Name: The Importance of Waste Management
Uploaded: 2024-10-31
Duration: 17 min 18 s
Description: The Importance of Waste Management. The Importance of Waste Management.

[Audio] The Importance of Waste Management. The Importance of Waste Management. 

Scene 1

[Audio] The Purpose for the Training
To raise awareness of our responsibilities regarding waste
To Promote the Healthcare waste types
And to Address some of the myths regarding Trust waste. 

Scene 2

Raise awareness of our responsibilities regarding waste
Promote the Healthcare waste types
Address some of the myths regarding Trust waste

[Audio] What is Waste?
"…any substance or object which the holder discards or intends or is required to discard…" Every procedure or process everyday will produce waste. Whether it's a paper hand towel or administering a cytotoxic medicine. Therefore, it is important to know where the waste needs to go.. 

Scene 3

“…any substance or object which the holder discards or intends or is required to discard…” 

Every procedure/process everyday will produce waste. Whether that is a paper hand towel or administering a cytotoxic medicine. Therefore, it is important to know where the waste needs to go.

[Audio] Why care about waste?
As the Producer of the waste, You and the T-R-U-S-T are Legally Responsible for its safe packaging, storing, transport, recovery, treatment and/or disposal.. 

Scene 4

As the Producer of the waste YOU and the TRUST are Legally Responsible for its safe packaging, storing, transport, recovery, treatment and/or disposal.

Clinical Waste Bins - Industrial Bins. Sack Holders. Cleanliness is of  paramount importance within hospitals, doctors surgeries and all healthcare  environments. Buy online from Bin Shop.

A picture containing text

Description automatically generated

[Audio] Waste Producer Legislation
There are more than 20 different legislations we must abide by with regards to healthcare waste!
For instance: Duty of Care Code of Practise (D-E-F-R-A), Hazardous Waste Regulations, HTM 07-01, Safe and Sustainable management of Healthcare Waste, The Environmental Protection Act and the Terrorism Act 2006
Our legal duties as an organisation are different to those set out at home!
Waste is segregated on how Dangerous or Hazardous it is to Humans, Animals and/or the Environment
Once thrown in a bin, 10 or more people could be in contact with the waste. For example, Domestic Services, Environmental Team and Contractors
10% of all waste is examined by the waste contractor to ensure we are safely segregating and disposing of healthcare waste compliantly.. 

Scene 5

There are more than 20 different legislations we must abide 
by with regards to 
healthcare waste!

Legal
Duty of Care Code of Practise (DEFRA)
Hazardous Waste Regulations
HTM 07-01 Safe and Sustainable Management of Healthcare Waste
The Environmental Protection Act
Terrorism Act 2006

Waste is segregated on how Dangerous or Hazardous it is to Humans, Animals and/or the Environment
Once thrown in a bin, 10 or more people could be in contact with the waste e.g., Domestic Services, Environmental Team, Contractors
10% of all waste is examined by the waste contractor to ensure we are safely segregating and disposing of healthcare waste compliantly.

Our legal duties as an organisation are different to those set out at home!

[Audio] The Environmental Impact
The N-H-S produces 5.4% of the UK's greenhouse gases.
Waste types are disposed of in different ways to reduce the impact on the environment in accordance with the waste hierarchy.
Some waste is used to produce electricity.
Incorrectly segregated waste can pose a serious risk to the environment. For example, soil, water and air contamination.. 

Scene 6

A turtle swimming under water with a mask and a face mask

Description automatically generated

The NHS produces 5.4% of the UK’s greenhouse gases.
Waste types are disposed of in different ways to reduce the impact on the environment in accordance with the waste hierarchy.
Some waste is used to produce electricity.
Incorrectly segregated waste can pose a serious risk to the environment e.g. soil, water and air contamination.

[Audio] The Waste Hierarchy
PREVENTION: Most preferred option: If you don't need it, don't buy it or use it!
REUSE: If the item is no longer required, rather than discard it, see if it can be used elsewhere!
recycling: Recyclable materials are segregated and extracted and manufactured into new products such as car mats, toilet roll, components for fridges.
recovery: anything that can't be recycled is incinerated at an Energy from Waste plant, to generate electricity for homes and businesses.
disposal: Least preferred option: waste goes to landfill.
Our Trust diverts 100% of waste away from landfill. 

Scene 7

PREVENTION – Most preferred option: If you don’t need it, don’t buy it or use it!
RE-USE – If the item is no longer required, rather than discard it see if it can be used elsewhere!
RECYCLING – Recyclable materials are segregated/extracted and manufactured into new products such as car mats, toilet roll, components for fridges.
RECOVERY – anything that can’t be recycled is incinerated at an Energy from Waste plant, to generate electricity for homes and businesses.
DISPOSAL – Least preferred option: waste goes to landfill.

[Audio] Why are there so many colours for healthcare waste?
So emergency services can safely clear any spillage of healthcare waste on the highways and byways.
And It helps identify different final disposal methods, making it more environmentally friendly.. 

Scene 8

A yellow and black dress

Description automatically generated with medium confidence

Chart, funnel chart

Description automatically generated

A picture containing text, bin, container

Description automatically generated

A picture containing text, toiletry, perfume, yellow

Description automatically generated

Diagram

Description automatically generated

Helps identify different final disposal methods, making it more environmentally friendly.

A truck accident on the road

Description automatically generated

So that emergency services can safely clear any spillage of healthcare waste on the highways and byways.

[Audio] Waste Disposal Language
There are different disposal methods for clinical waste
High Temperature Incineration, also known as H T I, for disposal of Yellow Bags, Yellow Sharps, Purple Bags, Purple Sharps and Anatomical.
The waste is incinerated at high temperature to render it safe for the environment, but it is not a sustainable method and there are only 2 H-T-I incinerators for the whole of England's H-T-I waste.
Alternative Treatment, also known as A T, for disposal of Orange Bags and Orange Sharps
This waste goes through two processes. Firstly, it's autoclaved (sterilisation through steam) to render it safe from infectious substances, then it' sent for low temperature incineration to generate electricity to put back into the National Grid, also known as E f W – Energy from Waste, which is a more sustainable method of disposal.
Energy From Waste (E f W), for the disposal of Offensive and Blue Pharmaceutical waste.
The waste is sent directly to E f W, the most sustainable method.. 

Scene 9

Different disposal methods for clinical waste

Alternative Treatment (AT) Orange Bags, Orange Sharps

Energy From Waste (EfW)  Offensive Waste & Blue Pharma

A picture containing icon

Description automatically generated

Autoclaved to render it safe, then sent for low temperature incineration to generate electricity (EfW – Energy from Waste) – more sustainable than HTI

Sent directly for low temperature incineration to generate electricity (EfW – Energy from Waste) the most sustainable method of disposal

Incinerated at high temperature to render it safe for the environment – not a sustainable method

High Temperature Incineration (HTI) Yellow Bags, Yellow Sharps, Purple Bags, Purple Sharps, Anatomical

[Audio] 'Energy from Waste, also known as E F W'
Although focus should still be on waste minimisation, Energy from Waste is a renewable solution that can provide low carbon electricity. E f W plants burn municipal solid waste, often called general or domestic waste, to produce steam in a boiler, and the steam is used to power an electric generator turbine. The electricity produced is then put back into the national grid to compliment other renewable energy sources such as wind and solar.
All the waste gases emitted from the plant meet very tight limits placed on them through legislation. As a result, energy from waste plants contribute only a small fraction of both local and national particulate and other emissions. About 3.1% of the UK's energy comes from waste incinerators.. 

Scene 10

All the waste gases emitted from the plant meet very tight limits placed on them through legislation. As a result, energy from waste plants contribute only a small fraction of both local and national particulate and other emissions.

EfW plants burn municipal solid waste, often called general or domestic waste, to produce steam in a boiler, and the steam is used to power an electric generator turbine. The electricity produced is then put back into the national grid to compliment other renewable energy sources such as wind and solar.

Although focus should still be on waste minimisation, Energy from Waste is a renewable solution that can provide low carbon electricity.

About 3.1% of the UK’s energy comes from waste incinerators.

[Audio] How much does it cost to dispose of healthcare waste?
High Temperature Incineration (H T I) costs between £990 to £1500 per tonne
Alternative Treatment (A T) costs between £550 to £1000 per tonne
Energy from Waste (E f W) costs between £330 to £600 per tonne. 

Scene 11

cost for disposal is between
£990 to £1500 per tonne

cost for disposal is between
£550 to £1000 per tonne

cost for disposal is between
£330 to £600 per tonne

[Audio] N-H-S-E National Waste Strategy
N-H-S England have set targets to all Trusts nationally, to reduce waste volumes and increase segregation as part of 'Delivering a Net Zero N-H-S--' by 2026. The target set out in the National Waste Strategy are as follows:
The approximate waste percentages produced by each Trust must be 20% of HTI, 20% AT and 60% Offensive Waste & Blue.
Trusts must also reduce their carbon emissions by 50% from waste management.. 

Scene 12

Fqure 2: Measures of success by tarWt date (indicative only)
100% of NHS trusts and
fmmdation trusb have
dedicated waste rtuna*rs
(at least 0.5 FTE) with
accountable individuals for
waste rnanaøert*nt
identified across all
All clWcal waste
by NHS providers is
regularly reported with a
minimum of 95% accuracy
All NHS providers achieve
CliNcal Waste segregaton
targets of HTI. AT
and OW
The average cost Of
clinical waste managen*M
reduces by 15% per tonne
Of
2023
2024
2026
2026
2028
All NHS providers
introduce arrangements for
the management of the
offensive waste stream
50% reduc60n in carbon
emissions produced from
waste muugement in NHS
reduc60n in carbon
emissions produced from
waste management in NHS

Reduce waste and increase segregation.
 ‘Delivering a Net Zero NHS’.

The target set out in the National Waste Strategy are 20% HTI, 20% AT and 60% Offensive Waste & Blue.

[Audio] Recycling Waste
Every year, the Trust sends approximately 520 tonnes of materials for recycling.
That's equivalent to the weight of 149 ambulances.
The waste streams we send for recycling are:
Domestic Recycling (extracted recycling from the domestic waste stream)
Paper
Cardboard
Glass
Plastics
Metals (including catering tin cans)
Wood
Used batteries
Garden waste
Toner cartridges and
Electronic waste,
As well as a multitude of other materials. 

Scene 13

Domestic Recycling (extracted recycling from the domestic waste stream)
Paper
Cardboard
Glass
Plastics
Metals (including catering tin cans)
Wood
Used batteries
Garden waste
Toner cartridges
Electronic waste
As well as a multitude of other materials

[image] A yellow and green ambulance Description automatically generated

Every year, the Trust sends approximately 520 tonnes of materials for recycling.
That’s equivalent to the weight of 149 ambulances.

[Audio] Recycling of Plastic and Carboard
For cardboard to be recycled, it must be clean and free from any contamination and should be flat packed before discarding. Plastics must be rinsed from milk or food waste and squashed before disposing into clear bags. These cannot be recycled if there are fluids or food contamination or Medicine/ chemical contamination.. 

Scene 14

A plastic water bottle

Description automatically generated with medium confidence

A picture containing plastic, drinking water

Description automatically generated

A stack of cardboard boxes

Description automatically generated

Clean and free from any contamination.
Cardboard must be flat packed.
Plastics rinsed and squashed then placed into clear bags.
NO Liquids.
NO Food contamination.
NO Medicine or chemical contamination.

[Audio] Recycling of Glass & Ceramics
These orange glass bins must not be used for the disposal of any waste.
This does Not get recycled and is ILLEGAL to use as it does not meet with regulations for disposal.
Please use the heavy duty brown paper bags (can be sourced from facilities) for unwanted or broken domestic glass and ceramics, for example jars, ceramic mugs and plates et cetera These are then sent for recycling.
The blue healthcare waste stream must be used for medicine bottles, vials, blister packs. This should only be used for medicine waste that is not returned to pharmacy for destruction.. 

Scene 15

A red bucket with a handle

Description automatically generated

CANNOT BE USED FOR ANYTHING INCL. DOMESTIC GLASS OR HEALTHCARE GLASS (e.g. medicine bottles). 
 Does NOT get recycled and 
is ILLEGAL to use.

Use heavy duty brown paper bags (obtained from facilities) for unwanted or broken domestic glass and ceramics (e.g. jars, ceramic mugs and plates etc).
 These are recycled!

Use the blue healthcare waste stream for medicine bottles, vials, blister packs. This should only be used for medicine waste not returned to pharmacy for destruction.

[Audio] Recycling of Paper and Magazines
It's not just confidential paper that can go into the consoles, All paper can, including, newspapers & magazines. The Paper is recycled into toilet paper and brown paper products, for example envelopes.
Please do not discard confidential waste into any Healthcare waste stream as it is not G-D-P-R secure and can be inspected, opened and seen.
G-D-P-R applies to 'personal data' meaning any information relating to an identifiable person who can be directly or indirectly identified, in particular by reference to an identifier.
Wet paper (for example hand towel) or contaminated paper with food or bodily fluids et cetera, must not be placed into the console.
Please seek advice from the Waste Manager and data & governance leads.. 

Scene 16

Checkmark PNG, Checkmark Transparent Background - FreeIconsPNG

ALL paper (including confidential), newspapers & magazines to go into the console.

Paper is recycled into toilet paper and brown paper products (envelopes).






Please do not discard confidential waste into any Healthcare waste stream as it is not GDPR secure and can be inspected, opened and seen.

GDPR applies to ‘personal data’ meaning any information relating to an identifiable person who can be directly or indirectly identified, in particular by reference to an identifier.

Wet paper (e.g. hand towel) or contaminated paper with food or bodily fluids etc., must not be placed into the console.

Please seek advice from the Waste Manager and data & governance leads.

[Audio] Recycling of Toner Cartridges
Discarded cartridges must be placed back into the original packaging and sealed to avoid toner powder spillage, before it can be recycled.
The toner is an extremely fine powder, which in itself is not classed as a substance hazardous to health, but any dust in substantial concentration may cause respiratory tract irritation resulting in coughing and sneezing.. 

Scene 17

[image] Several colored ink cartridges next to several boxes Description automatically generated

Discarded cartridges must be placed back into the original packaging and sealed to avoid toner powder spillage, before it can be recycled.

The toner is an extremely fine powder, which in itself is not classed as a substance hazardous to health, but any dust in substantial concentration may cause respiratory tract irritation resulting in coughing and sneezing.

[Audio] Domestic Waste
Disposal of waste classed as domestic or household waste. These bins are best placed next to hand towel dispensers and sinks to capture the hand towel waste. This waste is disposed of through Energy from Waste, once the recycling material has been extracted.
The domestic waste stream is not for the disposal of Liquid Waste, P-P-E from clinical areas (including masks), Medicine or chemical contamination, Sharps or anything that can puncture the bag.. 

Scene 18

[image] Diagram Description automatically generated

General Waste Only.
Bins placed next to hand towel dispensers and sinks.
Disposed through Energy from Waste.
NO Liquid Waste.
NO PPE from clinical areas (including masks).
NO Medicine or chemical contamination.
NO Sharps or anything that can puncture the bag.

[Audio] Offensive, (also known as Tiger) Soft Waste Only. Waste that is not contaminated with medicines, chemicals or infectious micro-organisms from the treatment of patients.
Placed in patient side Rooms (not in isolation), Bed Bay's and Toilets.
Can contain Contamination blood or bodily fluids from non-infectious patient.
Disposed through Energy from Waste.
The offensive waste stream is not for the disposal of Liquid Waste, Medicine or chemical contamination, Sharps or anything that can puncture the bag.. 

Scene 19

Offensive (Tiger) Soft Waste Only Not contaminated with infectious waste, medicines or chemicals

[image] Diagram Description automatically generated with medium confidence

Side Rooms (not in isolation).
Bed Bay’s and Toilets.
Contamination of blood or bodily fluids from non-infectious patient.
Disposed through Energy from Waste.
NO Liquid Waste.
NO Medicine or chemicals.
NO Sharps or anything that can puncture the bag.

[Audio] Infectious Soft Waste Only (also known as Orange bagged Waste). Waste contaminated with infectious micro-organisms from the treatment of patients but not contaminated with medicines or chemicals
Placed in Isolation Rooms. I-P-C door signage dictates if the room is in isolation. sluice or supervised departments.
If side rooms are annually 90% or more in isolation, then only orange waste bins are required all year round.
Can contain Contamination of blood or bodily fluids from infectious patient.
After being rendered safe from the autoclave process, it's disposed of through Energy from Waste.
The orange bagged waste stream is not for the disposal of Liquid Waste, Medicine or chemical contamination, Sharps or anything that can puncture the bag.. 

Scene 20

Infectious Soft Waste Only 
Not contaminated with medicines or chemicals

Isolation Rooms, sluice or supervised departments.
If side rooms are annually 90% or more in isolation, then only orange waste bins are required.
Contamination of blood or bodily fluids from infectious patient.
After being rendered safe, it’s disposed through Energy from Waste.
NO Liquid Waste.
NO Medicine or chemicals.
NO Sharps or anything that can puncture the bag.

[Audio] Contaminated Infectious Soft Waste Only (also known as Yellow bagged waste). Waste contaminated with infectious micro-organisms from the treatment of patients and/or contaminated with medicines or chemicals
This waste stream is typically found in Laboratories and Theatres.
Can contain medicinal/chemical contamination.
Used for high-risk infection, also known as high consequence infectious diseases, for example Ebola or Middle East respiratory syndrome also known as mers
Disposed of through High temperature incineration.
The yellow bagged waste stream is not for the disposal of Liquid Waste, cytotoxic or cytostatic medicines, Sharps or anything that can puncture the bag.. 

Scene 21

[image] Yellow
Bag
NHS
Waste that is contaminated With highly infectious
micro-organisms and/or contaminated with
medicines/chemicals from the treatment Of patients
Highly Infectious Waste
Soft healthcare waste, including items containing bodily fluids
and blood contaminated With medicines or
Gloves, aprons, masks and dressings
No sharps, No cytotoxic or cytostatic, medicines or chemicals

Typically found in Laboratories or Theatres.
Medicinal/chemical contamination.
Used for high-risk infection e.g. Ebola or Middle East respiratory syndrome also known as MERS
High temperature incineration.
NO Liquid Waste.
NO cytotoxic/cytostatic medicinal contamination.
NO Sharps or anything that can puncture the bag.

Contaminated Infectious Soft Waste Only 
Contaminated with medicines or chemicals

[Audio] Correctly Tying Clinical Waste Bags
Clinical waste bags should not be filled anymore than two thirds full.
Bags must be swan necked, creating a handle allowing for safely holding the bag.
Bags must be tightly tied using a zip tie.. 

Scene 22

Clinical waste bags should NOT be filled anymore than 2/3 full.

Bags must be swan necked, creating a handle allowing for safely holding the bag.

Bags must be tightly tied using a zip tie.

[Audio] Bins at Point of Production
Waste bins should be: Clean and Free from damage or rust, Self-closing and pedal operated, no open wastepaper bins in open patient areas for example nurses stations. soft closing for in patient areas, Not overflowing or overfilled, and not contain spare bags.
Bins should be placed in the correct location:
For example
Domestic waste bins should be available in all areas and situated next to sinks.
Offensive waste bins must be placed in sluice rooms, bed bays, side rooms not in isolation, showers and toilets as appropriate Orange waste bins to be placed in sluice rooms, infectious side rooms and supervised departments for example I-C-U--, theatres et cetera
Infectious orange bagged waste must not be located in public areas!. 

Scene 23

Waste bins should be - 
Clean
Free from damage or rust
Self-closing and pedal operated
In patient areas - soft closing
Not overflowing or overfilled
Not contain spare bags
In the correct location:

Domestic waste bins – all areas especially by sinks.
Offensive waste bins – sluice rooms, bed bays, side rooms not in isolation, showers and toilets as appropriate
Orange waste bins – sluice rooms, infectious side rooms and supervised departments e.g., ICU, theatres etc.

Infectious orange bagged waste must not be located in public areas!

[Audio] Orange Sharps
Infectious sharps waste, not contaminated with medicines or chemicals
To be used for non-medicinally contaminated sharps for example scissors, razors and Needles/Syringes used by Phlebotomists for taking blood samples. The waste is collected by an External Contractor and transported for Alternative Treatment, eventually going for disposal to E f W The orange sharps waste stream is not for the disposal of Liquid Waste, medicine or chemical waste, or soft healthcare waste for example swabs, dressings or plasters.. 

Scene 24

Orange Sharps Infectious sharps waste, 
not contaminated with medicines or chemicals

Used, non-medicinally contaminated sharps e.g. scissors, razors.
Phlebotomy Needles/Syringes.
Final disposal through EfW.
NO Liquid Waste.
NO Medicine or chemicals.
NO Soft healthcare waste e.g. swabs, dressings, plasters.

[Audio] Other Clinical Waste Streams we produce
These waste streams are collected by an External Contractor and transported for High Temperature Incineration
Yellow Waste Stream
Hazardous Infectious waste contaminated with chemicals or medicines
Cytotoxic / Cytostatic
Hazardous waste contaminated with cytotoxic or cytostatic medicines
Cytotoxic substances damage or kill cells.
Cytostatic tends to slow or inhibit cellular activity and multiplication.
Anatomical
Identifiable body tissue and parts. (Doubled up heavy duty yellow bags can be used for larger anatomical items). 

Scene 25

Yellow Waste Stream
Hazardous Infectious waste contaminated with chemicals or medicines

Anatomical
Identifiable body tissue and parts. (Doubled up heavy duty yellow bags can be used for larger anatomical items)

Waste is collected by an External Contractor and transported for High Temperature Incineration

Hazardous waste contaminated with cytotoxic or cytostatic medicines

[Audio] Blue Medicine, also known as Pharmaceutical Non-Hazardous waste
For non-hazardous medicine waste only. To be stored in the clean utility room.
What can go in these bins:
Any medicine that is non-hazardous
Expired medicines
A-L-L empty medicine blister packs and bottles
Drug destruction kits
Liquid controlled Drugs, only with the presence of med gel sachets to ensure that the liquid controlled drugs cannot be drawn back out. What can't go in:
Hazardous medicines (cytotoxic/cytostatic)
I V and blood giving sets
Infectious waste
Blood or any bodily fluids
Outer packaging for medicines
Confidential data
Sharps. 

Scene 26

For non-hazardous medicine waste only. To be stored in the clean utility room.

What can go in:
Any medicine that is non-hazardous
Expired medicines
ALL empty medicine blister packs and bottles
Drug destruction kits
Liquid controlled Drugs

What can’t go in:
Hazardous medicines (cytotoxic/cytostatic)
IV and blood giving sets
Infectious waste
Blood or any bodily fluids
Outer packaging for medicines
Anything that identifies a patient
Sharps

NHS Supply Chain Code: FDR543 Manufacturer: Medline Manufacturer Code: RE2015

[Audio] For sharps to be disposed of compliantly, here is 9 point check to follow Lid must be fitted securely
Temporary closure must be in place Lid colour must match the label
Duty of Care Information must be completed (without the label being fully completed, it cannot legally be transported on the road for disposal)
Free from external contamination
No paper or packaging must be present within the sharps tub
Correctly segregated waste stream
Sealed and permanently closed when ¾ full
Must be closed after 6 months from opening date ready for disposal
Department to place into a secure area ready for collection. 

Scene 27

9 Point Check
Lid must be fitted securely
Temporary closure must be in place 
Lid colour must match the label
Duty of Care Information must be completed
Free from external contamination
No paper or packaging
Correctly segregated waste stream
Sealed and permanently closed when ¾ full
Must be closed after 6 months from opening date
Department to place into a secure area ready for collection

A picture containing cup

Description automatically generated

[Audio] Disposal of used Vacsax
To ensure the safety and wellbeing of those handling this type of waste, used VacSax must be placed into an approved UN3 2 9 1 leak proof container.
The yellow cardboard VacSax boxes do not meet with UN approved packaging standards required to transport this waste for final disposal.
They must not be discarded into any bagged waste (double bagged or not).. 

Scene 28

[image] A close up of several boxes Description automatically generated

To ensure the safety and wellbeing of those handling this type of waste, used VacSax must be placed into an approved UN3291 leak proof container.

The yellow cardboard VacSax boxes do not meet with UN approved packaging standards required to transport this waste for final disposal.

They must not be discarded into any bagged waste (double bagged or not).

[Audio] Waste Produced from Community Healthcare
All healthcare organisations have a legal duty to ensure that waste produced by the actions of healthcare staff in the community (for example in a patient's home, and classified as hazardous due to an inherent risk of infection, or cytostatic/cytotoxic medicines, sharps or other hazards), are not disposed of in the domestic waste stream.
Healthcare staff working in the community are responsible for the waste produced as a result of their activities and should otherwise comply with the duty of care requirements.. 

Scene 29

A picture containing text, house, clipart

All healthcare organisations have a legal duty to 
ensure that waste produced by the actions of healthcare staff in the community (e.g. in a patient’s home, and classified as hazardous due to an inherent risk of infection, or cytostatic/cytotoxic medicines, sharps 
or other hazards), are not disposed of 
in the domestic waste stream.

Healthcare staff working in the community are responsible for the waste produced as a result of their activities and should otherwise comply with the duty of care requirements.

[Audio] Interesting Facts
On average the whole of York & Scarborough Teaching Hospitals produces the following:
Approximately 1000 tonnes of Clinical Waste. This is equivalent weight to: 2000 Polar Bears
Approximately 1690 tonnes of Non-Clinical Waste.
This is equivalent weight to: 300 African Bull Elephants
Combined weight This is weight equivalent to: 30 Blue Whales That's equivalent to 2667 humans each weighing approximately 70 kilograms. 

Scene 30

On average the whole of York & Scarborough 
Teaching Hospitals produces the following:

Approx. 1000 tonnes of Clinical Waste.   
This is equivalent weight to: -
2000 Polar Bears

Approx. 1690 tonnes of Non-Clinical Waste.
This is equivalent weight to:-
 300 African Bull Elephants

An elephant with tusks

Description automatically generated

Combined weight - This is weight equivalent to:-
 30 Blue Whales

A blue and white jellyfish

Description automatically generated with low confidence

A blue fish and a blue background

Description automatically generated with medium confidence

[Audio] Next Steps
Continue to improve waste segregation at source
Be aware of the dangers when handling the different waste streams
Start thinking about your areas – what waste do you produce and what do you need.
Spread the word and don't be afraid to ask of how to compliantly and safely dispose of an item
Speak with the Trusts Waste Manager for any queries. 

Scene 31

Continue to improve waste segregation at source
Be aware of the dangers when handling the different waste streams
Start thinking about your areas – what waste do you produce and what do you need.
Spread the word and don’t be afraid to ask of how to compliantly and safely dispose of an item
Speak with the Trusts Waste Manager for any queries

[Audio] Thank you for taking the time to complete this session.. 

Scene 32

A car on a black background

Description automatically generated

A pair of checkered flags

Description automatically generated




The Importance of 
Waste Management 

avatar

The Purpose for the Training
To raise awareness of our responsibilities regarding waste
To Promote the Healthcare waste types
And to Address some of the myths regarding Trust waste

What is Waste?
"…any substance or object which the holder discards or intends or is required to discard…" 
Every procedure or process everyday will produce waste. Whether it's a paper hand towel or administering a cytotoxic medicine. Therefore, it is important to know where the waste needs to go.

Why care about waste?
As the Producer of the waste, You and the T-R-U-S-T are Legally Responsible for its safe packaging, storing, transport, recovery, treatment and/or disposal.

Waste Producer Legislation
There are more than 20 different legislations we must abide by with regards to healthcare waste!
For instance: Duty of Care Code of Practise (D-E-F-R-A), 
Hazardous Waste Regulations, 
HTM 07-01, Safe and Sustainable management of Healthcare Waste, 
The Environmental Protection Act and the Terrorism Act 2006
Our legal duties as an organisation are different to those set out at home!
Waste is segregated on how Dangerous or Hazardous it is to Humans, Animals and/or the Environment
Once thrown in a bin, 10 or more people could be in contact with the waste. For example, Domestic Services, Environmental Team and Contractors
10% of all waste is examined by the waste contractor to ensure we are safely segregating and disposing of healthcare waste compliantly.

The Environmental Impact
The N-H-S produces 5.4% of the UK's greenhouse gases.
Waste types are disposed of in different ways to reduce the impact on the environment in accordance with the waste hierarchy.
Some waste is used to produce electricity.
Incorrectly segregated waste can pose a serious risk to the environment. For example, soil, water and air contamination.

The Waste Hierarchy
PREVENTION: Most preferred option: If you don't need it, don't buy it or use it!
REUSE: If the item is no longer required, rather than discard it, see if it can be used elsewhere!
recycling: Recyclable materials are segregated and extracted and manufactured into new products such as car mats, toilet roll, components for fridges.
recovery: anything that can't be recycled is incinerated at an Energy from Waste plant, to generate electricity for homes and businesses.
disposal: Least preferred option: waste goes to landfill.
Our Trust diverts 100% of waste away from landfill

Why are there so many colours for healthcare waste?
So emergency services can safely clear any spillage of healthcare waste on the highways and byways.
And It helps identify different final disposal methods, making it more environmentally friendly.

Waste Disposal Language
There are different disposal methods for clinical waste
High Temperature Incineration, also known as H T I, for disposal of Yellow Bags, Yellow Sharps, Purple Bags, Purple Sharps and Anatomical.
The waste is incinerated at high temperature to render it safe for the environment, but it is not a sustainable method and there are only 2 H-T-I incinerators for the whole of England's H-T-I waste.
Alternative Treatment, also known as A T, for disposal of Orange Bags and Orange Sharps
This waste goes through two processes. Firstly, it's autoclaved (sterilisation through steam) to render it safe from infectious substances, then it' sent for low temperature incineration to generate electricity to put back into the National Grid, also known as E f W – Energy from Waste, which is a more sustainable method of disposal.
Energy From Waste (E f W), for the disposal of Offensive and Blue Pharmaceutical waste.
The waste is sent directly to E f W, the most sustainable method.

'Energy from Waste, also known as E F W'
Although focus should still be on waste minimisation, Energy from Waste is a renewable solution that can provide low carbon electricity. 
E f W plants burn municipal solid waste, often called general or domestic waste, to produce steam in a boiler, and the steam is used to power an electric generator turbine. The electricity produced is then put back into the national grid to compliment other renewable energy sources such as wind and solar.
All the waste gases emitted from the plant meet very tight limits placed on them through legislation. As a result, energy from waste plants contribute only a small fraction of both local and national particulate and other emissions. 
About 3.1% of the UK's energy comes from waste incinerators.

How much does it cost to dispose of healthcare waste?
High Temperature Incineration (H T I) costs between £990 to £1500 per tonne
Alternative Treatment (A T) costs between £550 to £1000 per tonne
Energy from Waste (E f W) costs between £330 to £600 per tonne

N-H-S-E National Waste Strategy
N-H-S England have set targets to all Trusts nationally, to reduce waste volumes and increase segregation as part of 'Delivering a Net Zero N-H-S--' by 2026. The target set out in the National Waste Strategy are as follows:
The approximate waste percentages produced by each Trust must be 20% of HTI, 20% AT and 60% Offensive Waste & Blue.
Trusts must also reduce their carbon emissions by 50% from waste management.

Recycling Waste
Every year, the Trust sends approximately 520 tonnes of materials for recycling.
That's equivalent to the weight of 149 ambulances.
The waste streams we send for recycling are:
Domestic Recycling (extracted recycling from the domestic waste stream)
Paper
Cardboard
Glass
Plastics
Metals (including catering tin cans)
Wood
Used batteries
Garden waste
Toner cartridges 
and
Electronic waste,
As well as a multitude of other materials

Recycling of Plastic and Carboard
For cardboard to be recycled, it must be clean and free from any contamination and should be flat packed before discarding.   
Plastics must be rinsed from milk or food waste and squashed before disposing into clear bags. 
These cannot be recycled if there are fluids or food contamination or Medicine/ chemical contamination.

Recycling of Glass & Ceramics
These orange glass bins must not be used for the disposal of any waste.
This does Not get recycled and is ILLEGAL to use as it does not meet with regulations for disposal.
Please use the heavy duty brown paper bags (can be sourced from facilities) for unwanted or broken domestic glass and ceramics, for example jars, ceramic mugs and plates et cetera These are then sent for recycling.
The blue healthcare waste stream must be used for medicine bottles, vials, blister packs. This should only be used for medicine waste that is not returned to pharmacy for destruction.

Recycling of Paper and Magazines
It's not just confidential paper that can go into the consoles, All paper can, including, newspapers & magazines. The Paper is recycled into toilet paper and brown paper products, for example envelopes.
Please do not discard confidential waste into any Healthcare waste stream as it is not G-D-P-R secure and can be inspected, opened and seen.
G-D-P-R applies to 'personal data' meaning any information relating to an identifiable person who can be directly or indirectly identified, in particular by reference to an identifier.
Wet paper (for example hand towel) or contaminated paper with food or bodily fluids et cetera, must not be placed into the console.
Please seek advice from the Waste Manager and data & governance leads.

Recycling of Toner Cartridges
Discarded cartridges must be placed back into the original packaging and sealed to avoid toner powder spillage, before it can be recycled.
The toner is an extremely fine powder, which in itself is not classed as a substance hazardous to health, but any dust in substantial concentration may cause respiratory tract irritation resulting in coughing and sneezing.

Domestic Waste
Disposal of waste classed as domestic or household waste. These bins are best placed next to hand towel dispensers and sinks to capture the hand towel waste. This waste is disposed of through Energy from Waste, once the recycling material has been extracted.
The domestic waste stream is not for the disposal of Liquid Waste, P-P-E from clinical areas (including masks), Medicine or chemical contamination, Sharps or anything that can puncture the bag.

Offensive, (also known as Tiger) Soft Waste Only. 
Waste that is not contaminated with medicines, chemicals or infectious micro-organisms from the treatment of patients.
Placed in patient side Rooms (not in isolation), Bed Bay's and Toilets.
Can contain Contamination blood or bodily fluids from non-infectious patient.
Disposed through Energy from Waste.
The offensive waste stream is not for the disposal of Liquid Waste, Medicine or chemical contamination, Sharps or anything that can puncture the bag.

Infectious Soft Waste Only (also known as Orange bagged Waste).  
Waste contaminated with infectious micro-organisms from the treatment of patients but not contaminated with medicines or chemicals
Placed in Isolation Rooms. I-P-C door signage dictates if the room is in isolation. sluice or supervised departments.
If side rooms are annually 90% or more in isolation, then only orange waste bins are required all year round.
Can contain Contamination of blood or bodily fluids from infectious patient.
After being rendered safe from the autoclave process, it's disposed of through Energy from Waste.
The orange bagged waste stream is not for the disposal of Liquid Waste, Medicine or chemical contamination, Sharps or anything that can puncture the bag.

Contaminated Infectious Soft Waste Only (also known as Yellow bagged waste). 
Waste contaminated with infectious micro-organisms from the treatment of patients and/or contaminated with medicines or chemicals
This waste stream is typically found in Laboratories and Theatres.
Can contain medicinal/chemical contamination.
Used for high-risk infection, also known as high consequence infectious diseases, for example Ebola or Middle East respiratory syndrome also known as mers
Disposed of through High temperature incineration.
The yellow bagged waste stream is not for the disposal of Liquid Waste, cytotoxic or cytostatic medicines, Sharps or anything that can puncture the bag.

Correctly Tying Clinical Waste Bags
Clinical waste bags should not be filled anymore than two thirds full.
Bags must be swan necked, creating a handle allowing for safely holding the bag.
Bags must be tightly tied using a zip tie.

Bins at Point of Production
Waste bins should be: 
Clean and Free from damage or rust, Self-closing and pedal operated, no open wastepaper bins in open patient areas for example nurses stations. soft closing for in patient areas, Not overflowing or overfilled, and not contain spare bags.
Bins should be placed in the correct location:
For example
Domestic waste bins should be available in all areas and situated next to sinks.
Offensive waste bins must be placed in sluice rooms, bed bays, side rooms not in isolation, showers and toilets as appropriate 
Orange waste bins to be placed in sluice rooms, infectious side rooms and supervised departments for example I-C-U--, theatres et cetera
Infectious orange bagged waste must not be located in public areas!

Orange Sharps
Infectious sharps waste, not contaminated with medicines or chemicals
To be used for non-medicinally contaminated sharps for example scissors, razors and Needles/Syringes used by Phlebotomists for taking blood samples. 
The waste is collected by an External Contractor and transported for Alternative Treatment, eventually going for disposal to E f W The orange sharps waste stream is not for the disposal of Liquid Waste, medicine or chemical waste, or soft healthcare waste for example swabs, dressings or plasters.

Other Clinical Waste Streams we produce
These waste streams are collected by an External Contractor and transported for High Temperature Incineration
Yellow Waste Stream
Hazardous Infectious waste contaminated with chemicals or medicines
Cytotoxic / Cytostatic
Hazardous waste contaminated with cytotoxic or cytostatic medicines
Cytotoxic substances damage or kill cells.
Cytostatic tends to slow or inhibit cellular activity and multiplication.
Anatomical
Identifiable body tissue and parts. (Doubled up heavy duty yellow bags can be used for larger anatomical items)

Blue Medicine, also known as Pharmaceutical Non-Hazardous waste
For non-hazardous medicine waste only. 
To be stored in the clean utility room.
What can go in these bins:
Any medicine that is non-hazardous
Expired medicines
A-L-L empty medicine blister packs and bottles
Drug destruction kits
Liquid controlled Drugs, only with the presence of med gel sachets to ensure that the liquid controlled drugs cannot be drawn back out.
 
What can't go in:
Hazardous medicines (cytotoxic/cytostatic)
I V and blood giving sets
Infectious waste
Blood or any bodily fluids
Outer packaging for medicines
Confidential data
Sharps

For sharps to be disposed of compliantly, here is 9 point check to follow 
Lid must be fitted securely
Temporary closure must be in place 
Lid colour must match the label
Duty of Care Information must be completed (without the label being fully completed, it cannot legally be transported on the road for disposal)
Free from external contamination
No paper or packaging must be present within the sharps tub
Correctly segregated waste stream
Sealed and permanently closed when ¾ full
Must be closed after 6 months from opening date ready for disposal
Department to place into a secure area ready for collection

Disposal of used Vacsax
To ensure the safety and wellbeing of those handling this type of waste, used VacSax must be placed into an approved UN3 2 9 1 leak proof container.
The yellow cardboard VacSax boxes do not meet with UN approved packaging standards required to transport this waste for final disposal.
They must not be discarded into any bagged waste (double bagged or not).

Waste Produced from Community Healthcare
All healthcare organisations have a legal duty to ensure that waste produced by the actions of healthcare staff in the community (for example in a patient's home, and classified as hazardous due to an inherent risk of infection, or cytostatic/cytotoxic medicines, sharps or other hazards), are not disposed of in the domestic waste stream.
Healthcare staff working in the community are responsible for the waste produced as a result of their activities and should otherwise comply with the duty of care requirements.

Interesting Facts
On average the whole of York & Scarborough Teaching Hospitals produces the following:
Approximately 1000 tonnes of Clinical Waste.   
This is equivalent weight to: 
2000 Polar Bears
Approximately 1690 tonnes of Non-Clinical Waste.
This is equivalent weight to:
 300 African Bull Elephants
Combined weight  This is weight equivalent to:
 30 Blue Whales
 
That's equivalent to 2667 humans each weighing approximately 70 kilograms

Next Steps
Continue to improve waste segregation at source
Be aware of the dangers when handling the different waste streams
Start thinking about your areas – what waste do you produce and what do you need.
Spread the word and don't be afraid to ask of how to compliantly and safely dispose of an item
Speak with the Trusts Waste Manager for any queries

Thank you for taking the time to complete this session.