decarbonisation champions within community pharmacy.