Access to primary care in rural communities presents logistical and environmental challenges. Patients living far from healthcare facilities often rely on out-of-hours teleconsultations, but if medication such as antibiotics is needed, they may need to travel long distances to collect prescriptions. This creates barriers to timely care and contributes to avoidable travel-related carbon emissions. REMEDY project has introduced automated medication collection lockers and vending machines as alternative access points for urgently required out-of-hours medication. These systems may reduce travel and lower the environmental footprint of medication access. This study examines the carbon emissions associated with obtaining urgent medication after a tele-consult in rural Wales, comparing traditional hospital collection with the use of REMEDY lockers in Dolgellau/Holyhead.To quantify and compare carbon emissions associated with out-of-hours medication access following a tele-consultation via (1) hospital-based dispensing and (2) automated REMEDY collection lockers.We will conduct a quantitative modelling study using retrospective data from patients who received an out-of-hours tele-consult resulting in urgent prescribing. The study population includes residents in rural areas served by the Dolgellau and Holyhead REMEDY systems who contacted the 111 service between December 2025 and May 2026. Home postcodes will be extracted from Adastra records. Travel distances for hospital collection versus the nearest locker will be calculated, and carbon emissions estimated using UK Government GHG Conversion Factors. Locker manufacturing emissions will be sourced from the supplier, and operational energy use measured via smart plug. These will be converted to per-use CO₂e values and added to total emissions estimates. The primary outcome is CO₂ emissions per medication access event.We anticipate lower travel distances, and therefore reduced CO₂ emissions, for patients using local REMEDY lockers compared with hospital collection. Locker operation emissions are expected to be minimal relative to travel savings, though final results will depend on usage patterns.Automated prescription lockers may reduce the environmental impact of medication access in rural communities while improving convenience and easing pressure on out-of-hours services.By quantifying these effects, the study will provide evidence to support NHS Wales’ decarbonisation strategy and guide wider adoption of innovations toward net-zero healthcare.