News
I’m getting impatient. Itchy even. Seven years on from a workshop with 16 medical and nursing royal colleges convened by Global Action Plan and the UK Health Alliance on Climate Change (UKHACC), we’ve now completed the set of pilot projects into health professional education on air pollution that all present agreed were essential.
Having run projects to learn how respiratory, child health, maternity, general practice and heart health professionals can best communicate with patients about air pollution, we now have a suite of open source training materials, patient resources and insights to help health professionals talk to patients about air pollution.
It’s a package developed by and for health professionals and is ready to be rolled out across the UK.
The need is clear and since that first conversation with the UKHACC members in 2018, it has been repeatedly and clearly recommended in key papers including the 2019 UK Clean Air Strategy [i], the 2021 Future Prevention of Death Report in the case of Ella Kissi Debrah [ii], the 2022 Annual Chief Medica Officer’s Report [iii], the 2024 Defra/UKHSA Air Quality Information System Review [iv] , the 2025 Royal College of Physicians Breath of Fresh Air report [v] and the recent 10 Year Health Plan [vi].
But where is the response and the actual action?
Beyond the Global Action Plan pilots, alongside pioneering local authorities and healthcare organisations taking the initiative and running local training programmes for health professionals on air pollution – such as in Southampton, Islington and Tunbridge Wells and the work of the Royal College of Paediatrics and Child Health – over the last seven years there has been disappointingly little in the way of systemic training, upskilling or equipping of health professionals to talk to patients about the biggest environmental threat to our health.
However, there are signs that air pollution is slowly starting to enter the medical curricula, as the Royal College of Physicians report that of the 32 medical schools in the UK, almost all included the health impacts of air pollution in their core syllabus, although in half of the schools it was only briefly mentioned in passing; NICE asthma guidelines now include reducing exposure to air pollution as part of personalised asthma plans; the internal medicine training (IMT) stage one curriculum reportedly now mentions air pollution; and the RCPCH has appointed clean air fellows to develop policy and resources on air pollution [1].
Despite these green shoots, evidence suggests that health professionals still feel insufficiently trained on air pollution and its health impacts, which in turn hampers conversations with patients about air pollution [2]. This is a frustrating truth we encounter whenever we speak to healthcare staff, as our pilots have shown that when they receive basic training on air pollution their confidence to talk to patients increases significantly [3]. And as a pilot in Islington demonstrated, when then patients receive information about air pollution from a GP, they feel more likely to change their behaviour to reduce their exposure to air pollution [4], thus protecting their health.
‘Our pilots have shown that when health professionals receive basic training on air pollution their confidence to talk to patients increases significantly”
Having trained 225 health professionals (and counting), who often look after some of the people most vulnerable to air pollution – sick children, pregnant women, those with heart and lung conditions, those attending GP surgeries – Global Action Plan has learned that:
· Health professionals are willing to provide advice on air pollution to vulnerable p
· The way messages are communicated, while largely similar across healthcare, will vary between professions and the messages to be communicated need to be tailored to different patient groups
· Healthcare staff are often overburdened and time-poor. A community health visitor or specialist nurse may have minutes to talk to a patient about air pollution risks and mitigation measures - a GP or midwife may have seconds. Having resources like a leaflet or websites to direct patients to such as the www.cleanairhub.org.uk for public information on air pollution available helps
· Health professionals cannot be expected to be air pollution experts, but the core messaging to pass on to patients is relatively simple: it’s about the health harms – individual exposure reduction actions tailored the individual’s situation – actions we can all take to reduce air pollution
· Patients mustn’t be made to feel responsible for overcoming the air pollution
This latter point is critical. Air pollution is a collective problem affecting us all. The biggest responsibility to clean up our air sits with the polluters and those with the power to do something about it – namely government and industry. And not just the part of government officially tasked with tackling air pollution – the Department for Environment, Food and Rural Affairs – but the many other departments whose activities cause the air pollution – such as the Department for Transport, Department for Energy Security and Net Zero, Ministry of Housing, Communities and Local Government – alongside the Department of Health and Social Care that will otherwise continue to absorb the £27billion+ annual cost of air pollution.
We have been told in focus groups “If air pollution was a problem, then my GP would have mentioned it and the government would be doing something about it.” It is a failing that this isn’t happening. So where is the systematic health sector leadership on air pollution? The list of important people and places listed above who recognise the need to do something shows the need.
But where is the action?
Who is taking responsibility? After seven years Global Action Plan now has free resources and insights to help with the solutions, and I am itching to get these into standard healthcare education, training and practice.
We are looking for a partner to work with us to map out the route to mainstreaming air pollution education and training and where our healthcare professional and patient resources can best be applied. If this could be you or your organisation please contact [email protected]
'In the 6 years I was in medical school, and now 17 years as a consultant physician, I have never once, unless I instigated the training or invited an expert speaker, had any training on air pollution. Despite it being something that causes nearly 40,000 deaths across the UK each year.’
Consultant Respiratory Physician
Our thanks go to:
Islington Council, Tunbridge Wells Borough Council, Defra, Clean Air Fund and pharmaceutical company Boehringer Ingelheim for their support on this journey
Thanks also to all the health professionals who took part in our pilots, learning more about air pollution themselves before testing different approaches and messaging with patients. Your enthusiasm and feedback has been truly invaluable.
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[1] A breath of fresh air: responding to the health challenges of modern air pollution | RCP
[3] mobilising_health_professionals_insights_report_exec_summary.pdf
[4] National-Primary-Care-Insights-Report.pdf
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[i] The 2019 UK Clean Air Strategy committed to “…equip health professionals to play a stronger role by working with the Medical & Nursing Royal Colleges and the General Medical Council to embed air quality into the health profession’s education and training.”
[ii] The 2021 Future Prevention of Death Report in the case of Ella Kissi Debrah recognised that “The adverse effects of air pollution on health are not being sufficiently communicated to patients and their carers by medical and nursing professionals. The evidence at the inquest was that this needs to be addressed at three levels: a. Undergraduate…..b. Postgraduate…..c. Professional Guidance.”
[iii] The 2022 Annual Chief Medical Officer’s Report stated that “The training of healthcare staff should include the health effects of air pollution and how to minimise these, including communication with patients.”
[iv] The 2024 Defra/UKHSA Air Quality Information System Review made the recommendation to “Work with the relevant professional health bodies and regulators to upskill health care professionals on the health impacts of air pollution, enabling health care professionals to provide appropriate actionable health advice to the public and susceptible groups.”
[v] The 2025 Royal College of Physicians Breath of Fresh Air report sets out that “Healthcare professionals must be equipped with the knowledge and confidence to discuss this issue with their patients…”
[vi] And the 10 Year Health Plan promises “We will explore ways to strengthen collaborations with the health community to improve awareness of and communications on the health impacts of air pollution.”
