Effective clinical waste management

Dr Andy Nichols, lecturer, Faculty of Health and Human Sciences’ at Plymouth University, writes on behalf of the Infection Prevention Society about the importance of maintaining effective clinical waste management within the NHS.

Ensuring effective clinical waste procedures is crucial to protecting patients against serious risk from infection spread or injury, but it also has wider cost implications for the NHS and potentially damaging effects on the environment.

Clinical waste is defined as waste that consists of or is contaminated by human or animal tissue, body fluids, or healthcare equipment such as dressings and sharps which unless made safe may be hazardous to anyone that comes into contact with it. If not disposed of correctly, it can lead to injury or infection.

As someone who has been working in infection control for more than 25 years in community or hospital settings, I have seen first-hand the mismanagement of waste, in particular clinical waste. In my first hospital infection control job, I remember walking around the wards I covered and looking into clinical waste bags only to find them commonly containing things like the previous day’s newspapers and other non-clinical items.

Worryingly, it seems that mismanagement of waste still occurs today. In the research into healthcare waste management I recently completed, things such as banana skins, uncontaminated food wrappers, and even a whole section of a window blind were found in clinical waste bins.

This remains an issue we should be concerned about, not least because a proportion of clinical waste will be disposed of by incineration – which releases greenhouse gasses into the atmosphere. The NHS’ own Sustainable Development Unit has estimated that the NHS carbon footprint in England alone for 2015/16 is 22.8 million tonnes of carbon dioxide equivalents (MtCO2e).

In addition to this, the disposal of clinical waste is more expensive than domestic waste; in the typical NHS hospital that I have recently been working in, the cost of clinical waste disposal was around three times as expensive as domestic waste disposal. Much of what is disposed of within those clinical waste bags - such as newspapers or food wrapping - might not actually be clinical waste, and this suggests the NHS is spending money unnecessarily on clinical waste disposal.

A report published by the Royal College of Nursing (RCN) in 2011 gave some indication of just how expensive NHS waste management is. The RCN study achieved a 65 per cent response rate from 287 NHS organisations across the United Kingdom and found that it cost £65,336,004 to treat or dispose of bagged waste during 2009-10.

That’s a lot of money, especially when you consider that a proportion of it is being spent needlessly and expensively on the disposal of items placed with clinical waste bags that may have no need to be there.

With NHS funding under continuing pressure, the IPS and its members are advising on the management of healthcare waste to prevent and control the risk of infection caused by contact with it. We need to consider how best to manage healthcare waste management costs in order to enable savings to be redirected into patient care.

The Infection Prevention Society (IPS) represents around 2,000 members working in the field of infection prevention and control, and plays a key role in helping to protect the public. Its vision is that no person is harmed by a preventable infection.