Offensive Waste stream for primary care settings rolls-out across England

The roll-out of new mandatory measures across England, which are designed to dramatically cut the volume of healthcare waste being needlessly sent to incineration, is expected to save the NHS in excess of £2 million per year, says independent healthcare waste management company Anenta.

Under the changes, which began in February, the Offensive Waste stream is being introduced on a compulsory basis, ensuring that the majority of waste from healthcare settings is disposed of using either alternative treatments, or energy from waste processes that render healthcare waste safe. 

The switch to the Offensive Waste stream as the primary disposal route for waste produced by the healthcare sector is in line with the Health Technical Memorandum 07-01. The change will reduce CO2 emissions associated with incineration, and will cut the volume of waste sent to landfill.

Analysis of over 2,500 primary care Duty of Care audits conducted by Anenta, has shown that 58% of healthcare professionals with responsibility for waste management are unfamiliar with the Healthcare Technical Memorandum, the latest iteration of which came out in March 2023, resulting in inadequate training and waste management policies. This has contributed to poor segregation and spiralling levels of waste being incorrectly disposed of in Orange waste bags, which go to incineration.

Changing primary care waste disposal habits and practices is seen as pivotal if the NHS is to achieve its Net Zero targets and forms a key part of the NHS’s Waste Strategy. As such, the switch to the Offensive Waste stream is designed to put an end to the disposal of waste via the wrong streams and is being rolled-out in phases across England.

NHS Integrated Care Boards (ICB), with support from Anenta where appropriate, have been informing GP practices when the changes are due to come into effect in their area. This started in the South East of England with NHS Surrey Heartlands ICB. The final area of England, the South West, is due to implement the new Offensive Waste stream in May/June.

To support the transition, Health Education England is providing all NHS staff with access to a new e-learning course that will play a vital role in preparing all NHS staff for the new Offensive Waste stream.

Created with the help of Anenta, the new 30-45 minute training module is accessible free of charge via the Health Education England online portal. It outlines what waste should go into which waste stream, correct segregation practices, and other important waste related guidance.

The most noticeable change is the introduction of yellow and black Offensive Waste ‘tiger bags’ as the primary waste stream for healthcare waste, excluding non-contaminated recyclable items. Sharps containers and the current colour coding regime of their lids will remain the same.

With the introduction of the Offensive Waste stream, Orange bag volume is set to fall, as these should only be used where soft healthcare waste comes into contact with patients presenting conditions that are deemed to be infectious (Category B). This one change will cut large volumes of waste being incorrectly disposed of through the incineration stream, and will also avoid the risk of waste contractors refusing to make collections due to ‘non-compliance’, which could put primary care services at risk of disruption.  

To help avoid this eventuality, all locations that produce clinical waste will now need to complete a new Pre-Acceptance Audit (PAA) – even if current PAAs are in date, to ensure that all waste produced is correctly detailed.

Commenting on the roll-out of the new Offensive Waste Stream, Graham Flynn, director at Anenta said: “The introduction of the Offensive waste stream will be transformational for the NHS. It will help to save money that can be better used to fund front line services and will also reduce CO2 resulting from incineration, as well as large volumes of waste being sent to landfill. The new e-training will help all in the primary care sector understand and align with the new Offensive Waste stream, improving the segregation of waste at every level of the NHS.”

Flynn added: “Without a new PAA audit, which accurately takes account of volumes of Offensive Waste being produced, healthcare waste cannot be collected from waste producers. To avoid this, and potential enforcement action being imposed by the Environment Agency, we’ve worked closely with NHSE, IPC, Local Commissioners, and industry experts to deliver the new training module, which is freely available to all on the Health Education England portal, and is designed to assist and ensure compliance.”