RCN report on waste management in the NHS

The RCN report compiled and published in 2011 from a raft of Freedom of Information (FoI) requests concerning waste management in the NHS has recently come to the fore.

The report is available here.

Helpfully, the report quantifies, albeit from an incomplete and thus somewhat unreliable data set, quantities of waste produced, stratified by municipal, offensive and “infectious”. Though this last categorisation is somewhat flexible and open to a particularly wide interpretation, it is clear that few have accepted the most recent attempt by the Environment Agency to manipulate the figures of healthcare waste outputs by further down-regulation of the bulk of orange-bag waste to sanitary/offensive.

Yet more interesting is the table of costs for disposal. Though massive ranges of cost can be seen, this report does not consider the premium charges or smalls, and for minor but high-cost fractions such as cytotoxic wastes, tissue wastes, some related chemical wastes, and dental amalgam).

The report considers England, Wales, Scotland and Northern Ireland, and within those countries Foundation/acute trusts, Primary care trusts, Care trusts and Mental health trusts and should therefore include data representing a particularly wide diversity of producers, outputs, waste types and locations that perhaps explains yet further the apparent variation in costs. That the average costs for sanitary/offensive and for “infectious” wastes vary so little gives support to the idea that additional to producers’ views of waste classification and regulation, there is no real financial motivator to down-regulate wastes, especially if that means the cost impact of managing an additional waste stream.

The RCN report is a superficially valuable report that would benefit from further and more detailed study to investigate those issues raised above, and others, and to permit comparison of current data from that of 2010/11.

Despite that reservation, the RCN report represents a vast amount of effort, including effort by those hit with FoI requests. It is an important document and one those should be dusted off for review every now and again.



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