Is the NHS wasting money and recycling enough?

Is the NHS wasting money and recycling enough?

Is the NHS wasting money and recycling enough? I had to ask myself this question the other week when talking to a nurse about hospital procedures and practices. The NHS wasting money might be real.

Also, as you will read, the NHS isn’t recycling enough either. I find that worrying given the focus on climate change and taking care of our planet for future generations.

As we see so much in the press these days about how financially strapped the NHS is, I wonder and worry whether its practices could inadvertently be contributing to the NHS wasting money.

I say this purely based on anecdotal conversations I’ve had with NHS staff. What I write here is just a snapshot based on my patient experience. So it’s not the whole truth and the NHS may be saving money in other areas (I hope). Also, I am not an expert on hospital procedures on waste disposal and recycling. Finally, I want the best for the NHS. Having had a serious illness and benefited from NHS treatment, I love and support what it aims to do.

What happens to most one-use plastic in the #NHS? Is it recycled, incinerated or does it go to landfill? #recycling #healthcare Click To Tweet

But the NHS wasting money doesn’t help its cause

Every few months I have a treatment and during it I often chat to the staff on duty. I recently spoke to a nurse about recycling in the NHS and she explained the procedure for collecting used needles which go into a special plastic bin kind of like this one. (This one is my other half’s needle bin where he puts his used needles from injecting insulin.)

Picture of a yellow bin for used needles. A healthcare worker told me about how these bins are collected every 2-3 weeks as per hospital procedure whether they are full or not. She wasn't sure if the bin was incinerated with the needles. If it is, that is the NHS wasting money in my opinion. I think bins for needles could be sterilised and reused.

In hospital, the bin is routinely collected every 2-3 weeks as per hospital procedure. Even if the bin isn’t full of used needles, it is collected. The healthcare worker believes the contents are incinerated but wasn’t sure whether the bin is too.

If the bin is being incinerated, then why doesn’t the hospital let the bins become full? By not doing that, the hospital could be using and paying for more bins than it needs to.

If the bin is not being incinerated, I wonder if it is sterilised and reused. Do any hospitals do this?

Here’s a scenario which felt like it’s the NHS wasting money and not promoting sustainable disposal of materials

During the treatment I have every few months, a needle is put into the ankle area and an electrical current is passed through it. This is what the equipment for the procedure looks like when I enter the treatment room.

The picture shows a medical device called Urgent PC and a package of items (the Urgent PC lead set) which goes with it. The device can be reused. But the lead wire in the package cannot. It can only be used once. If it becomes disconnected from the device, it can't even be reused. That's an example of unsustainable design and potentially the NHS wasting money.

The device is the Urgent PC Stimulator and the package contains the following:

  • 1 PC lead wire
  • 2 sterile needles
  • 1 alcohol pad

A picture of a medical treatment device called Urgent PC which is an example of unsustainable design and the NHS wasting money. The main device can be reused. But the lead, which is circled in green, can only be used once and if it falls out of the device, a new one has to be used. The lead could be designed so that it can be reused and one only need to attach the alcohol pad (circled in blue) to the lead.

The lead (circled in green) can only be used one time. If it falls out of the machine, it cannot be plugged back in. Sometimes it falls out. So the nurse has to open a new package.

Each package costs £40. This clinic goes through 65-70 of them in a week. That is £2,600 to £2,800 per week.

I had been wondering why the lead can’t be designed so that a new alcohol pad (circled in blue) can be attached as that is the only item that is stuck to a person’s skin. I was thinking that the lead itself could be sterilised to be used again.

I know some people may say that using an item once leads to lower infection rates, etc, etc. But really? Do sterilisation practices not work?

The package comes with two needles (circled in red). However, I often have the issue that the nurses can’t get the needle into the place it needs to be for the treatment to work effectively. They have gone through more than two needles with me during a treatment session.

(I wish I asked them how many of the packages are used due to a lead falling out or needing more needles. Question for my next visit.)

So I called the device manufacturer to find out more about the device’s product design

I spoke to an employee who explained that the lead delivers electrical resistance through a thin copper wire and the electrical resistance degrades the lead. The lead has only been tested to be used once and the lead can be used for an hour of stimulation. Each treatment is 30 minutes.

The employee advised me that the needle is a standard acupuncture needle and they can be used as an alternative if more than two needles are needed. This can save another package having to be opened which is good to know.

The company has the sole patent

According to this employee, the company currently has the sole patent for this medical device. So there’s no competition at the moment. I wonder if there was, would this increase innovation in product design so more parts of the device could be safely reused and maybe bring prices down?

In this day and age where there is a much stronger focus on how we are treating our planet, I feel making products that can only be used once to be poor product design. But as you will read further on, money seems to play a role.

Recycling is also an issue in the NHS

Compounding the issue of the NHS wasting money potentially on one-use items, it also isn’t recycling much uncontaminated medical waste. According to the Waste and Resources Action Programme (WRAP), only 7% of healthcare plastic waste is recycled.

According to www.wrap.org.uk, only 7% of #healthcare plastic waste is recycled in the UK. When will this change? #recycling #healthcare Click To Tweet

Furthermore, according to Recycle Health Organisation, ‘there are no established nationwide in-hospital recycling schemes… nor are effective measures being taken to seek alternatives to plastic consumption in healthcare.’

There’s more. The Recycle Health Organisation also quotes the Marine Conversation Society’s work which has demonstrated that since 2013, ‘organisations within NHS England have purchased more than half a billion disposable plastic cups for hot drinks, cold drinks and dispensing medicines.’ 

I think we need more initiatives in the NHS as featured in this Twitter post.

Picture of a twitter posted dated 26th May 2019 by @steve_kingmagic showing a bin of inhalers being collected for recycling. The Twitter post reads: "Another batch of used inhalers sent for recycling. There is absolutely no need for these to go to landfill. Inhalers are made of high quality plastics and aluminium. Please keep returning these to the pharmacy, we really appreciate it. Please share this important message."

But reusing and recycling in the NHS doesn’t seem to be a straightforward issue

Back to the conversation I had with the employee. He said that the lead for the Urgent PC Stimulator is made up of a copper wire and plastic. He wasn’t sure if it could be recycled. If the manufacturer isn’t sure, how can the NHS be sure?

He shared his knowledge of hospitals preferring to use disposable items as it reduces the risk of infection. He talked about the balance of cost between someone’s care in hospital for a urinary tract infection (he mentioned that costs £2,700 and 5 days of care) versus the cost of using a disposable item which reduces infection risk.

He also said 20 years ago hospitals more often sterilised items to reuse. Items would be shipped to a sterilisation plant and you had to plan how many items you had on hand at the hospital, how many were en-route to being sterilised, how many were currently being sterilised and how many were on their way back. He said this was costly.

Finally, he added that regulations and procedures in healthcare did not make it easy to reuse and recycle.

But what are the medical device companies doing to promote recycling?

The person I spoke to said that medical device companies are doing their bit by focusing on packaging, i.e. using cardboard and paper where ever they can. However, he said this is a difficult issue to resolve because medical devices need to be airtight and sterile which only plastic can provide.

That’s a good start. But is it enough?

I think medical device companies could also make items that can re-used (where possible), be recycled and communicate recycling instructions to hospitals.

Is the NHS wasting money someone else’s gain?

According to the person I spoke to, medical device companies tend not to launch products to market which will not give them a good return on investment. The market for the Urgent PC Stimulator is small. This leads me to wonder if single-use items can help to ensure the return on investment for the research and development of such products?

It feels to me there is a delicate balance between companies wanting to make money and minimising risk of infection to the patient. Single-use items enable both. A price to pay is more goes to landfill if the disposable items aren’t recyclable or able to be incinerated.

There is something in all of this about what is easy to achieve. It seems to me that money – whether it’s making money or saving it – is what currently makes things feel easy or more doable. I feel that is the go-to reason people often use.

Picture of a person standing and throwing a disposable plastic cup towards a pile that has 'landfill' written on it. One one side of him is a box that says 'return on investment' and a Great British Pound sign, Euro sign and US Dollar sign. On the other side is a box that says 'Minimise risk of infection to patients'. The person is saying, 'Items you use once achieve both!' The point being made is disposable items you use once which the NHS has to purchase can enable a return on investment for the manufacturer and minimise risk of infection to patients. But if the item has to go to landfill, then this doesn't help in the long run.

It’s heartening to read about organisations who are promoting recycling in healthcare

Waste and Resources Action Programme (WRAP) and the Recycle Health Organisation promote finding alternatives for plastic where possible, promote and introduce recycling schemes in hospitals and community healthcare settings, push for sustainable product design, raise awareness and more. All of this is necessary.

What can you do?

These are a few things you can do to minimise costs and/or recycle. It’s not an exhaustive list and you may have some ideas of your own.

  • As a patient, when you see items being used once in hospital and you are wondering if it will be recycled or you think there is the potential to use it more than once, ask about it. Learn more and share what you learn on social media to raise awareness.
  • Sign the Recycle Health Organisation’s petition here to implement and legalise stringent plastic recycling plans in UK hospitals.
  • If you use medical equipment, ask your GP, consultant and/or pharmacist about how and where to recycle it.
  • When you go to hospital for treatment or to visit someone, bring your own cup for coffee/tea and water.

What’s it like for you?

Have you ever experienced medical equipment being used once and then discarded and thought, ‘Hey, why can’t that be used again?’ Or have you learned that items used in your treatment are not recyclable? I’d love to know if you have. Share your experiences and thoughts in the comments below or alternatively email them to me (contact form in sidebar).  

If you are living with a challenging health issue or are caring for someone who is, and would like support to return to a sense of wellness, have a look at how we can work together and get in touch for a free no obligation consultation.

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© Copyright Barbara Babcock 2019

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