Annual State of the NHSScotland Assets and Facilities Report for 2012

Annex D

Review of Waste Services

Background

This is the first time that waste has been included in the State of the NHSScotland Assets and Facilities Report, and it is likely to be the subject of increasing focus and attention in the coming years. The Scottish Government wishes to track waste performance carefully, seeking improvement for a number of reasons. These include needing effective responses to the Waste (Scotland) Regulations 2012 and recent sustainability policy requirements, as well as to reduce costs. NHS Boards' waste management costs amounted to just over £10m in 2010-11, with 'cost per consumer week' increasing by some 25% from the previous year.

The Government's vision is for Scotland to be a zero waste society "where waste is seen as a valuable resource, valuable materials are not disposed of in landfills, and most waste is sorted for recycling, leaving only limited amounts to be treated". Adoption of the waste hierarchy is at the heart of the Zero Waste Plan (June 2010) and the 2012 Regulations to improve waste performance. The five principles of the hierarchy are: (a) prevention; (b) preparing for re-use; (c) recycling; (d) other recovery, e.g. energy recovery; and (e) disposal.

National Performance Framework Target and KPI for waste

To measure NHSScotland's performance, the 'waste cost per consumer week' KPI was derived solely from Cost Book data under code 430 (domestic waste uplift and disposal costs, and 'hospital incineration' costs). More detailed codes are also given: ash removal (5573); refuse disposal (5574); trade effluent charges (5576) and clinical waste (5577) The terminology here, and scope, no longer reflect current waste practice or reporting, and only cover the 250 hospitals in the Cost Book. These issues may in part explain the differences between eMART data for the same period. Accordingly, recommendations will be made to update the Cost Book waste parameters.

Benchmarking

In 2011, the NHSScotland Waste Management Steering Group (WMSG) recommended revision of the eMART waste KPIs, to align reporting with regulatory requirements and current procedures in Boards. Previously, the KPIs had captured 5 elements: clinical waste (an out-of-date term), recycled waste, WEEE, skip waste and domestic waste. The new format includes some 38 KPIs in 6 main groups: healthcare (yellow, orange and red stream) wastes; source-segregated domestic waste for recycling; and un-segregated domestic waste sent either to a Materials Recovery Facility, or to landfill or other treatment. Key advantages are that the new approach can account, not just for hospital waste, but for all wastes produced on a Board-wide basis; it also removes some of the inaccuracies of site-based reporting where waste is transferred, often from a range of small sites, to a bulking station.

The KPI recommendations were approved by the SFG and the Benchmarking Programme Board. The new format was used for the first time to capture the 2011/12 waste data. That data will be used as the basis for the 2013 SAFR, and will inform updating of the Cost Book categories. This will help to consolidate a new and more accurate baseline from which to monitor waste management performance in future. Boards will now complete quarterly eMART returns from 2012/13 onwards, using the new format to inform the benchmarking process.

Finally, the new reporting arrangements reflect the fact that waste may generate some income streams for Boards, as quality recycled materials have some market value, e.g. cardboard, metals, etc. The relevant KPIs will be brought to the attention of the Cost Book User Group.

Waste (Scotland) Regulations 2012

The Waste (Scotland) Regulations 2012 are detailed but, broadly, require:

• Businesses (including hospitals) to present dry recyclable materials (glass, metals, plastics, paper, and card/cardboard) for collection from 1 January 2014
• Businesses (temporarily excluding hospitals^[4]) to ensure separate collection of food waste from 1 January 2014
• Key recyclables (plastics and metals) to be removed from mixed waste prior to incineration (from 1 July 2012)
• Local authorities to provide householders with a collection service for dry recyclables (from 1 January 2014) and food waste (from 1 January 2016)
• Materials collected separately for recycling to be banned from going to landfill or incineration (from 1 January 2014)
• Biodegradable municipal waste to be banned from going to landfill, from 1 January 2021
• Food waste disposal to be banned from entering the public drain or sewer from 1 January 2016 (potential implications for hospital sluices and food macerators)
• That the quality of recyclate is not to be compromised by poor segregation or mixing with other wastes, and so as not to hamper further recycling.

Industry's response, particularly that of the waste services sector, is vital to help NHSScotland meet its responsibilities under these regulatory requirements.

The Waste Management Steering Group (WMSG) and Zero Waste Scotland (ZWS)

The WMSG represents all NHS Boards on waste management issues and has a key coordinating and support role, including the development of technical guidance and training. It ensures that Boards are not left to cope alone with the complex range of strategic waste management issues and compliance requirements. Recently, the WMSG's role has been strengthened by engaging in partnership with ZWS, as part of the ZWS health sector support programme. ZWS is recruiting staff and initiating projects to:

• build on recent work understanding the amounts, origins and composition of healthcare and other wastes arising from NHS Boards;
• further develop understanding of what the Regulations will mean for NHSScotland
• identify, wherever possible, an indication of associated infrastructure costs required to implement and comply with the Regulations, to allow Boards to develop investment plans and business cases for Scottish Government funding
• clarify the operational and procedural changes required, to help improve procedural guidance (and associated training) for NHS staff, principally through revisions to Scottish Healthcare Technical Note 3 (SHTN3).

Waste management recommendations and NHSScotland investment planning

One key purpose of the State of the NHSScotland Assets and Facilities Report, and benchmarking, is to take account of a range of issues from performance and risks to legal compliance and other requirements, and then identify and analyse trends leading to possible improvements.

The results of the WMSG and ZWS work will be disseminated at the first opportunity. Whilst it is too early to quantify the investment costs required in waste management-related infrastructure, procedural guidance and staff training, the new Regulations will mean, almost inevitably, a focus on the range of bins and other receptacles of appropriate sizes required for effective source-segregation and collection of the various waste materials specified. These, the 'food waste to drain' ban, and segregation of food waste will present operational and financial challenges for all Boards at wider roll-out where applicable across the whole estate.

New national domestic waste contract

Earlier in 2012, NSS National Procurement established a national framework contract for the provision of municipal/domestic waste services. Boards are able to take advantage of this contract, which will run for two years prior to review.