Great Ormond Street Hospital have partnered with the MRC Centre for Environment and Health, Imperial College, London to enable annual average air pollution estimates for home postcodes to be displayed on the Electronic Medical Record (EMR) Epic system, thus providing clinicians with up to date local air pollution data. The information provides clinicians with an immediately accessible educational resource, accelerating the actions required to inform and support their patients on their health and well-being.
Estimated deaths due to long-term exposure to ambient air pollution in England in 2019 were equivalent to 26,000 to 38,000 a year 2. In April 2021, the South London Coroner, Philip Barlow, concluded that 9yr old Ella Adoo Kissi-Debrah died of asthma, contributed to by exposure to excessive air pollution 1. He criticised both medical and nursing staff for failing to adequately inform Ella’s mother of the risks. In his 2022 Chief Medical Officer’s Annual Report into Air Pollution (CMO’s Air Pollution Report 2022 ), Chris Whitty made only two recommendations to the NHS, one of which stressed the importance of communicating the health risks to patients:
“The training of healthcare staff should include the health effects of air pollution and how to minimise these, including communication with patients”
Despite the well-established and disproportionate harm caused by Air Pollution, it was rarely included in medical or nursing education until the coroner’s criticism in 2021. Upskilling clinicians will be a significant task. Very few hospitals provide any education at all and it not mandatory in any. Many clinicians understandably expect patient-specific data when asked to counsel families on risk. Knowing the local air-pollution levels for a child attending our hospital would require significant effort on their part before this innovation.
The figure illustrates our approach. Prior to launch we surveyed clinicians and parents to refine the build and provide a baseline.
Our survey results provided information on the needs of our patients and clinical staff.
The display went live in November 2022, with a communication strategy being rolled out over the subsequent months. We are now actively seeking feedback to drive resource improvements and will assess impacts after 6-12 months. Our strategy and proposals have already generated interest from other NHS trusts and both regional and national government – in replicating our intervention. This would not be difficult to accomplish, given that many trusts have similar electronic systems. With the valuable and continued support from Imperial College to use their original data, the practice could be expanded nationally in a relatively short space of time. We are actively looking for partners to refine the resources and assess the impact of this intervention.
For more details and support on how to replicate this work, please contact email@example.com
1. Barlow, P. (2022, 12 09). REGULATION 28: REPORT TO PREVENT FUTURE DEATHS. Retrieved from Judiciary UK:
2. Mitsakou, C. (2022). Updated mortality burden estimates attributable to air pollution. In UK Health Security Agency. Chemical hazards and poisons report; Issue 28. Reducing health harms associated with air pollution;. Retrieved from:
3. Whitty, C. (n.d.). Chief-medical-officers-annual-report-2022-air-pollution. Retrieved from: