Systems for effective and sustainable resource management at hospitals

There is an urgent need to reduce waste at hospitals. A significant decrease in waste generation can be attained through the introduction of recycling and circular economy systems.

Hospital waste management is an important environmental and public safety issue, due to the infectious, toxic or hazardous nature of the waste. The relatively recent addition of cafes and retail outlets into hospitals provides further challenges for waste management operations. A number of environmental risks may arise from hospital waste due to the releases of pathogens and toxic pollutants into the environment. The term ‘clinical waste’ may be used to describe waste generated by healthcare facilities and similar activities that may pose a risk of infection or may prove hazardous.

Hospital waste is a category of waste that is considered highly hazardous, and precautions must be taken to prevent direct exposure of the waste to workers and members of the public. It is imperative that hospital waste is suitably managed and problem areas eradicated to ensure a lower risk of infection.

Waste in hospitals can be categorized into two main parts;

• Hazardous/risk waste- Infectious, pathological, sharps, pharmaceutical, genotoxic, chemical and radioactive waste
• Non-risk- Other garbage, leftover foodstuffs, cardboards, packages etc.

In order for the waste to be managed properly good administration and organization along with adequate legislation, financing and active participation of trained and informed staff must be included. It is imperative to know the quantity of waste generated in order to establish up with adequate measure to deal with the waste in a responsible and effective manner. 

Although most waste is destined for landfills, hospital waste is not permitted to enter landfills, as it would result in contamination of drinking, surface and ground waters. The most widely practiced disposal method of hospital waste is incineration. However, this is expensive and inadequate incineration of unsuitable materials leads to pollutants being released into the atmosphere. Hence, incinerators must operate at the optimum temperature between 850-1100C, and fitted with special gas cleaning equipment to comply with international atmospheric standards for dioxins and furans.

Although legislation plays an important role for the implementation of prevention/avoidance/ recycling systems into the NHS, the behaviours of the individuals working or visiting in and around the area are also crucial. As people’s attitudes shift towards a more environmentally sustainable approach, the concept of recycling would be easier to understand, especially if the individuals have a clear understanding of various materials should be thrown in their respective bins. Waste reduction and recycling in health care management could potentially lead to a cost reduction opportunity, as almost 60% of waste could be recycled through careful segregation methods. To develop best practice, high quality data will be needed to understand the scale of the challenge and the opportunities for reduction/reuse and recycling, alongside a clear view of the necessary infrastructure, service provision and behaviour change programmes required.

To this end, the aims of this study are to;

• Identify, review and assess the systems for handling waste materials, that include general, commercial and clinical waste as well as recyclables within NHS facilities across the UK;
• Identify, audit and critically review procurement of products for a calendar year at a major hospital with a particular focus on increasing reuse and recycling;
• Identify, audit and critically review waste arisings for a calendar year at a major hospital, including general, commercial and clinical waste;
• Develop and test recommendations on how reuse/recycling systems could be efficiently implemented into NHS facilities.