WASTE MANAGEMENT POLICY AND PROCEDURE

1 WASTE MANAGEMENT PROCEDURE Facilities Page 1 of 92 Document Control Title WASTE MANAGEMENT Manual Author Author s job title Deputy Director of Facilities Directorate Facilities Department Hotel Services Version Date Issued Status Comment / Changes / Approval July 2015 Final Published on BOB April 2016 Revision Published on BOB March 2018 Final Complete review July 2018 Revision Updated flowcharts. Published on BOB July 2019 Revision Updated Appendix 4 to reflect current situation and clarified amalgam WASTE . Main Contact Deputy Director of Facilities Facilities Directorate North Devon District Hospital Raleigh Park Barnstaple, EX31 4JB Tel: Direct Dial Tel: Internal Email: Lead Director Director of Facilities Superseded Documents Issue Date March 2018 Review Date March 2021 Review Cycle Three years Consulted with the following stakeholders: (list all) Infection Control Medicines MANAGEMENT Sodexo Facilities Health and Safety Advisor Approval and Review Process Health & Safety Committee Local Archive Reference G.

2 \\ Facilities Procedural Documents Local Path WASTE MANAGEMENT Manual Filename WASTE MANAGEMENT Manual WASTE MANAGEMENT PROCEDURE Facilities Page 2 of 92 POLICY categories for Trust s internal website (Bob) Facilities Tags for Trust s internal website (Bob) WASTE , rubbish, clinical WASTE , toxic WASTE , recyclable, offensive WASTE , human tissue Northern Devon Healthcare NHS Trust WASTE MANAGEMENT PROCEDURE Page 3 of 92 Contents Document Control .. 1 1 INTRODUCTION .. 7 2 OBJECTIVES .. 7 3 WASTE DESCRIPTIONS, PACKAGING AND DISPOSAL SUMMARY TABLE .. 9 4 GENERAL WARDS/DEPARTMENTS WASTE SEGREGATION AND HANDLING .. 24 General Health & Safety .. 24 Offensive WASTE final disposal is Landfill .. 27 Infectious WASTE final disposal is heat disinfection plant .. 27 Medicine contaminated WASTE /clinical WASTE not appropriate for offensive stream final disposal is incineration.

3 28 Non-cytotoxic/static medicine contaminated WASTE ( IV bags, lines, tubing etc contaminated with medicines or not contaminated such as plain saline or glucose) (see page 22 WASTE MANAGEMENT Flowchart) 28 Cytotoxic/static medicine contaminated WASTE .. 28 Suction containers disposal route is either heat disinfection plant or landfill .. 29 Sharps WASTE all sharps WASTE is incinerated .. 29 General Information .. 29 Sharps WASTE (Non-cytotoxic/static sharps ) .. 29 Sharps WASTE (cytotoxic/static) final disposal is incineration .. 30 Medicine WASTE final disposal is 31 General .. 31 Pharmacy returns .. 31 Non-cytotoxic/static medicines (not returned to Pharmacy) should be disposed of in the yellow 22 litre container.. 31 Empty/partly used Blood Bags* disposal route incineration .. 31 Cytotoxic/static medicines (not returned to Pharmacy) final disposal is incineration.

4 32 Controlled Drugs .. 32 Feeds .. 32 Domestic WASTE (including glass) final disposal is landfill .. 33 Recyclable WASTE green bags and cardboard .. 33 Recyclable WASTE IT consumables .. 34 Food WASTE .. 34 Confidential WASTE .. 34 Batteries .. 35 Large, bulky WASTE items and non- medical electrical/electronic equipment .. 35 Medical equipment .. 36 WASTE chemicals .. 36 Alcohol hand gels .. 36 Fluorescent tubes .. 37 Mattresses .. 37 Northern Devon Healthcare NHS Trust WASTE MANAGEMENT PROCEDURE Page 4 of 92 5 38 Clinical/infectious WASTE yellow bags .. 38 Set up WASTE .. 38 Suction 38 Human tissue, limbs and organs .. 39 Teeth not containing 39 Amalgam .. 40 6 OBSTETRICS/GYNAECOLOGY/COMMUNITY MIDWIVES .. 41 Placentas .. 41 Foetal tissue and remains .. 41 Suction 41 WASTE produced from home births.

5 41 General .. 41 Sharps .. 42 Transport of WASTE .. 42 7 DIALYSIS .. 43 WASTE generated by other trusts on Northern Devon Trust premises .. 43 8 ORAL, MAXILLO FACIAL AND ORTHODONTICS DEPARTMENT .. 44 Orthodontic wires .. 44 Teeth .. 44 Amalgam .. 44 Precious metals .. 44 Photographic slides .. 45 Gypsum .. 45 9 MEDICAL IMAGING/X-RAY .. 46 Barium .. 46 Contrasts .. 46 10 A&E / FRACTURE CLINIC .. 47 Plaster casts - infectious .. 47 Plaster casts non-infectious and gypsum .. 47 11 PATHOLOGY DEPARTMENT .. 48 General .. 48 Clinical/infectious WASTE yellow 48 Autoclaves .. 48 Human tissue/anatomical WASTE Histology and Mortuary .. 49 Foetal tissue and remains .. 49 Glass slides .. 49 Blood products and blood sample tubes .. 50 Northern Devon Healthcare NHS Trust WASTE MANAGEMENT PROCEDURE Page 5 of 92 Chemically contaminated clinical/infectious WASTE .

6 50 Chemicals and empty containers .. 50 General information .. 50 Empty containers .. 51 Chemical disposal 51 Chemical disposal Other .. 51 Disposal to sewer .. 51 12 PHARMACY .. 53 General Information .. 53 Pharmacy returns .. 53 Non-cytotoxic/static medicines .. 54 Cytotoxic/static medicines .. 54 Non-pharmaceutically active IV fluids ( saline and glucose) .. 54 Feeds .. 55 Disposal to sewer .. 55 Controlled drugs .. 55 Third party and general public WASTE .. 55 Chemicals .. 55 13 PODIATRY .. 57 Gypsum .. 57 Chemicals (ie Phenol and Hydrochloric Acid) .. 57 WASTE generated in GP Practices .. 58 WASTE generated in patients homes .. 58 14 CHEMOTHERAPY UNIT .. 59 Cytotoxic/static medicine contaminated WASTE (see Appendix 7 for full list) .. 59 15 ELECTRICAL BIOMECHANICAL ENGINEERING DEPARTMENT (EBME).

7 60 General medical equipment .. 60 Batteries .. 60 General medical equipment at community sites .. 60 16 FACILITIES AND MAINTENANCE DEPARTMENT (INCLUDING THE MAIN WASTE COMPOUND AT NDDH) .. 61 Domestic WASTE compactor NDDH .. 61 Cardboard baler .. 61 General skip/container .. 62 Batteries .. 62 Fluorescent tubes .. 62 Refrigeration equipment .. 63 WASTE electrical and electronic equipment (WEEE) .. 63 Chemicals (including paints and solvents) .. 64 Scrap metal .. 64 Northern Devon Healthcare NHS Trust WASTE MANAGEMENT PROCEDURE Page 6 of 92 Asbestos WASTE .. 65 Construction WASTE .. 65 Contractors WASTE .. 65 Garden WASTE .. 65 17 IT DEPARTMENT .. 66 General .. 66 Batteries .. 66 IT Equipment .. 66 18 CATERING DEPARTMENT .. 67 General .. 67 Food WASTE .. 67 Cooking oil .. 67 Cardboard.

8 67 19 COMMUNITY HEALTHCARE WASTE .. 68 20 WASTE FROM THIRD PARTIES AND THE GENERAL PUBLIC .. 70 WASTE from third parties .. 70 WASTE to third parties (if NDHT is third party on other sites) .. 70 WASTE from the general public .. 70 21 WASTE HANDLING, MOVEMENT & COLLECTION .. 72 Domestic Team handling and movement of WASTE .. 72 Portering Team handling, movement and collection of WASTE .. 72 22 LOCATION OF EXTERNAL WASTE STORAGE AREAS .. 74 23 OPERATION OF WASTE HANDLING EQUIPMENT .. 77 24 HEALTH AND SAFETY .. 78 Incidents from WASTE MANAGEMENT activities .. 78 Accident and incident reporting .. 78 Personal protection .. 78 WASTE spillages .. 78 25 ENVIRONMENTAL PERMITTING EXEMPTIONS .. 80 26 WASTE CONTRACTS AND LEGAL PAPERWORK .. 81 27 WASTE MANAGEMENT TRAINING .. 82 28 AUDITING AND MONITORING .. 83 29 APPENDIX.

9 84 Northern Devon Healthcare NHS Trust WASTE MANAGEMENT PROCEDURE Page 7 of 92 INTRODUCTION North Devon Healthcare NHS Trust (NDHT) is keen to ensure the safe and sustainable MANAGEMENT of wastes produced from healthcare activities on the North Devon District Hospital (NDDH) site and Community Sites, through the following: Ensuring all WASTE streams are disposed of appropriately, according to legislation and good practice Reducing the amount of WASTE produced Making best use of the WASTE that is produced by maximising re-use, recycling and where feasible composting Minimising the amount of WASTE disposed of to landfill Providing relevant training and information to staff, patients and visitors Providing the necessary equipment and facilities to allow the safe and correct handling and storage of WASTE . The Trust is working in partnership with a number of WASTE contractors to reduce the amount of domestic WASTE sent to landfill and increase the amount of WASTE recycled and/or composted.

10 Where feasible the Trust will also introduce measures to minimise and recycle WASTE including reducing the amounts clinical/infectious WASTE produced, by improving the segregation of clinical/infectious and domestic WASTE and the introduction of the offensive WASTE stream. This document has been produced in line with the general recommendations made in the HTM 07-01, Safe MANAGEMENT of Healthcare WASTE . This PROCEDURE should be read in conjunction with The Trust s WASTE MANAGEMENT POLICY , which describes the Trust s overall objectives for WASTE MANAGEMENT , together with the MANAGEMENT arrangements and accountabilities for delivering those objectives. The Trust s WASTE MANAGEMENT POLICY and any other relevant policies are found on the Trust s intranet site Policies . OBJECTIVES The Trust is required to comply with both environmental and WASTE legislation.