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Kidney treatment is significant contributor to NHS waste

Kidney care contributes “significantly” towards the amount of waste generated by the NHS, a survey by the Campaign for Greener Healthcare has found.

Dialysis is the most common treatment for end-stage kidney disease and single-use pre-packaged products have enabled an increase in its availability. However, this has led to high levels of packaging waste which becomes clinical waste, limiting its potential for recycling because this usually must be incinerated. In 2005, the NHS generated 400,000 tonnes of waste, of which 29% was clinical.

Results from the survey also found that 75% of clinical areas surveyed did not use recycling bins, and plastic and packaging waste from dialysis equipment is not recycled in 70% of renal units surveyed.

In a recent ‘webinar’ held by sustainability forum 2degrees, green nephrology fellow responsible for improving environmental sustainability of renal care at the Campaign for Greener Healthcare Dr Andrew Connor said: “It’s clear that dialysis produces a huge amount of waste and it’s also clear that much of this waste could be recycled but rarely is. Given that dialysis is so repetitive, it really does lend itself to making changes in this regard. It seems to be that effective segregation is the key issue here. What we all need to be doing is getting better recycling systems into our renal units.”

A case study at Queen Margaret Hospital in Dunfermline on how to reduce, re-use and recycle in renal units found just over £18,000 in cost savings. Improved segregation at source meant that more material went into the domestic waste stream for recycling rather than into the clinical waste stream.

Furthermore, the amount of saline bags used were reduced, and expensive washbowls that were disposed of after one use are now being washed out for re-use. Plastic canisters holding fluid for the dialysis process are now being recycled, diverting 20,000 canisters from landfill each year.

In another case at the Runcorn Road satellite dialysis unit in Birmingham, the introduction of a baler made the material more attractive to local firms for collection. More than four tonnes of plastic canisters were collected each year and the unit saved £3,150 a year by not having to pay landfill disposal costs.

Readers' comments (1)

  • Pressure groups almost invariably stretch the truth to advance their own cause and the Campaign for Greener Healthcare is no exception.

    Though regulatory constraints are still impeding the development of plastics recycling applications from non-burn waste treatments there are neither requirements to incinerate this waste, nor any significant amount of packaging waste entering the clinical waste stream.

    Discrete and almost invariably short-term studies of waste interventions such as that reported from Dumfirmline are almost invariably misleading. Headline savings are more apparant that real and the data presented distorts reality.

    Several similar studies are published. Each magnifies the possible savings noted in studies lasting for between 1 and 14 days to reach ridiculous yearly savings. It just doesn't work - properlky constructed studies looking at annual data, or at least a follow-up study and 3, 6 and 12 months are unlikely to show any real differences. Unless, of course, the study centre is so bad that it was breaching the varous waste management standards that in extremis would result in failure to achieve the minimum standard requird for safe healthcare delivery as specified in the Hygiene Code and as now monitored by teh Care Quality Commission. Surely not?

    These studies can help identify to waste producers the advantages of better source segregation, and more appropriately identify barriers to better source segregation that can be fixed easily usually by some simple but previously overlooked intervention. All else, including headline claims of vast savings achieved by summing up annual savings from studies conducted over just a few short hours or couple of days, placed in teh hands of a pressure group and not subject to the rigours of properly founded scientific study, is little more than smoke and mirrors.

    Ian Blenkharn
    Blenkharn Environmental, London

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