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1 Environment and sustainability Health Technical Memorandum 07-01 Safe management of healthcare waste Environment and sustainability Health Technical Memorandum 07-01: Safe management of healthcare waste DANGEROUS WHEN W. DIOACTIVE. 3. ORGANIC PER. ISBN 0-11-322766-3. 9 780113 227662. Health Technical Memorandum 07-01: Safe management of healthcare waste Health Technical Memorandum 07-01 Safe management of healthcare waste Crown copyright 2013. Terms of use for this guidance can be found at ii Preface About Health Technical Memoranda main source of specific healthcare-related guidance for estates and facilities professionals. Health Technical Memoranda (HTMs) give comprehensive advice and guidance on the design, The core suite of nine subject areas provides access to installation and operation of specialised building and guidance which: engineering technology used in the delivery of healthcare.

2 Is more streamlined and accessible;. The focus of Health Technical Memorandum guidance encapsulates the latest standards and best practice in remains on healthcare-specific elements of standards, healthcare engineering, technology and sustainability ;. policies and up-to-date established best practice. They are applicable to new and existing sites, and are for use at provides a structured reference for healthcare various stages during the whole building lifecycle. engineering. Figure 1 Healthcare building life-cycle DISPOSAL CONCEPT. RE-USE. DESIGN & IDENTIFY. OPERATIONAL OPERATIONAL. MANAGEMENT REQUIREMENTS. Ongoing SPECIFICATIONS. MAINTENANCE TECHNICAL & OUTPUT. Review PROCUREMENT. COMMISSIONING. CONSTRUCTION. INSTALLATION. Healthcare providers have a duty of care to ensure that Structure of the Health Technical appropriate governance arrangements are in place and are Memorandum suite managed effectively.

3 The Health Technical Memorandum series provides best practice engineering standards and The series contains a suite of nine core subjects: policy to enable management of this duty of care. Health Technical Memorandum 00. It is not the intention within this suite of documents to Policies and principles (applicable to all Health unnecessarily repeat international or European standards, Technical Memoranda in this series). industry standards or UK Government legislation. Where Health Technical Memorandum 01. appropriate, these will be referenced. Decontamination Healthcare-specific technical engineering guidance is a Health Technical Memorandum 02. vital tool in the safe and efficient operation of healthcare Medical gases facilities. Health Technical Memorandum guidance is the iii Health Technical Memorandum 07-01 Safe management of healthcare waste Health Technical Memorandum 03 Electrical Services Electrical safety guidance for low Heating and ventilation systems voltage systems Health Technical Memorandum 04 In a similar way Health Technical Memorandum 07-02.

4 Water systems represents: Health Technical Memorandum 05 Environment and sustainability EnCO2de. Fire safety All Health Technical Memoranda are supported by the Health Technical Memorandum 06 initial document Health Technical Memorandum 00. Electrical services which embraces the management and operational policies from previous documents and explores risk management Health Technical Memorandum 07. issues. Environment and sustainability Some variation in style and structure is reflected by the Health Technical Memorandum 08. topic and approach of the different review working Specialist services groups. Some subject areas may be further developed into topics DH Estates and Facilities Division wishes to acknowledge shown as -01, -02 etc and further referenced into Parts A, the contribution made by professional bodies, B etc.

5 Engineering consultants, healthcare specialists and Example: Health Technical Memorandum 06-02 NHS staff who have contributed to the production of represents: this guidance. Figure 2 Engineering guidance FIC DOC. H SPECI UM. L T EN. A TS. HE. HTM 08. HTM 01. Specialist Services Decontamination S T R Y S TA N D A. DU RD. IN S. & EUROPEAN. NAL ST. HTM 07. IO HTM 02. T. AN. NA. Environment & Medical DA. H E A LT H S P E. INTER. CUMENTS. sustainability Gases RDS. HTM 00. RDS. INTER. Policies and Principles DA. NA. AN. IO. ST. T. NA. DO. HTM 06 L& N HTM 03. Electrical IN EUROPEA S Heating &. DU D. C. Services STR AR Ventilation IF I. IC. Y S TA N D Systems IF. C. EC. D. HTM 05 HTM 04. O. Fire SP. U Water C. M Safety Systems H. EN T. TS AL. HE. iv Executive summary This guidance was produced and updated in partnership Technical Memorandum 07-06: Disposal of with DH, Defra and the Department for Transport and pharmaceutical waste in community pharmacies' as a with the full support and cooperation of the Regulators sector guide (see the Community pharmacies' sector ( Environment Agency and the Health and Safety guide).)

6 Executive) and the devolved administrations. a focus on practical advice and examples for classifying It provides an update to Health Technical Memorandum waste, in particular the infectious and offensive waste 07-01 first published in 2006 . The key areas of change streams, including case studies to highlight best include: practice;. updates to legislation, specifically for environmental a review of the terminology used for healthcare, permitting and transport/carriage regulations ; clinical and non-clinical wastes. a focus on the waste hierarchy through procurement This edition supersedes previous editions. practices, and the elimination, minimisation, recycling Apart from the direct environmental benefits achieved by and recovery of waste;. the compliant management of healthcare waste, this a drive to address the carbon impact related to waste guidance presents opportunities for introducing cost through resource efficiency, transport impacts and savings, safer working practices and reducing carbon disposal arrangements; emissions related to managing waste.

7 The integration of new sector guides on GPs and dental practices as well as incorporating Health v Health Technical Memorandum 07-01 Safe management of healthcare waste Acknowledgements The following individuals and organisations have contributed to the production of this guidance: Mick Fanning WSP Group Louise Wood WSP Group Catherine Lynas WSP Group Peter Hoffman Health Protection Agency Jeff Hart Department for Transport Chris Lewis Welsh Health Estates Bob McIntyre Environment Agency Tony Ryan Buying Solutions Martin Castle Vehicle Certification Agency Gul Root Department of Health Lorraine Holme Department of Health Steve Lutener Pharmaceutical Services Negotiating Committee John Newbold Health and Safety Executive Mark Heggie Scottish Environment Protection Agency Allison Townley Northern Ireland Environment Agency Teena Patel Department for Environment , Food and Rural Affairs Alison Gadsby Department for Environment , Food and Rural Affairs Dave Wiltshire Thames Water Brian Latham IHEEM.

8 Howard Stevens Abertawe Bro Morgannwg University Health Board vi Contents Preface Executive summary Acknowledgements 1 Introduction, scope and applicability 1. Who should use this Health Technical Memorandum? What is provided in the Health Technical Memorandum? Update to Health Technical Memorandum 07-01 ( 2006 ) and key changes Guidance status and implementation Essential standards of quality and safety 2 Glossary and acronyms 5. 3 Legislation and healthcare waste 8. Overview of regulatory regimes Environment and waste legislation Waste Framework Directive Duty of care and controlled waste Local authorities' responsibilities Environmental permitting and waste management licensing Hazardous waste ( England , Wales and Northern Ireland) and special waste (Scotland). Consignment notes European Waste Catalogue (EWC).

9 Controlled drugs Producer responsibility Infection control Health and safety legislation Management responsibilities Control of Substances Hazardous to Health (COSHH). Health and safety at work Consulting employees Transport and carriage legislation Carriage regulations Procurement regulations European procurement regulations Procurement guidance 4 Healthcare waste definitions and classifications 19. Typical wastes produced by healthcare activities Clinical and hazardous waste Healthcare waste classification and assessment framework Step 1. Step 2. Step 3. Step 4. Step 5. Step 6. Specific waste types vii Health Technical Memorandum 07-01 Safe management of healthcare waste Amalgam waste Medical devices Implants Radioactive waste Domestic (municipal) waste Blood transfusion bags Gypsum and plaster casts 5 Waste minimisation, segregation, colour-coding and storage 48.

10 Waste minimisation Waste-derived carbon impact Importance of waste segregation Colour-coding Container labelling Infectious waste: yellow stream Anatomical waste red-lidded receptacles Infectious waste: orange stream Infectious liquid waste: yellow or orange receptacles Medicinal products blue-lidded receptacle Cytotoxic/cytostatic waste yellow with purple stripe or purple stream Sharps waste receptacles with yellow, purple and orange lids Fully discharged syringes Offensive/hygiene waste yellow/black bags Domestic waste (usually black bags). Specialist arrangements for segregation Chemical waste: fixer and developer Amalgam white containers Radioactive waste Large equipment and mattresses Implanted devices Successful waste segregation Case study University College London with MITIE. Implementing waste segregation systems Waste receptacles Storage and frequency of collection 6 Managing compliance 68.