Healthcare waste

Healthcare Waste is classified as 'Clinical Waste' when a clinical assessment identifies that the item of waste:

• Poses a risk of infection;
• Poses a chemical hazard;
• Contains medicines with a pharmaceutical-active agent.

Examples of Clinical Waste include:

• Human or animal tissue
• Blood or other bodily fluids
• Excretions
• Drugs or other pharmaceutical products
• Swabs or dressings
• Syringes, needles or other sharp instruments
• Any Healthcare Waste which may prove hazardous or may cause infection to a person coming into contact with it.

Clinical Waste should never be disposed of with general Household / Commercial Waste or recycling, it requires separate collection.

If the waste presents a hazard or risk of infection it should be classified and described appropriately and will need to be separated and packaged for appropriate treatment and disposal. This will be in an Orange or Yellow bag/bin to be determined following a clinical assessment. The healthcare practitioner is responsible for correct classification, removal (or arranging to remove) and disposal of this waste.

If you are a patient and you are unsure if waste produced by treatment or self-care is Clinical Waste, which requires a separate Clinical Waste collection service, please ask your healthcare practitioner.

If you run a business and you are unsure if waste produced on your premise is Clinical Waste, which requires a separate Clinical Waste collection service, please ask your Commercial Waste Contractor.

Sharps are items of healthcare waste that could cause cuts or puncture wounds, including:

• Needles and the needle part of a syringe;
• Scalpels and other blades;
• Broken glass ampoules; and
• The patient end of an infusion set.

Sharps waste does not include:

• Syringe bodies (other than the needle) and the residual medicine they contain;
• Medicinal waste in the form of bottles, vials, ampoules, opened ampoules;
• Tubes or tablets;
• Swabs or other soft infectious waste or anatomical waste;
• Broken crockery / glassware from non-healthcare items (e.g. a coffee jar).

Self-medicating patients who use injectables (e.g. diabetics) with no healthcare practitioner involved in administering injections should be prescribed with a sharps receptacle relevant to the medication being administered. The GP or healthcare practitioner should train the patient how to use the receptacle safely and advise the patient about local disposal options.

Once the sharps receptacle is filled to the “fill line”, it should be sealed by the householder and taken back to the GP surgery or to the local pharmacy for disposal, or arrangements for collections (a referral) should be made by the healthcare practitioner with a Healthcare Waste contractor or via Doncaster Clinical Commissioning Group (Doncaster CCG).

We are aware that some GP’s / Pharmacies feel they do not have the capacity to manage returned sharps boxes. Discussions were held with Doncaster CCG in 2017 and it was agreed they would commission a replacement sharps box collection / delivery service for self-medicating patients in the borough to coincide with the council ceasing collections, this service is currently provided by a private contractor SRCL.

Patients who do not have arrangements in-place through their GP/Pharmacy are advised to contact Doncaster CCG directly to set up a collection. Patients can also contact SRCL directly to set-up collections which are funded by Doncaster CCG. Contact details are provided below for both organisations.

• Doncaster CCG:  01302 566005
• SRCL (home-patients):  03332 405153 (srclhomepatients@nhs.net)

Healthcare Waste is classified as ‘Offensive Waste’ when a clinical assessment identifies the item of waste:

- Does not pose a risk of infection;
- Does not pose a chemical hazard;
- Does not contains medicines with a pharmaceutically-active agent; but - May be unpleasant to others who come into contact with it.

Examples of Offensive Waste include non-infectious:

• Minor first aid and self-care waste such as plasters;
• Nappies and Incontinence pads;
• Stoma / Catheter bags;
• Sanitary products and used condoms;
• Animal faeces / soiled animal bedding;

Offensive Waste can also be produced without any direct or indirect association with a healthcare practitioner (someone legally recognised to treat patients), for example, waste produced from first aid or hygiene using over the counter products. Soiled nappies, incontinence pads and sanitary towels are not ‘Healthcare Waste’ under normal circumstances and can be disposed of with your general Household Waste (Black bin).

Offensive Healthcare Waste produced in healthcare facilities requires a separate collection service. However, limited provisions (exemptions) are in-place for the placement of certain Offensive Wastes produced as a result of Community Healthcare in general Household Waste (Black bin). The healthcare practitioner may therefore dispose of Offensive Healthcare Waste in a patients Black bin, or advise a patient to do so, provided the relevant exemptions are followed and it is legal to do.

Offensive Waste produced in commercial environments but resulting from first aid or hygiene using over the counter products such as soiled nappies, incontinence pads and sanitary towels are not ‘Healthcare Waste’ under normal circumstances and can be disposed of with your general Commercial Waste (Black bin) unless a business produces more than 7Kg per collection cycle, in which case it requires separate collection, please consult your waste contractor for advice.

The Council may, following an application by a resident or healthcare practitioner, agree to provide additional storage capacity to residents / patients who produce Offensive Healthcare Waste, or Offensive Household Waste. There is no charge for this service but we can only provide an additional 120 Litre capacity for this purpose. We will exchange your 240 Litre bin for a larger 360 Litre bin, we will not provide a separate bin for Offensive Waste.

It is the healthcare workers responsibility to ensure the disposal of Offensive Healthcare Waste in the Councils general Household Waste stream (Black Bin) is lawful.

General Household Waste ordinarily contains plasters, dressings and incontinence products. Where the healthcare worker produces the same or similar items, these can be double-bagged and placed in the domestic waste (with the householder’s permission) provided the amount produced is relatively small (less than 7Kg per collection cycle is a useful indicator)

If the householder is self-medicating with no healthcare worker involved, they are able to dispose of their own waste into the black-bag waste stream. Stoma / Catheter bags should be emptied into a toilet before being wrapped or bagged and placed in the general Household Waste.

If a healthcare worker is involved in the care of a stoma patient, the waste from a stoma patient can be disposed of in the black-bag waste stream, unless following a ‘Clinical Assessment’ the classification changes e.g. Infectious.

Incontinence pads are only classed as Clinical Waste if the patient / resident producing them is suffering from an infectious disease. Non-infectious incontinence pads are normally classified as Offensive Waste and should be wrapped thoroughly before being put in your general Household Waste (Black bin). Infectious incontinence pads (Clinical Waste), as determined by clinical assessment, must be stored and collected separately from other waste, the healthcare practitioner should make suitable arrangements for its collection and disposal, not the resident.

Unwanted medicines should be taken to your local pharmacist for secure destruction. GP’s also have a general duty of care to ensure the appropriate disposal of waste medicines that are returned by patients but it is preferable they are returned to a pharmacist directly.