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The right diagnosis for a hospital’s waste

Aintree University Hospital (AUH) serves a population of around 333,000 around Liverpool, Sefton and Kirby.

As a teaching hospital, it offers further specialist services to a wider population of 1.5 million residents across the north-west. B&M Waste Services has been providing waste management for the hospital since 2010 when it began managing the hospital’s general waste programme.

In 2011, a report by the Royal College of Nursing projected an annual saving of £5.5m to the NHS if hospital waste was classified and segregated correctly. AUH approached B&M to undertake an audit of its clinical and offensive waste segregation and disposal.

Working with the hospital’s general manager, site facilities manager and the infection prevention and control team, B&M reviewed procedures, with the aim of making significant cost savings and improve environmental performance. It determined that Aintree was disposing of its offensive waste into clinical waste bags and sending these for incineration and autoclaving at a significant cost.

Following the audit, B&M carried out a full risk assessment and produced method statements for all procedures. They cover the detail of disposal of offensive waste from the moment it is put in a bin through to it leaving the site. B&M assisted in the design of a bespoke waste compound in accordance with AUH’s requirements and deployed 450 wheelie bins along with compactor technology; one was installed for general waste and another for offensive waste.

In 2013, B&M introduced a confidential document shredding service, with around 160 discreet lockable cabinets put in place around the site. A certificate of destruction is provided by email after every shred, and all shredded material is 100% recycled. There is also a dedicated battery collection and recycling service.

Training days were held for staff to learn about the new waste segregation system, which involved more than 500 of the hospital’s domestic and clinical staff. Copies of the training presentation were distributed across the hospital, a version was uploaded to AUH’s intranet and publicised in its monthly magazine to help with the induction of new staff.

The interactive presentation allowed staff to understand the new system and raise any questions. Staff who attended the training were given an information card outlining the three waste streams: offensive, infectious and domestic. This, along with posters and intranet information, helped staff to understand what they needed to do even before the new waste disposal systems were rolled out.

Previously, Aintree’s porters were responsible for handling waste before it left the site. But following the installation of the waste compound, Aintree employed two on-site waste operatives in full-time positions. In 2013 this was doubled to four full-time people due to the increase in segregated waste streams coming out of the site.

It was one of B&M’s drivers who spotted the opportunity to recycle more cardboard, noticing the large amount that was being collected. As a result, a cardboard baler was installed allowing for greater quantities to be recycled and providing rebates for the hospital.

AUH has been 100% committed to the waste management programme from the start, and a number of the initiatives have been industry- leading in the healthcare sector. The hospital has come a long way in a relatively short space of time and its approach is rightly seen as an example of best practice in the NHS.

Rose Warnock is corporate contract manager at B&M Waste Services

Recycling at AUH by numbers

As a result of the waste segregation at AUH, clinical waste output has been reduced by more than 28 tonnes a month, avoiding costly incineration. Offensive waste is now sent to landfill where the methane produced is captured and reused to generate electricity.

More than 300 tonnes of offensive waste were collected in 2012 and 2013, and this year the figure will be in excess of 350 tonnes. Clinical waste output has been reduced by more than a third, with subsequent bin collections down 50%. Black bin bag waste currently stands at 828 tonnes a year – or 70 tonnes a month – which is taken to B&M’s £1m refusederived fuel (RDF) facility in Trafford Park, achieving 100% recovery.

Because of segregation and use of the on-site baler, cardboard recycling rose to 180 tonnes in 2014 compared with 26 tonnes in 2011 and no recycling before then. A further 55 tonnes of mixed metals, paper and plastic, which are stored in a dedicated ro-ro in the waste compound and collected on request, have been collected in the past year and achieved a 100% diversion from landfill.

Paper and card is also segregated, baled and 100% recycled.

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