Leading the ‘reduce, re-use and recycle’ crusade

Indeed, the waste management team, in partnership with SRCL and Bywaters, was recently recognised at the Trust’s annual awards for significantly reducing waste sent direct to landfill and increasing recycling by 34 per cent in 2010/11. For these achievements, they were awarded the Peter des Roches Sustainability Award.

The two hospitals that form the Trust, located on the banks of the Thames in central London, treat more than one million patients each year combined and produce approximately 2,000 tonnes of domestic and clinical waste per annum.

The trust is passionate about operating to the highest environmental standards and is dedicated to encouraging its staff to do so, too.

From introducing schemes for more sustainable transportation and lunchtime walks, through to combined heat and power (CHP) engines and a network of sustainability champions, it hopes to make a significant improvement across all its operations. And it’s already delivering significant results; the CHP engines, which are located on both sites, save nearly £2m per year and have reduced carbon emissions by 16 per cent – or 11,000 tonnes – a year.

Waste is an important focus for improved sustainability and the trust is actively trying to implement the waste hierarchy of ‘reduce, reuse and recycle’ across all its hospital sites, including its satellite units.

The nature of work conducted on site requires extremely stringent regulations to maintain public health and prevent the spread of infection. This has, however, led to much of its waste being classed as clinical and being heat treated or incinerated to eradicate all infection risk. In reality, much of the waste Guy’s & St Thomas’ produces is actually easily recyclable – paper, card, plastics, food and flowers – all of which can all be turned into new products if kept separate from clinical waste streams.

“Looking back, just four years ago, near enough all our waste, which didn’t require specialist treatment, went to landfill,” says trust waste manager Alan Armstrong. “We’ve made significant progress in the interim, but the main challenge is educating our 12,000 staff members to instil recycling into their everyday work lives. It’s a difficult challenge, especially in this environment, but by undertaking waste audits within different wards and departments and providing guidance on how to improve sustainability we’ve seen significant achievements in a short time.”

Armstrong heads up a 34-strong team that includes representatives from its two waste management partners, SRCL and Bywaters. In a relatively unique arrangement within the NHS, Guy’s & St Thomas’ has appointed SRCL to undertake overall management of its waste contracts with overriding objectives to reduce waste going direct to landfill and improve segregation to ensure waste goes to the most appropriate solution.

Armstrong adds: “Working in partnership with our waste management providers has helped us deliver results more quickly. We operate as one team; we have representatives from both companies based within the NHS team. Consequently, we are all striving for a common goal and we know that we can rely on their service delivery”.

Bywaters has strategically placed blue recycling bins, known as the ‘bycycler’ throughout the hospital, to collect mixed dry recyclables such as paper, cardboard, cans and plastic bottles. Office supplies, such as toner cartridges, electronics and batteries are also recycled via separate collection processes.

Steady adoption of the blue recycling bins is helping the hospital on its way to its 2012 target of 40 per cent recycling. Meanwhile, a good relationship between the waste team and housekeeping is helping to identify areas where more recycling bins can be placed and also areas of non compliance.

By educating staff through waste awareness sessions, leaflets and training, participation and engagement have increased across all departments. Armstrong adds: “Women’s services have been a key success for us. Across 15 departments, we’ve removed around 200 black bag bins and replaced them with the bycycler. Key to achieving this level of engagement has been a passionate recycling champion who has helped change behaviour on the ground and encouraged people to put recycling first.

“However, we also encounter, and overcome, resistance; a lot of it can be solved by education. For instance, at a recent waste awareness day on more than one occasion staff said to us that the segregated recycling actually ended up in landfill, which is categorically not the case. In a hospital with over 12,000 staff ensuring a good level of understanding is a difficult task to achieve and there are inevitable misunderstandings and urban myths about our recycling processes,” Armstrong explains.

When it comes to furniture, the waste team has achieved hospital-wide behavioural change. Indeed, no department is able to order new furniture without first consulting with the waste team and its furniture reuse scheme is in high demand. “We’ve been pleasantly surprised by how the furniture reuse scheme has been embraced across the trust. We take all unwanted furniture and find it a new home. Often demand outstrips supply, especially when it comes to chairs, but even with items that are broken beyond repair we salvage the usable parts – like wheels – and reuse them to fix other items.” It is believed that this scheme has saved the trust in excess of £60,000.

Clinical waste
Changes in staff behaviour when it comes to waste have improved recycling rates and had an important impact on the amount of clinical waste Guy’s & St Thomas’ produces.

Through more stringent waste segregation, clinical waste levels have dropped significantly giving further evidence to the Royal College of Nursing’s estimates that between 40 to 50 per cent of waste ending up in clinical waste bags is domestic waste that doesn’t need such stringent treatment. In the first half of 2011, clinical waste sent for incineration – the most costly – and carbon intensive - of disposal options – fell by 48 per cent, despite an increase in the amount of overall clinical waste produced by the hospitals, while recycling increased by 34 per cent compared to same period in 2010.

Armstrong adds: “We’re delighted with the achievements we’ve made to date. However, we’re not sitting back on our laurels. Looking towards 2012 we are focusing on segregating out offensive waste from clinical streams”.

Offensive waste has recently been re-categorised to enable its disposal to deep landfill or through waste to energy processes as it has minimal infection risk compared to clinical waste. However, infection control will err on the side of caution to eliminate all risk. Therefore, Armstrong and the team will be identifying departments where the offensive waste can be easily separated – for example special care baby units. This has already been rolled out to the Trust’s mobile endoscopy unit where all waste is suitable for the offensive stream.

However, the team recognises that there will be limitations and for some departments – such as ward areas – it may be safer from an infection control perspective to treat all waste as clinical.

The dedication of the team and all Guy’s & St Thomas’ staff has made a significant difference in transforming the environmental credentials of one of the busiest hospitals in the world. The achievements and practices that have been developed here are, like their medical results, setting the benchmark for UK healthcare providers.

Further information
www.guysandstthomas.nhs.uk