1. Handling Waste in a Healthcare Trust – Implementing Sustainable Change through Employee Engagement North East Recycling Forum Presentation March 1st 2012

2. P ERSONAL BACKGROUND Worked for IKEA for 14 years Fast-paced, volume-driven, bottom-line focused. Co Renowned for hard-earned ‘green’ credentials. Wasn’t always that way Began at the back door 1998/99 By 2001 every store has Environment Specialist Initial focus on waste and costs Control over waste established Moved issue into store – why is this happening? Stock Loss Groups, Recovery Dept’s, etc. By 2009 – 85% of dry waste being recycled in UK

3. J OINING AN NHS T RUST Like stepping back in time! Trust representative of a lot of trusts in UK. Risk averse (All about compliance) Focus on clinical service delivery. Anything else seen as peripheral. General appreciation for ‘environmental’ work lacking. Benefits to organisation not fully understood or appreciated.

10. Saving £13,000 p.a.

11. Saving £3,000 p.a.

12. B Y J ULY 2011… Recycling in 40+ leased, managed and owned buildings. Cost savings of >£30,000 p.a. on domestic waste Recycling approx 60% of volume. Supporting local organisations with unwanted furniture. Staff support for changes and observed behaviour change. New, more dynamic draft waste policy. Legal, compliant and environmentally healthier operation.

13. B UT HOW DID WE GET THERE ? Investigation of alternatives: Biffa – Dry Mixed Recycling (Trafford Park)

14. B UT HOW DID WE GET THERE ? Wybone bins Risk, Fire, Infection Control approved Two-bin solution Easy to implement Easy to use Minimal management Investigation of alternatives:

15. B UT HOW DID WE GET THERE ? Employee engagement Trust-wide e-mails Intranet Posters Communication on bins Communication beside bins Communication via line managers Face to face discussion Waste Manager on site during implementation Removing waste paper baskets Unpacking and labelling new bins Discussing benefits of new system (sometimes heated!) Empowerment of domestic service staff

16. W HAT CAN I RECYCLE ?

17. W HAT CAN ’ T I RECYCLE ?

18. O VER -C OMMUNICATE ! W ORDS AND I MAGES

20. H EALTHCARE W ASTE – T HE SITUATION Most waste coming out of wards, bedrooms, treatment rooms, classified as ‘clinical’ The only route for bulk ‘clinical’ waste was incineration. Incineration = £600 per tonne disposal Bulk incineration cost the Trust £40,000 in 2010 HCW contract cost Trust £80,000 in 2010 in total No distinction made between infectious, potentially infectious, offensive and domestic waste in clinical areas of buildings. Completely Mixed Waste! Perception that everything was being burnt!

21. A LOT OF THIS GOING ON

22. A NEW CONTRACT – H.E.S. Y&H Clinical Waste Consortium tender Won by Healthcare Environmental Services Installation of an autoclave in Normanton. 18-01-03 ‘Orange’ infectious waste - autoclaved. 18-01-04 ‘Tiger’ offensive waste - landfilled Removal of domestic waste from clinical stream? Significant opportunity for: Segregating waste streams, Securing compliance Saving money Protecting the environment Recycling (!)

23. T WO - STAGE APPROACH 1. Secure Routines: Bagging, tagging and segregation Engage with porters, domestics, 3 rd party FM, etc. Explain reasons for change – sell; don’t tell. Check for understanding. Open discussion Follow up regularly 2. Investigate Alternatives and Implement Change Outlets for waste fractions secured Identify opportunities areas (treatment rooms) Introduce new-style ‘Duo’ bin (Wybone) 2 bins taking 4 waste streams Segregation at source secured Minimal training of clinical staff: all done using communication and awareness “There is no appetite for extensive re-training on waste…”

24. M OVE FROM THIS …

25. T O THIS

26. O FFENSIVE V’ S I NFECTIOUS W ASTE

27. ‘B ELT & B RACES ’ APPROACH TO COMMUNICATION

28. R ESULTS FROM THIS INITIATIVE Compliance secured Environmentally preferable solutions Domestic waste removed from HCW steam Majority waste in treatment rooms = domestic! Greater understanding of 18.01.03 & 18.01.04 Costs reduced. Average monthly bill was £7,000 Now £2,500 External Interest in this way of working.

29. S UMMARY 1. Provide the right tools and easy to follow routines 2. Communication, Communication, Communication. 3. Engagement is key Face up to people: Be seen on the day Be seen implementing the solution Be seen “getting your hands dirty” Engage and Explain. Try not to justify. Don’t use ‘environment’ to win the argument!

30. W INNING ARGUMENTS ( IN THIS ORDER ) 1. Financial 2. Legal 3. Policy/Strategy 4. Efficiency/Workload 5. Environment