Whose waste is it anyway?

A couple of years ago, an increasing number of community nurses got a bee in their collective bonnet about the carriage of clinical wastes in their NHS-funded cars.

The issue was that wastes produced during care delivered by community nurses visiting a patient in their own home was considered by Local Authorities to be tin the ownership of the nurse, and thus of the primary care trust. That had a small, probably insignificant, cost impact on the LA who might have approached this by agreeing a notional cross-charge to the PCT.

But that wasn’t good enough.  So, told to take their wastes with them the nurses got into a tizz and created all sorts of rather silly issues regarding the safety of wastes in their vehicle boot. What would happen if their was a crash? What about smell?  What about Saturdays, when I go use the car to got to Tesco for my groceries?

New containers for individual waste sacks and bins were introduced, costs escalated, and eventually it all boiled down. And despite all of the changes that were implemented to facilitate safe carriage of small quantities of clinical waste by car, there arose mush evidence that in the event most community nurses were ignoring the guidelines and leaving waste with the patients, sometimes wrapping it in newspaper to hide it in a black sack or adding it to the patient’s own clinical waste output, and coaching patients to deny knowledge of this is challenged by the LA.

More recently, I have noticed a few domiciliary clinical waste collection forms that include the following clause:

“I agree to my treatment provider (GP/Nurse/other) leaving my clinical waste on my premises awaiting collection. The contact details for my treatment provider are: (enter their name, address and contact telephone number).”


There is no alternative. Sign the agreement or there will be no collection by the Local Authority. It might not matter too much, but it would be consequent upon completing the form to request clinical waste collections that the patient was required to accept responsibility for the GP/nurses waste. That might include sharps and pharmaceutical wastes not normally produced by the patient’s own self-administered care.

Common sense should prevail. However, leaving the patient in the firing line when things go wrong seems inherently unfair. One can only hope that a Court would have more sense, though in these days of civil penalties who can envisage a rabid persecution of some poor patient, stuck in their own home and dependent on the NHS, social care and their Local Authority, being blamed for the failings and unprofessional approach to waste management of others?



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