Better waste management

Our strategy
- Project proposals and supporting documents
- Our Green plan

We will the reduce the level of waste (including hazardous waste) we produce as a Trust, by improving waste management capabilities across the organisation, including embedding best practices around recycling and disposal.

From the 2020 all staff survey results, it was evident that waste was a main area of concern which needed to be addressed. The Trust Green Team are excited to announce the launch of the Better Waste Campaign to enable our staff to segregate waste better. Segregating waste better will reduce our climate change emissions from the disposal of waste.

Reusable sharps bins trail at Hammersmith Hospital

ICU East and ICU West at Hammersmith Hospital have piloted a new innovation that reduces the environmental impact of disposing of sharps containers. Traditionally, the NHS use single use sharps containers. Once full, the entire plastic container, along with the contents, is incinerated. As part of the trial, environmentally friendly sharps bins were trialed. Instead of being incinerated, the bins were taken off-site, safely emptied of their contents, cleaned, and returned to the ward to be reused for up to ten times before the bin is recycled into something new.

The 8 week trial on ICU East and ICU West found that staff found the innovative reusable product sharps containers safe and easy to use and that using containers that have a lower environmental impact is important to staff. The impact of the trial was that it reduced our environmental impact by 1.26 tCO2e. This is the equivalent of a large house worth of carbon dioxide in volume or seven months emissions by an average petrol car or the carbon dioxide absorbed by 60 trees in a year. Rolling this innovation out across the Trust could reduce our environmental impact by up to 177 tCO2e, when compared to single use containers, and also save 93 tonnes of plastic per annum.

Reducing unnecessary cannulation at Charing Cross Hospital

At Charing Cross Hospital, accident and emergency staff lead a project to reduce unnecessary cannulation in the A&E department. A baseline measurement carried out as part of a quality improvement project at Charing Cross Hospital emergency department (ED), found that:

86 per cent of patients attending a 24 hours consultant led A&E were cannulated
Over 40 per cent of the cannulas inserted upon attendance were not used
A survey also revealed that 68 per cent of patients complained of pain and discomfort associated with cannulation

The multi-disciplinary team leading the project at Charing Cross Hospital estimated that unnecessary cannulation in the emergency department was potentially costing £125,000 and generating an excess of 24,000 KgCO2 per year.

A year long project to reduce unnecessary cannulation began, with the team working to educate colleagues and change behaviour to support economical cannula use in the emergency department. To raise awareness, the project team designed posters encouraging staff to ‘contemplate before you cannulate’. These highlighted patient comfort, cost considerations and environmental impact around unnecessary cannulation, alongside clear actions to take. These, along with other visual prompts were placed in key areas in the department, as well as on phlebotomy forms. The team also worked with all the emergency department consultants, drawing on clinical expertise and findings from the baseline measurement of unnecessary cannula-use to develop, agree and circulate ‘traffic light’ indications to help decide when cannulation is required.

An audit after 12 months showed a 25 per cent decrease in cannulation during attendance in the emergency department, down to 61 per cent. Of the patients cannulated during attendance, only 27 per cent were unused, down from 40 per cent. This constitutes a reduction of 40 unnecessary cannulations a day and suggests a potential annual reduction in associated carbon of around 19,000 kgCO2e with a cost saving of around £95,000.

Improved clinical waste segregation at the Trust

Our Better Waste Campaign has made great progress in reducing the amount of infectious clinical waste we produce across the Trust. The proportion of our clinical waste going into the tiger- striped clinical waste stream increased from a Trust average of 25 per cent in April 2022 to 43 per cent in March 2024.

This is a big win for the environment because the disposal of tiger-striped clinical waste requires less energy and emits less greenhouse gases than the disposal of orange (infectious) clinical waste. The World Health Organisation recommends that the majority of (appropriate) clinical waste can safely go into the non-infectious or non-hazardous clinical waste bins.

Circular Economy Healthcare Alliance

Alongside several other NHS Trusts, Imperial College Healthcare NHS Trust is part of the Circular Economy Healthcare Alliance. The alliance demonstrates a commitment to a greener and more sustainable NHS. In being part of the alliance, the Trust advocates for a shift towards always using reusable products whenever safe to do so, and will always use suppliers that value sustainability.

Want to learn more about segregating waste?

Check out our 4 key resources that make learning how quick and easy.