Complete the Cycle Grampian Gateway Project

Executive Summary

The NHS Grampian (NHSG) and GlaxoSmithKline (GSK) Joint Working Project aims to deliver information about patterns of inhaler medicines wastage, by offering out the GSK “Complete the Cycle” Scheme to all community pharmacies in NHS Grampian and measuring the levels of medicine remaining in the returned inhalers. An NHSG media campaign, will seek to raise awareness around compliance and medicines waste and to encourage, in particular, patients with respiratory disease to speak to the pharmacy team and /or pharmacist about their respiratory medications and adherence. Local training, support materials, existing pathways and services will be used to ensure respiratory patients receive appropriate advice and counselling to enable the patients to get maximum benefit from their medications to minimise medicines waste.

Within the project, the key objectives are:

  • To provide patients with an opportunity for referral to a pharmacist with the aim of improving inhaler technique and promoting medication concordance
  • To collect, quantify, characterise and measure the type and level of unused/partially used/used inhalers in NHS Grampian to enable better understanding of the pattern of inhaler wastage
  • Deliver a media campaign to raise awareness of the recycling scheme and encourage patients to speak to their pharmacist about their respiratory disease and medications
  • Increase community pharmacy teams’ knowledge and understanding of the management of respiratory disease and the place and use of associated medicines in respiratory disease treatment
  • Reduce the number of unused or partially used inhalers being returned.

The project will run from June 2014 to November 2016.

The benefits of the project:

The Patient

  • Improved awareness of and access to onward referral to existing services e.g. intervention from community pharmacy team, specialist nurse, GP
  • Provides a specific opportunity for patients to consult with a Health Care Professional in addition to review at a GP surgery
  • Patient awareness raised around the cost of unused inhalers and the benefits of better adherence.

The NHS – Grampian Health Board

  • Opportunity to take forward and build upon historical media campaign around unused medicines following on from NHS Grampian’s “Only order what you need”
  • Opportunity to provide additional educational support for community pharmacy teams on respiratory brief interventions
  • Opportunity to improve patient outcomes through improved adherence to prescribed respiratory medicines
  • Reduced spend on medicines waste disposal as “Complete the Cycle” elements will be provided and funded by GSK
  • Reduced carbon footprint
  • Reduction in the amount of inhaled medication being wasted
  • Opportunity to share outcomes and gain recognition with the wider NHS


  • Increased acknowledgement and understanding of the role of GSK in supporting NHSG to improve medicines’ adherence and reduce medicines’ wastage
  • Opportunity to build reputation and trust with NHS Grampian
  • Progress towards environmental target of zero waste to landfill by 2020
  • By encouraging patients to have a conversation with a pharmacist about their respiratory disease and medications, adherence to respiratory treatments, including those offered by GSK, may increase.

Contact details

NHS Grampian:

Dr Caroline Hind
Deputy Director of Pharmacy and Medicines Management
01224 556088


Lynda Friel
Project Implementation Manager
07717 801 035


UK/RESP/0225/15. Date of preparation April 2015.