Tina Benfield and June Cadman of the UK’s Chartered Institution of Wastes Management speak to HEQ about the management of health, care, and clinical waste.
The Chartered Institution of Wastes Management (CIWM) is the UK’s leading professional body for the resources and waste sectors, representing more than 5,500 members. CIWM, a registered charity founded in 1898 which is incorporated by a Royal Charter, aims to ‘influence, inform and inspire’ sustainable waste management and disposal.
June Cadman, Waste Management and Environmental Services Officer at Rotherham NHS Foundation, and Tina Benfield, Technical Manager at CIWM, both Fellows of CIWM, speak to HEQ about sustainable waste management and the challenges posed by COVID-19.
What support or resources does CIWM offer for professionals undertaking management of clinical and healthcare waste?
CIWM provides a wealth of information and knowledge to its members and those working in the resources and waste sector. There are regular updates keeping all members informed of changes within the sector, along with our journal Circular Online – the daily online news and update page and information available to members in the Knowledge Hub. CIWM also has a weekly eNewsletter which is distributed to all members and includes updates on legislation and policy.
CIWM has a special interest group on healthcare waste; this is where CIWM members exchange ideas, best practice and the key issues which are affecting this particular area of the resources and waste sector. This group not only looks at clinical waste, but also healthcare waste arising from the community – in relation to tattooists, care in the community, beauticians and cosmetic professionals, and needle litter.
CIWM also works closely with the government and regulators of each country and has a great deal of influence with regards to issues within the clinical and healthcare waste sector. CIWM’s special interest group regularly features attendance by the regulator, where ideas are exchanged and pre-consultation work with the sector has improved operations and clarified regulations.
As the professional body for the resources and waste sector, being a member of CIWM enables those members working in the clinical and healthcare sector, to show they have a level of knowledge and experience to give confidence to the regulator that they have the acumen to sustainably manage healthcare waste.
What is the significance of safe, sustainable healthcare waste disposal within the broader effort to prevent the spread of infection?
Managing healthcare waste in a safe and sustainable manner reduces the impact on the environment and human health. Countries which do not have such structured collection, handling and treatment of healthcare wastes do increase the risk of those who come into contact with this waste of contracting disease.
CIWM is aware that there is extensive potential for infection from any waste and the procedures put in place by all operators – wearing gloves, not eating, smoking or drinking while working, and personal hygiene procedures – reduces the risk of catching infections from handling waste. These procedures have been reiterated during the pandemic and kept the resources and waste operatives at a much lower risk of catching the COVID-19 virus during their work operations.
What are the key challenges specific to the management and safe disposal of waste from clinical and healthcare sources?
One of the key challenges is ensuring that healthcare waste is categorised and handled in the correct manner; once the waste is categorised the appropriate method of treatment and disposal can be followed. Waste arises in numerous parts of the clinical and healthcare setting – on the ward, in the theatres, care homes and at home from outpatient care.
Another significant current challenge has been the large increase of infectious waste stream which has occurred as a result of the COVID-19 pandemic, and which has impacted on the current capacity of waste disposal routes.
Do these challenges differ at all for the management of healthcare-type waste from non-clinical facilities, such as care homes?
Healthcare waste from care homes does depend on what facilities the care home offers, as not all offer medical support to the residents. Newer infection control protocols which have arisen as a result of COVID-19 have meant that there is now more personal protective equipment (PPE) waste than previously, and so the volume of waste produced by care homes has increased. The capacity of care homes to store waste before collection can be impacted by this increase in volume.
Has the COVID-19 pandemic had an impact on the way in which waste is managed and handled, particularly within the healthcare sector? How has the pandemic affected the waste management sector as a whole?
Currently, as long as processes within a healthcare setting are followed as set down by the HTM 07-01 guidance note, the current COVID-19 pandemic has not heightened the risk that members of staff carrying or moving waste may become been infected with the virus. Some NHS Trusts have had to store waste, due to capacity issues around their service; but those helping with the moving and storing of waste have also not been infected with the virus. If waste is packaged in line with the official guidance, then it is safe to move and will not contribute to the spread of infection.
On a practical front, the pandemic led to an initial over-categorising of waste: there was waste going into some streams which usually do not have high volumes; this led to waste having to be stored on site awaiting collections which had to be rescheduled. Once guidance was issued on the safe and correct categorising of waste, volumes became more manageable. There has been an increase in PPE, due to nursing staff and other healthcare workers following personal hygiene guidelines, and this has impacted on the treatment capacity of sites. This has meant that waste has had to travel to the nearest available site, increasing transport costs.
As you would expect with the increase in volumes there has been a subsequent need for more containers to collect, store and move waste.
The impact on the wider resources and waste sector includes non-clinical waste going to municipal facilities for treatment, along with waste management operators changing their service as less commercial and industrial waste is needed to be collected due to businesses moving people to work at home and retail and hospitality spaces closing. Local authorities were impacted in terms of the service they usually offer to households to deposit their bulky and other household waste through household waste recycling centres – as people spent more time at home, more people were clearing out their cupboards, sheds and garages. These changes meant employees were diverted from other service roles.
What changes could be made at a policy level to better support sustainable practices within healthcare waste management and disposal?
CIWM suggests there needs to be a wider consideration of the whole system: this is being approached through the Department of Health’s sustainable development management plan 2017-2022 which includes carbon footprint and estate waste and recycling. In light of the current pandemic, there will need to be some consideration given to treatment capacity that is adaptable and flexible; and CIWM will work with government departments to assist in this requirement.
June Cadman FCIWM
Waste Management and Environmental
Rotherham NHS Foundation
Tina Benfield FCIWM, CEnv
Chartered Institution of Wastes Management