Winner - Embedding Inhaler Recycling into the NHS (2025)

South East London Integrated Care System,
(South East London Integrated Care Board, King’s College Hospital, SEL Alliance)

Project summary

In June 2024, South East London (SEL) ICS launched England’s first fully NHS-funded, ICS-wide inhaler recycling project. Running across 20 community pharmacies and all five acute and mental health trusts in SEL, the pilot is fully integrated across primary and secondary care. The public can return used inhalers to any participating site, where they are separated from regular medicines returns and sent for 99.9% component recovery—including aluminium, plastic, and residual HFA gas.

Inhalers are the largest single contributor among medicines to the NHS carbon footprint, accounting for 3% of total NHS emissions. In 2020, the NHS became the first health system globally to commit to Net Zero, later formalised through the Health and Care Act 2022 and the Delivering a Net Zero National Health Service report, which provides statutory guidance to ICBs.

This project responds to that call-to-action and aligns with SEL ICB’s Green Plan, which pledges to reduce emissions within its footprint. It also serves as a proof-of-concept to inform NHS England’s assessment of the viability of nationwide, routine inhaler recycling.

A project working group and formal agreement were developed between SEL ICB, King’s College Hospital (KCH), SEL Pharmacy Alliance (community pharmacy federation), Guy’s and St Thomas’ (Essentia), and other stakeholders, ensuring structured cross-sector collaboration. The scheme uses existing NHS clinical waste infrastructure, including contracts with PHS Group and Grundon Waste Management, to implement a new disposal route for pressurised metered dose inhalers (pMDIs)—from return point to recycling plant—ensuring efficiency and minimal disruption.

Community pharmacies collect pMDIs in specially designated bins under a new locally commissioned service. Acute trusts operate a parallel route with bins across respiratory clinics, wards, and outpatient pharmacies. No extra staff are needed. Inhalers are safely transported to Grundon for specialist recovery.
Over 12,000 inhalers have been collected, with strong staff and patient engagement, and growing interest in expansion from providers across England. Behavioural science-informed communications—including posters, stickers, and digital surveys—were co-designed with patients to encourage correct disposal. Monthly data reporting tracks return rates and will support a full NHSE-led evaluation in 2025/26.

This innovative project shows inhaler recycling can be embedded in existing NHS systems. It presents a replicable and scalable national model, supporting medicines optimisation, waste reduction, and sustainability. The pilot’s outcomes will inform future commissioning and advance the NHS’s Net Zero goals.