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Practices to change the way they segregate and dispose of healthcare waste under new measures

by Beth Gault
3 May 2023

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General practices in England are having to alter the way they dispose of healthcare waste under new measures introduced by the NHS.

The changes have introduced the ‘offensive waste stream’ as compulsory for primary care settings, meaning it will become their main route of waste disposal. Practices will need to introduce arrangements for segregating it by introducing bins, signage and labelling, according to the NHS clinical waste strategy released in March.

The switch is aimed at reducing the amount of healthcare waste that goes to incineration or landfill. This hopes to save the NHS around £2m per year, reduce carbon emissions and help reach the NHS’s net zero targets.

The offensive waste stream should include non-clinical waste that is non-infectious and doesn’t  contain pharmaceutical or chemical substances but may be unpleasant to anyone who comes into contact with it, such as outer dressings or gowns contaminated with body fluids (see box). This waste is to be disposed of in yellow and black-striped bags or ‘tiger bags’.

The new rules aim to reduce the volume of waste incorrectly put into orange bags (and that go to incineration), which should only be used for soft healthcare waste that has come into contact with patients who may be infectious.

Sharps containers and current colour coding for their lids remains the same.

The measures were unveiled in the Health Technical Memorandum 07-01, a framework for best practice waste management which was updated in March 2023.

The changes are being rolled out across England, with ICBs informing GP practices when they will take effect in their area. Meanwhile, NHS Surrey Heartlands ICB has already begun the switch while the South West of England will be the final area to adopt the new measures in May/ June.

What is offensive waste?

Offensive waste is waste that:

  • is not clinical waste
  • is not infectious, but may contain body fluids, secretions or excretions
  • is non-hazardous
  • falls within waste codes 18 01 04 if from healthcare.

Source: Health Technical Memorandum 07-01

Due to the changes, practices will now need to complete a new pre-acceptance audit (PAA), even if their current one is in date. 

Graham Flynn, director at waste management service Anenta, said: ‘Without a new PAA audit, which accurately takes account of volumes of offensive waste being produced, healthcare waste cannot be collected from waste producers.

He added that the introduction of the offensive waste stream ‘will be transformational for the NHS’. ‘It will help to save money that can be better used to fund front line services and will also reduce CO2 resulting from incineration, as well as large volumes of waste being sent to landfill.’

To support the transition, Health Education England is providing all NHS staff with access to a new e-learning course, which can be linked to here. It outlines which waste should go into which waste stream, correct segregation practices, and other important waste related guidance.

The NHS has set a target that healthcare providers should classify 60% of its waste as offensive waste by 2026.

Last month, a Somerset practice shared some tips on how to improve a waste management strategy to ensure it has a positive impact on sustainability goals.

Practice managers and GPs will also be able to hear more about reducing general practice’s carbon footprint at this year’s Management in Practice event in Birmingham. Register here for free.