To burn or not to burn: Reducing the single-use burden on the NHS 


Roger Wright, Waste Strategy and Packaging Manager at Biffa, unpacks the next steps for the healthcare industry and the “crucial role” of innovation and resilience in sustainable healthcare.

Clinical waste is one of the NHS’ biggest sustainability challenges and it was only worsened by the impacts of Covid-19 and resulting PPE usage across Britain. How can the nation’s healthcare sector think differently about clinical waste management to tackle the climate crisis that threatens to increase pressure on the NHS?

More than nine million people in England are projected to be living with a major illness by 2040, an increase of 2.5 million compared to 2019, according to the Health Foundation. While caring for those in need is and should be the top priority for the NHS, the amount of waste produced by the UK’s healthcare system sits at odds with the UK Government’s environmental ambitions across the same period.

Clinical waste is not a new challenge, comprising 15% of all waste created by hospitals, but the Covid-19 pandemic has amplified the issue. Most of this waste is incinerated, releasing harmful carbon emissions into the atmosphere – and with the Government’s Waste and Resources Strategy targeting a 50% reduction in carbon emissions by 2026, a step-change in how we manage clinical waste is urgently needed.

The UK’s healthcare network continually proves itself conscientious and caring of both the population and the planet.

For an already beleaguered healthcare system, this is a hard pill to swallow, but the NHS is not backing down from the challenge. Our recent research survey conducted by the YouGov analysis institute found that 65% of respondents surveyed within the medical and health sector believe their business participates in the circular economy. Moreover, 77% believe the circular economy is important to their day-to-day activity. 

The UK’s healthcare network continually proves itself conscientious and caring of both the population and the planet. Not only do we share this sentiment, but have the technical know-how to help the NHS improve its sustainable waste resilience.

Being dynamic and flexible to change can help the healthcare sector recover quickly from shocks like Covid-19, and prepare for future pandemics. Reviewing and improving clinical waste management is one of several positive steps to take on the journey towards sustainable, resilient healthcare.

15 types of plastic, one major responsibility  

NHS plastic waste

Firstly, there are intricacies of material use and disposal unique to the healthcare industry.

Every item used in healthcare facilities must be sterile – from operating equipment to everyday items used by patients on the ward. Disposal methods used for clinical waste must also address and deal with any potential biohazard contamination.

Being cheap, resilient, and easy to clean and sterilise, plastic is a miracle material in the context of a healthcare facility. Unfortunately, it’s also very challenging to recycle – largely due to its variations.

There are 15 types of plastic used in healthcare and items can be composed of hundreds of different combinations. Separating these materials to be recycled individually, while also controlling the risk of infection, is a tall order.

Incineration has therefore always been regarded as the safest option for clinical waste disposal. However, this cannot be the long-term answer.

Reduce, recycle, recover 

Hardly any clinical waste is currently recycled, but this is resolvable. The healthcare sector can reduce the amount of waste it classifies as clinical and redirect materials to more suitable, responsible means of disposal.

Of the many lessons learnt from Covid-19, one the sector must take seriously is the need to look into alternative materials. There are currently six billion items of PPE (equivalent to 28,000 tonnes), including around one billion masks, distributed by the NHS every year – and the majority of these are not recycled.

Investigating recyclable materials which serve the same protective purpose could vastly increase the volume of raw materials that can be recovered and reused from healthcare waste.

There are other significant sources of waste in healthcare that might not immediately spring to mind.

There are other significant sources of waste in healthcare that might not immediately spring to mind, like disposing of food and packaging correctly. Patients eat three meals a day, often resulting in large volumes of food being emptied into general waste.

A dedicated food waste bin means scraps can be disposed of in a more environmentally friendly way, like anaerobic digestion, rather than rotting and releasing carbon or methane into the atmosphere.

The same applies to recyclable packaging. Dedicated bins and advice for staff (like a sign detailing what recycling symbols mean) lower the chance of reusable material being piled in with clinical waste.

Innovation for tracking and teaching 

Digital waste tracking

Exciting technological developments will improve clinical waste management, creating a more sustainable future for healthcare.  

For example, smart bins are currently being trialled. They provide reports on the type of waste collected inside, working in line with digital waste tracking. Consequently, organisations gain a greater understanding of the waste they create and collect. 

This knowledge will enable healthcare professionals to work with waste management providers to optimise collections and bins. The results can also be used to educate staff and patients on the correct bin to put their waste into so they avoid “wishcycling”, leading to more informed, responsible decision-making all around.

Overcoming the single-use challenge 

A major challenge facing the healthcare system in terms of waste is the dependence on single-use materials. While historically this was a necessity for sterility, new understanding and technologies present opportunities for reuse and refill to reduce clinical waste disposal.

Fabrics for garments worn by patients are a great example of a resource which we need to see greater reuse of – and then, when it’s no longer a viable option, better recycling. Sharp objects are more challenging, as the nature of their use renders it difficult to safely recycle metals without risk of contamination.

Innovations in sustainable cleaning products and disinfectants, and new microwave and autoclave sterilisation technology, can enable both of these areas to reduce contamination risks while improving reuse and recycling. 

Knowledge is power 

Circular Economy

There are many opportunities available to the NHS to help it adopt achievable circular practices and reduce its environmental impact, with these principles applicable to any healthcare setting. It all starts with understanding what waste is created and how it can be most sustainably processed.

Assessing waste that enters bins, assisted by emerging technologies, and educating staff and patients to divert as many recoverable materials as possible from the clinical waste stream, is a strong start. Proper disposal of food waste and packaging offers an accessible springboard to begin thinking about sustainable waste resilience, with tools and services readily available.  

The healthcare sector, critical and hard-pressed as it is, deserves support; engage a waste management expert to help optimise waste streams and lower the carbon footprint. Sustainable steps now protect generations to come.

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