Three sustainability and waste experts on what the healthcare system can gain from circular economy principles.
Dr Terry Tudor, senior lecturer in waste management, University of Northampton….
Due to changing demographics, the health and social care system in the UK could become one of the largest sectors of the economy over the next 50 years. According to the Office for Budget Responsibility (pdf), health spending will rise from 6.8% of GDP in 2016-17 to 9.1% of GDP in 2061-62.
A big part of this system, the National Health Service (NHS) is one of the largest organisations in the world, with two million staff catering to a population of 52 million. The delivery of its services has a significant impact on the environment. The NHS, for example, is responsible for approximately 25% of all public sector greenhouse gas emissions in England.
There are a number of reasons for growing engagement with the sustainability agenda, including increasingly stringent legislation and targets for costs savings. Healthcare waste has been included as one of the eight priorities in the waste prevention plan for England and the NHS is expected to have achieved efficiency savings of £15–20bn over 2011–14.
Under the government’s Climate Change Act, NHS organisations have a commitment to meet a 10% reduction in carbon emissions by 2015 from a 1990 baseline. They are also expected to hit the mandatory governmental targets for emission reductions of 34% by 2020 and 80% by 2050. They are mandated to include sustainability and climate change in their annual reporting to Monitor, the independent regulator of NHS foundation trusts and the Department of Health.
Tackling these environmental issues is a huge and complex task but improvement can realise significant financial, social and environmental dividends. The issue is how stakeholders can work together to make these initiatives work better.
James Dixon, waste manager and sustainability lead, Newcastle upon Tyne Hospitals NHS Foundation Trust….
As a waste manager in a large organisation whose priority is patient care, convincing people of the need for efficient use and disposal of resources can be challenging. For example, it took over a year to get mixed recycling bins introduced to clinical spaces. You have got to pick your battles and celebrate your successes in the hope they spread.
The terms “disposable” and “single use” are swear words to a sustainability professional, but they are often critical in a healthcare setting to reduce the spread of infection. There is, however, a tendency to extend this beyond necessity. It is important that we challenge this wherever possible, working with clinicians to make balanced decisions.
We are getting there. In the last three years we have made over £800k of waste-related savings in our trust. This was achieved mainly by bringing together a number of waste and recycling contracts into a single one with tight sustainability focused specifications. This saved money and incentivised compliance with the waste hierarchy, tripling the rate of recycling and eliminating waste to landfill.
NHS Trusts across the country are having to find millions of pounds worth of efficiency savings. Shifting to a circular economy can help achieve this, freeing up funds for patient care.
Alexandra Hammond, associate director, sustainability, Guy’s and St Thomas’ NHS Foundation Trust….
In healthcare, far too many high value items such as furniture, unused medical products and pharmaceuticals end up as waste.
A long-standing frustration in waste management has been measurement. For years, it was common for healthcare providers – and most public and private companies for that matter – to be presented with a waste invoice without clear or broken-down analysis of volumes or types of waste removed. We are addressing this at Guy’s and St Thomas’ NHS Foundation Trust by working in partnership with Bywaters, a waste services provider.
Through staff education, regular auditing of waste streams, and the implementation of a department-specific tagging system for waste, the trust is revolutionising its approach to waste management. A small weighbridge at the Guy’s site – which spends nearly £500,000 on waste each year – will provide the team with a full understanding of where waste is coming from. This information can be used to engage staff and motivate them to reduce their waste.
For those high value items that used to sneak into the waste, there are measures in place. If furniture is damaged the waste team, in partnership with Bywaters, provides in-house repair. When furniture is no longer needed in departments, an in-house sharing programme allows departments in need to request and receive the items free of charge. Since it began about five years ago, this programme has saved the trust hundreds of thousands of pounds.
We waste resources at our economic, ecological and social peril. Using common sense and maximising the lifecycle of a product is simply good business.
Dr Terry Tudor, James Dixon and Alexandra Hammond will be involved in the panel debates at Birmingham’s RWM conference in September