Case Study: Imperial College Healthcare NHS Trust - Award-winning partnership at Major NHS Trust

A partnership between Grundon Waste Management and London’s Imperial College Healthcare NHS Trust was so successful in reducing waste that the Trust won a major nationwide award.

Over a two year period, it reduced its carbon footprint for waste by two thirds and, as a result, was named as a 2013 Gold winner in the prestigious Green Apple Awards for Carbon Reduction (NHS sector).

One of the largest acute trusts in Europe, it consists of Charing Cross, Hammersmith, Queen Charlotte’s and Chelsea, St Mary’s and Western Eye hospitals and, in partnership with Imperial College London, is one of the UK’s first academic health sciences centres (AHSCs).

In order to achieve such outstanding results, Grundon’s specialist clinical waste management team worked closely with the Trust’s facilities team to make major changes to the way waste is disposed of.

Achievements included:

  • implementation of a non-infectious clinical waste stream, allowing 25% of waste to go to energy recovery – up from 4% two years previously
  • an education and communication programme for staff
  • a 3% increase in non-clinical waste recycled and a 5% reduction in waste sent to landfill – achieving savings of £60,000 pa
  • CO2 emission reductions in excess of 184,600 kg
  • a cut in waste vehicle movements by 104 per year, saving over 6,000 miles
Imperial College NHS Trust waste management
Imperial College NHS Trust waste management

The implementation of the non-infectious clinical waste stream was important because clinical waste management makes a significant contribution to the carbon impact of the Trust’s activities.

And, given that the Trust’s Board had already signed up to a carbon management plan to achieve the 2015 NHS carbon reduction target of 25%, it was keen to support ways to meet the targets.

The infectious and/or offensive nature of clinical waste makes it more difficult to achieve sustainable waste management, something that many in the health sector struggle to manage successfully, and requires a clear methodology and understanding.

By working together, Grundon and the Trust’s waste management teams produced a series of policies and procedures to achieve maximum value from the waste stream. These included minimising any contamination from general and recyclable wastes, and recovering energy as a secondary resource using Energy from Waste (EfW) incineration.

Having identified the financial and environmental improvements, put a plan in place and agreed annual performance benchmarks, the project was approved by the Board and the Infection Control Board.

The Trust employs around 9,000 staff based over five acute hospital locations and a detailed communications plan was put in place across all the Trust’s hospital sites. This included a position statement from Infection Control to ensure all staff understood the proposed service changes, together with quick guides, new posters and bin labelling systems, plus a series of presentations and waste awareness days.

Alan Davis, Waste Manager at Imperial College Healthcare NHS Trust, said staff communication and understanding was one of the biggest challenges.

“There were plenty of questions about how infectious patients are, how symptoms are diagnosed and the different policies and procedures that needed to change,” he said.

“The whole process took a year to agree, and included working with our senior infection control teams, microbiologists, and health and safety, as well as training both nursing and facilities management employees, such as domestic staff and porters.

“Grundon inputted into the training and worked on areas such as cart design, posters, and service collection schedules, and we were able to implement a phased rollout over one month across our three large acute hospital sites.

“It’s an achievement that shouldn’t be underestimated as there were a number of obstacles that required sensitive dialogue, negotiation and ensuring that all staff fully comprehended the risk awareness issues.

“Grundon’s investment in disposal technologies is combined with a sound knowledge of the business, a focus on customer service, good communications and service delivery, plus remaining competitive on disposal rates within the market sector.

“They provided effective on-site processes and data analysis, enabling us to meet our legislation and compliance requirements, and partnered with us to help build and maintain a sustainable environment.

“The resulting compliance and cost savings, notwithstanding the huge environmental impact on our CO2 savings, is testament to what can be achieved by working together for a sustainable future.”

By working closely with the Trust, the Grundon team has been able to interpret the “Healthcare waste classification and assessment framework”, ensuring various waste types are correctly classified, the colour coding system is fully utilised and financial and carbon costs have been reduced.

One of the key areas where changes were made was in the Microbiology Department, where traditionally waste was sent for high temperature incineration in 60ltr one-way plastic burn bins. With the Trust buying 100 burn bins a month, this cost an average of nearly £6,000 a year.

Ensuring staff understood that with existing autoclaving on site the waste was rendered sterile, it was then able to go through the offensive waste route for recovery, meaning the Trust now simply uses bags to contain the autoclaved waste, saving over £5,100 a year.

And, because the waste is now sent as offensive, as opposed to the higher rate for high temperature incineration, further savings have been achieved of around £8,000 a year.

Disposal of the clinical waste takes place at one of Grundon’s state-of-the-art facilities where, over the last few years, the company has invested over £10 million in two high temperature steam sterilisation plants (hydroclaves) and a clinical waste incinerator, all of which meet, or exceed, the most stringent UK and EU requirements.

Imperial College NHS Trust waste management
Imperial College NHS Trust waste management

The Trust’s offensive waste is sent to Grundon’s Lakeside Energy from Waste facility for incineration – electricity generated from the plant goes into the National Grid – while waste going into the hydroclave is processed into Refuse Derived Fuel (RDF).

Becky Lillywhite, Grundon’s Commercial Manager-Clinical Waste, says the company very much sees the NHS as a partner rather than a customer, and is focused on working together to achieve the best results.

She said: “As Alan says, communication and staff engagement is critical to success. Recycling or segregating waste always starts with the individual, we had to make sure that the system we put in place met their expectations and that in turn everyone was clearly committed and bought into the changes.

“We engaged with the Trust’s senior staff and management teams and, importantly, the clinical staff so everyone could understand what we meant by the terms infectious and non-infections waste and the different items and circumstances that affected the disposal process.

“Once we had that understanding, we sought to develop appropriate systems in each of the hospitals across the multiple Trust sites that would not only meet waste management objectives, but also the clinical objectives in respect of infection prevention and control. It was very important to make sure that those two areas – clinical needs and waste management needs – were closely aligned.”

In addition to the benefits already accrued, Lillywhite says the Trust and Grundon are already working on future plans, adding: “We are currently looking at several innovations and new ideas which can continue to meet waste management needs, creating greater efficiency savings and also have a positive impact in contributing to their ongoing sustainable objectives”.

Davis continued: “These may include the introduction of anaerobic digestion, or alternative methods for waste food streaming, the advancement and continued interpenetration and understanding of new on-site treatment of waste technologies, to include potential recovery of precious alloys from medical instruments.

“Looking ahead, the development of new legislation and compliance requirements will shape our future. Any technology which will further reduce landfill and help save the world’s dwindling natural resources has to be seen as a positive move,” he concluded.

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