Heidi Barnard MCIWM, Head of Sustainability at NHS Supply Chain, has highlighted the NHS’s ambitious efforts to tackle healthcare waste and reduce carbon emissions through embedding circular economy principles into procurement, product design, and operational practices. The UK’s healthcare system, essential to public wellbeing, is also a major contributor to environmental waste, with NHS providers in England generating roughly 156,000 tonnes of clinical waste annually—the equivalent of more than 400 fully loaded jumbo jets. Traditionally, this waste has been managed through energy-intensive processes like high-temperature incineration and alternative treatments, which contribute significantly to the NHS’s carbon footprint.
In 2023, NHS England launched a comprehensive Clinical Waste Strategy aimed at transforming waste management over a decade. The strategy sets an ambitious target to reduce clinical waste by 80% and eliminate unnecessary disposal by promoting reuse and innovative onsite treatment methods. It also encourages NHS trusts and primary care providers to better segregate waste into a targeted 20-20-60 split: 20% for incineration, 20% infectious waste, and 60% offensive waste. This segmentation is designed to improve efficiency and reduce environmental harm. Critical to the strategy is ensuring that 100% of NHS providers appoint fully trained waste managers; a new professional qualification developed with the Chartered Institute of Waste Management (CIWM) supports this. The revised Health Technical Memorandum 07-01 provides updated technical guidance, encouraging trusts to adopt more sustainable waste segregation and processing techniques.
The Clinical Waste Strategy is part of a broader Greener NHS programme, launched in 2020, which addresses wider environmental impacts. The NHS is among the largest public-sector carbon emitters in the UK, producing around 24.9 million tonnes of CO₂ annually, with over 60% attributed to its supply chain. Recognising its purchasing power, the NHS is embedding sustainability into procurement through initiatives like the Evergreen Sustainable Supplier Assessment, which sets clear sustainability expectations for suppliers and promotes products that are durable and repairable rather than single-use disposables.
Waste remains a significant challenge. For instance, the NHS generates about 133,000 tonnes of plastic waste annually, with only 5% currently recyclable. Single-use plastics dominate medical equipment and packaging due to strict sterilisation and regulatory requirements. Yet, even small changes can yield substantial savings and waste reduction, as illustrated by Yorkshire Ambulance Service’s successful removal of 200,000 single-use items. Overordering and obsolete equipment also add to waste and carbon emissions. This calls for smarter design and procurement standards that prioritise sustainability, although regulatory nuances such as Medical Device regulations can slow the adoption of greener alternatives.
NHS Supply Chain has responded strategically with its “Buy Less, Buy Better, Buy Different” approach. This framework encourages reducing unnecessary consumption through shared best practices, prioritising sustainable supplier engagement, and embracing innovation such as digital health and value-based procurement. One practical application under the “Buy Less” pillar is the rollout of Inventory Management Systems (IMS) across NHS trusts. These systems enhance stock visibility, reduce waste, and improve patient care. For example, Northumbria NHS Trust reported a carbon reduction of 729 tonnes within six months of IMS implementation, nearly 1% of its total procurement-related footprint.
The Department of Health and Social Care’s Design for Life roadmap further supports this circular ambition. It sets out a vision for a circular economy in medical technology by 2045, aiming to reduce waste and emissions while creating green jobs and driving economic growth. The roadmap focuses on six pillars, including embedding sustainability throughout clinical training and procurement, incentivising circular business models, establishing reusable device standards, investing in decontamination and recycling infrastructure, encouraging sustainable MedTech innovation, and aligning leadership and procurement strategies nationally.
Pilots are underway to test the shift from single-use to reusable medical technologies in NHS Trusts. For instance, Hampshire Hospitals NHS Foundation Trust estimated annual carbon savings of over 31,500 kgCO₂e by switching to reusable surgical tray wraps, while NHS Wales projected emissions reductions up to 23.7 tonnes CO₂e per year by adopting reusable containers. Financially, NHS Wales projected savings of over £61,000 annually across ten years despite initial capital investments. Both trusts emphasised operational considerations such as infection control, infrastructure capacity, and stakeholder engagement as critical to successful implementation.
Despite these promising steps, challenges persist. There are cultural barriers, with longstanding equating of disposability with safety in clinical environments, alongside regulatory lag and infrastructure constraints. However, new training, leadership, and cross-sector collaboration are seen as key enablers. Accurate data collection and metrics on carbon emissions and cost savings are vital to tracking progress and reinforcing accountability.
Beyond reducing waste, the circular healthcare approach promises broader benefits: significant cost savings through decreased procurement and disposal expenses, enhanced supply chain resilience, and reallocation of resources to improve patient care. This transformation requires concerted effort across suppliers, clinicians, and policymakers and is fully aligned with the NHS’s core mission to care, heal, and do no harm.
In sum, healthcare waste should not be an unavoidable burden but a powerful opportunity. By embracing circular economy principles, the NHS aspires to lead global sustainable healthcare innovation, delivering better outcomes for patients, the environment, and public finances. As Heidi Barnard succinctly puts it, “Healing people shouldn’t harm the planet, because ultimately, our health depends on a healthy planet.”
Source: Noah Wire Services
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