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Background and Importance Medicines account for 25% of NHS emissions, 1 with oversupply causing waste in terms of expenditure, staff activities and environmental impact, as well as other issues such as patient safety when medicines are stockpiled at home. In 2020, the NHS became the world’s first health system to commit to reaching zero emissions. While most medicine waste reduction focuses on primary care, inefficiencies within secondary care also need addressing, as highlighted in the Green Plan.2 Aim and Objectives To assess the impact of an innovative medicines management policy on expenditure, sustainability, and dispensary workload in secondary care.Material and Methods The medicines management policy was updated such that rather than 14 days’ To Take Out (TTO) medication supplied routinely, only ‘sufficient supply’ was provided (in line with Standard Contract for NHS Providers). ‘Medicines Assessment for Discharge’ (MA4D), undertaken by ward-based staff (pharmacy and nursing) involved review of all medication already available, including patients own drugs (PODs) at home, or soon to be delivered, before any additional items were dispensed for discharge. Primary outcome: number of discharge medication items avoided per month.Secondary outcomes:financial savings (Mean cost of items dispensed multiplied by number avoided);carbon emission savings using a pharmaceutical emission factor (0.581kgCO2e/£)3;dispensary workload, estimated at ten minutes processing per item.Results In the first 5 months, discharge items avoided increased from 18% to 21%. Comparing January 2025 with January 2024 an extra 1 719 items were avoided, saving 290 staff hours (5.74 whole time equivalents). Extrapolated to full year benefits, this equates to an additional £369,542 and 214.7 tonnes CO2e saved across the trust.Conclusion and Relevance The simple tasks involved in MA4D have reduced unnecessary re-dispensing, minimised medicines costs and cut carbon emissions, within a secondary care organisation. The project now forms a key part of the trust’s Green Plan. The collaboration between pharmacy and nursing staff to deliver MA4D leads to earlier patient discharge and a safer home environment due to reduced medication duplication.The initiative is easily replicable within similar organisations, providing a practical model for hospitals seeking to advance their sustainability goals.References and/or Acknowledgements 1. Delivering-a-net-zero-nhs-july-2022.pdf2. How-to-produce-a-green-plan-three-year-strategy-towards-net-zero-june-2021.pdf3. UK and England’s carbon footprint to 2022 - GOV.UKConflict of Interest No conflict of interest