Information on Clinical Waste

NHS GM ICB has received several queries relating to various aspects of clinical waste. As such, we would clarify processes in place:-

1. NHS GM commission clinical waste collections with Rentokil Initial (RI)
2. Collections are scheduled to take place every 8 weeks (this is a Nationally agreed contract and cannot be varied)
3. Each community pharmacy has an allocated number of bins (this can be amended by contacting england.gmtop@nhs.net) if there is a proven need.

Excessive Waste

1. As a gesture of goodwill, NHS GM and RI have agreed to clear any excessive waste above the allocated number of bins within your next scheduled collection
2. RI drivers have been instructed to then leave the allocated number of bins
3. If pharmacies require an amendment this must be requested to england.gmtop@nhs.net  The following information is required to progress requests:-

• CLINICAL WASTE in the subject heading
• ‘F’ Code of pharmacy
• Full name and address of pharmacy (including post code)
• List of ALL care homes (including the names and FULL addresses) the pharmacy collects from
• Does the pharmacy have capacity to store more bins
• Explanation of why more bins are needed
• Submit photos of the waste currently stored on site
• Confirmation that pharmacy staff segregate waste appropriately

Waste Segregation

1. ALL packaging (where appropriate) should be removed and disposed of separately and in a confidential manner taking into consideration patient identifiable information
2. A ‘common sense’ approach should be applied when disposing of items such as dietary supplements e.g. Fortisip which can be poured into a sink and the plastic bottles recycled

Blue Lidded Bins (Patient Returned Medicines)

1. Pharmacy contractors have an obligation in pursuant of the NHS terms of service – Disposal of unwanted medicines as an essential pharmaceutical service to accept patients unwanted/unused waste medicines returned by patients to the pharmacy premises
2. This includes tablets, capsules, vials, ampules, creams / ointments and liquids

Yellow Lidded Bins (Sharps)

1. Sharps (needles & syringe) are categorised as a device and not a medicine, consequently pharmacies are not mandated to accept these from patients.
2. The issuing services should have the means by which the patient / resident can dispose of their sharps safely which may include the patient returning their sharps bins to the service or to other community service
3. The general rule tends to be whoever has prescribed the sharps bins, should in theory have arrangements in place for disposing of these bins ( i.e. GP Surgeries, hospitals, diabetic clinics)
4. Albeit local councils have a duty to dispose of patients’ clinical waste that is administered in the home, although they can apply a charge
5. Any pharmacy that does collect sharps must only dispose of domestic sharps waste
6. Needle Exchange sharps collections are not commissioned by NHS GM.  Pharmacies should contact their Local Authority to enquire what process is in place
7. NHS GM commission the removal of domestic sharps waste in Trafford, Salford, Manchester and Stockport

Flu Vaccination

1. Pharmacies that are undertaking the flu service (September to February) must comply with the national service specification, which states

“The pharmacy contractor is required to make arrangements for the removal and safe disposal of any clinical waste and personal protective equipment related to the provision of this service (including where the vaccination is undertaken off the pharmacy premises)”.

1. You should therefore have in place a private waste collection
2. This should be organised between yourselves and a waste contract provider as there is a financial element within this service to accommodate this collection
3. Therefore, all flu vaccination waste should be kept separate from any patient retuned medicines

Covid Vaccination

1. All pharmacies who are registered Covid Vaccination sites need to contact RI direct for collections
2. Collections for this service are ad-hoc and do not impact the 8-weekly collections
3. Contact sally.reade@rentokil-initial.com to arrange a collection date (normally scheduled within a few days of the request)

Care Homes Waste

1. NHS GM commissions the removal of waste from Residential Care Homes only
2. NHS GM does not commission the removal of waste from Nursing Care Homes
3. If pharmacies choose to accept waste from Nursing Care Homes, this must be funded by the pharmacy via a private waste contractor

Inhalers

1. Inhalers are classed as a device and not medicinal waste
2. However, RI have agreed these can be disposed of in the blue lidded bin with the following criteria:-

• 10 or less per 60L bin
• If there are more than 10 these would need to be dispersed across a number of 60L blue bins

1. This allows for Health & Safety – when the pressurised container goes through the high temperature incineration process, there is a pop or very small explosion that occurs.  So if a large number of inhalers were to be incinerated at the same time it may be unsafe