Sustainable innovations: Reducing plastic waste in the NHS

Monday 22 April marks Earth Day. The annual event was introduced in 1970 to raise awareness of global environmental issues and highlight the importance of conservation and sustainability. Five decades on, this message is increasingly important, and reminds us to act individually and collectively to protect our world and resources for now and the future.

This year’s theme is Earth vs Plastics, with the organisers demanding a 60% reduction in plastics production by 2040.

Within our Climate Change and Sustainability Strategic Approach 2023-2026, Public Health Scotland outlines how we, as a national NHS Board, will deliver our contribution to meeting Scotland’s climate ambitions, and support NHS Scotland and our social care partners do the same.

While the NHS in Scotland is constantly seeking safe and responsible ways to reduce plastic consumption in healthcare, it’s not always straightforward, and the focus must be on improvement of recycling practices.

In the first of a series highlighting great sustainable practice across the NHS in Scotland, Tanya Rhodes (PHS) and Mairead Gardner (NSS/Sustainability Action) spoke to Dietitian, Rosa Holt, and Waste Manager, Neil Duncan at NHS Grampian about a simple but innovative project to reduce plastic waste.

The initiative ensures that food supplement bottles – given to patients in hospital in situations where solid or self-feeding isn’t possible – are recycled. Since its introduction, the team has had UK-wide interest, a motion raised in the Scottish Parliament, and the message spreading widely through Rosa’s role with the British Dietetic Association.

We asked Rosa and Neil where their inspiration around sustainability came from?

Rosa: I grew up on a farm so that science/nutrition/environment link has always been there. I was using shampoo bars when I was 11. My parents were always keen and encouraging.

Neil: I've been in this role for nine years and was six years with the recycling team at Moray Council. I’m a bit of a waste geek; I enjoy recycling and trying to encourage others to be more sustainable. It's what we have to do.

Rosa: The effects are so clear, aren't they? We get these crazy weather patterns. We see the changes to our environment, and we can all make practical, tangible changes.

Rosa explained that conversations between herself, colleagues and Neil sparked the realisation that the hundreds of supplement feed bottles that were being disposed of each week could be recycled.

Rosa: I picked up on work that Neil was doing to improve recycling rates and making sure things go into the correct waste streams. I thought this was a really easy thing that we can do here. The majority of our patients in critical care are being fed with some kind of liquid nutrition, and we get through thousands of these little plastic bottles.

Neil: If you’re putting things into the clinical waste bins, we're paying a lot for the disposal, it’s going to England and being incinerated. So where do you put them? In a clear recycling bag, which costs effectively nothing, pennies, you know? There’s cost savings and a huge environmental benefit.

In a busy work environment, with long-established processes, implementing change is rarely simple. We asked Rosa and Neil what barriers they faced and how they were overcome.

Rosa: You accept that not everyone will do this, and that's OK. The pushback comes with the change of practice. I’ve asked for it to go into the compulsory training, and what we’ve tried to do, in a positive way, is set targets. At the moment, 6% of the products get recycled, and we’re hoping to achieve around 80% during the pilot year.

Neil: This venture has allowed me to go to wards and think about where recycling bins are; it needs to be as easy as possible. All ward kitchens and main kitchens should now have recycling bins rather than just dotted around wards. The hope is that bottles will be returned to the kitchens because we know there are recycling facilities there.

Communication was key, and the team found that humour helped to get the message across. Rosa describes videos the team made to encourage staff buy in:

Rosa: I asked the consultants one day if they could juggle. I asked Neil, “Neil, can you juggle?” We’ve filmed them juggling bottles. We asked the domestics, “Could you just walk up to this bin, really enthusiastic.” Because you're doing that, everyone's, like, “What's going on over there?!” That generates fun and interest, and helps it stick in people's minds.

Neil: People need reminded that you’re supposed to recycle at work. It’s strange, because it’s a legal requirement at work, but I don’t know if people know that. You don’t have to do it at home, but people do because it’s been made easier and it’s the right thing to do.

Although this trial started at Foresterhill, there is an opportunity to take this blueprint and roll it out across the whole of Grampian and beyond.

Rosa: We couldn’t have done this without support; including managers and ward staff who are encouraging us, letting us roll TV crews round wards at short notice.

What's been nice is, I've had patients getting in touch to say thank you. The patient journey is really important; they feel good knowing it’s not a wasteful process, and we're putting things where they should be going.

Find out more about sustainability at NHS Scotland