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Transform practices to keep value within NHS

The NHS produces around 600,000 tonnes of waste each year.

That is enough to fill the entire London 2012 Aquatics Centre. We would even have 100,000 tonnes of waste leftover once we had filled it. So we need to think creatively about how we address this.

At Guy’s and St Thomas’ trust, we work with waste partner Bywaters to find innovative ways to process our waste. One example is our partnership with Uptown Oil, a small business on our doorstep, that turns used cooking oil into biodiesel for London’s black cabs and local electricity generation.

Importantly, we also tackle the issue of eliminating waste at source. After careful work led by our procurement teams, appropriate controls have been put in place to ensure that items are purchased in appropriate quantities and at the right time, particularly items with expiration dates. This cuts waste, saves money and also frees up limited space within the hospitals.

A longstanding frustration in waste management has been measurement. For years, it was common for healthcare providers, along with most public and private companies, to be presented with a waste invoice without clear analysis of volumes or types of waste removed. With Bywaters, we are changing this at Guy’s and St Thomas’.

The trust is moving from being a passive producer of waste to an agent with all the tools to revolutionise the way it approaches waste management, by using staff education, regular auditing of waste streams and the implementation of a department-specific waste tagging system.

A small weighbridge at Guy’s – which spends nearly £500,000 on waste each year – will provide our waste team with department- specific waste analysis and a full understanding of where our waste is coming from. This information is invaluable, and will be used to further engage staff and motivate them to keep on reducing the amount of waste they produce.

We also have measures in place for those high-value items that used to sneak into the waste. In the case of furniture, for example, we buy high-quality products that last; when damage does occur, our waste team, in partnership with Bywaters, provides in-house repair.

When furniture is no longer needed in a department, we have an in-house sharing programme that allows departments in need to request and receive the items free of charge. Since its inception five years ago, this programme has saved the trust hundreds of thousands of pounds.   

Waste has value – it is often comprised of costly and increasingly scarce resources, and it is our responsibility to make sure that the trust retains this value. We pay for our waste to be removed by companies, which go on to process and sell it for a profit. This seems a poor deal for the NHS.‡

I believe the future of waste management in healthcare is one where the NHS is in control of its own waste streams, and adjusts its infrastructure and approach to keep this value within the NHS.

Alexandra Hammond is sustainability manager at Essentia, Guy’s and St Thomas’ NHS Foundation Trust.

  • Hear more at ‘Promoting resource efficiency in a healthcare environment - opportunities and challenges’ in the Circular Economy Connect Theatre at RWM in partnership with CIWM, which runs 16 to 18 September 2014 in halls 4 to 5 at the NEC, Birmingham. Registration, sponsored by Novelis, is available at

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