20 March 2019

Bringing the fight against single use plastics to Barts Health NHS Trust

The NHS produces up to 600,000 tonnes of waste every year at a cost of around £100 million and infectious clinical waste can cost more than £500 per tonne to dispose of. Most of this waste gets incinerated or processed and sadly, some of this will still go to landfill, with negative consequences for our environment.

At least 40% of operating theatre waste is recyclable and a large proportion of this is high-quality plastic. Jonny Groome, an anaesthetist at Barts Health NHS Trust, decided to set about finding a way to manage Barts’ waste so that plastic was either reusable or recyclable.

With support from UCLPartners Aspiring Improvers programme, Jonny and his team have successfully diverted anaesthetist plastic waste from landfill and have sparked a movement that is raising awareness of NHS plastic waste across the Trust and beyond.

First steps

The first person to convince was the Environmental Manager for Barts. A big part of a successful quality improvement project is getting all the right people on side, and this was a good place to start. Jonny and his team did a lot of homework before meeting with the waste managers and picked their sites carefully to ensure that they’d be able to scale the project successfully.

When they’d gained approval, the team found a company called RecoMed, who take away non-infectious medical PVC items for free and recycle them into tree ties for the horticultural industry. Clinical waste disposal is usually very expensive, but as the RecoMed scheme is free, it not only keeps these devices out of landfill, they also save the NHS money. If one anaesthetic mask, one length of oxygen tubing and one oxygen mask was put in the RecoMed waste stream for every anaesthetic delivered in the UK it would amount to 2250 tonnes of PVC. This could save around £1million a year for the NHS.

Early resistance

The anaesthetists did experience some resistance but found that the key to assuaging doubt was to provide robust data supporting economic and environmental gains. They learned that in order to complete simple tasks – such as getting PVC items into a bin, and then getting that bin into a holding area – they needed to have meetings with different groups at every level: nurses, private contractors, doctors, sustainability teams, waste teams, housekeeping… etc. This was incredibly time consuming and is something that needs factoring into planning a quality improvement project such as this.

The team also realised that it’s much easier to make headway with in-house NHS waste management teams.

Growing impact

Jonny’s plastic saving work started out at Newham and Whipps Cross University Hospitals, with great success. Since starting in April 2018, they have collected in excess of 200kg of medical PVC.

Now the project has developed into a much bigger movement, and they have founded a group called GASP (greener anaesthesia sustainability project), a platform for anaesthetists who are trying to achieve similar aims. GASP members offer advice to trusts and give lectures on sustainability. More recently they’ve even been invited to talk at a sustainability conference in Brighton.

Before joining Barts, Jonny worked in New Zealand where there was a huge emphasis on recycling and environmentalism. When he returned to the UK, he became aware of how much of an issue waste was in hospitals.

Sharing the latest on his project, he said: “Through education and staff engagement we are continuing to recycle more and more medical plastics across Barts Health each day. Our next stop is the Royal London Hospital and then on to the Barts Hospital too!”

UCLPartners Aspiring Improvers programme aims to create a network for people starting out in improvement, providing them with the skills and support to build their confidence and capability to get involved with, and eventually lead improvement. Participants take part in workshops, masterclasses on improvement with experts, and have the opportunity to build a quality improvement project and reflect and explore their ideas and challenges with colleagues. Find out more about the programme.