PHARMACY WASTE - FREQUENTLY ASKED QUESTIONS WHO ARE THE KMF WASTE & ENVIRONMENT TEAM? Kent & Medway NHS Facilities (KMF) is contracted to manage the Patient Returned Medicines contract on behalf of NHS England. We also offer auditing, training, advice, leaflets, posters and bin signs to assist sites in getting their waste disposal procedures correct. HOW DO I CONTACT THE WASTE & ENVIRONMENT TEAM? The team can be contacted on 01634 335220 or by email at waste.environment@kmpt.nhs.uk WHAT ARE KMF’S OPENING HOURS? We are open from Monday to Friday, 8:30am until 4:30pm. WHAT ARE KMF RESPONSIBLE FOR? KMF are responsible for the Patient Returned Medicines contract on behalf of NHS England. In addition we are responsible for some needle exchange and other specialist services commissioned within pharmacies by NHS England. All other wastes generated as part of the pharmacies activities are the sole responsibility of the pharmacy and are not funded by NHS England. However KMF can provide general waste management advice to assist your site with compliance and some of this advice is included below. SECTION 1 – CLINICAL WASTE WHAT IS INFECTIOUS OR OFFENSIVE WASTE? Infectious waste is any waste contaminated with blood or other bodily fluids or excretions that are infectious or potentially infectious. Offensive waste is non-infectious waste which does not require specialist treatment or disposal, but which may cause offence to those coming into contact with it. Clinical judgement is required to make the assessment between infectious and offensive waste. If in doubt, then the item should be placed in the infectious waste as a precaution. The ‘Guide to Assessment of Clinical Waste’ poster is available via the KMF Waste & Environment Team. WHAT COLOUR WASTE SACK SHOULD I USE? Orange Sack – Infectious Waste Yellow Sack with Black Stripe – Offensive Waste Page 1 WHAT IS A SHARP? Anything sharp or likely to tear a clinical waste bag e.g. phlebotomy sharps, syringe driver with needle attached, acupuncture needles, blades, scalpels, used medical instruments, patient disposable razors and broken ampoules. WHAT COLOUR SHARPS BOX SHOULD I USE? Orange Lid – Yellow Lid – Purple Lid – Sharps contaminated with blood only Sharps contaminated with non hazardous medicines Sharps contaminated with hazardous medicines It is accepted that there may also be some blood contamination on those sharps contained in the yellow or purple lidded boxes. As a general rule of thumb anything that comes out of the body (blood) would go in an orange lidded box and anything that goes into the body (fully or partially discharged syringes containing medicines) would go in a yellow or purple lidded box. HOW DO I KNOW IF A MEDICINE IS HAZARDOUS? There is a list of Hazardous medicines available from the KMF Waste & Environment Team and all medication should be checked against the list before deciding on a disposal option. If you are in any doubt you can also check with a Pharmacist if the medication has any Cytotoxic or Cytostatic properties. WHAT COLOUR MEDICINAL WASTE BOX SHOULD I USE? Blue Lid Purple Lid – Non hazardous medicines Hazardous medicines DO I HAVE TO SEGREGATE MEDICINAL WASTE? Yes, all medicinal waste returned to the pharmacy must be segregated into hazardous and non hazardous. To ensure the safety of pharmacy staff, patients should be questioned on the contents of their returns prior to acceptance. The items should be emptied into a sorting tray; then they can be safely segregated and placed into their correct bins. Medicinal waste bins can be used for Tablets and Liquids in their original packaging of blister packs or bottles. Loose tablets can also be placed in these bins for disposal. All empty medicine bottles must be placed in the medicinal waste bin as we are prohibited from rinsing the residue down the sink. SECTION 2 – NON CLINICAL WASTE CAN I PUT MY WASTE IN STREET BINS, TAKE IT HOME OR TO THE LOCAL TIP? The street bins, household collections and local civic amenity sites are provided for domestic use only. Businesses are not permitted to use these services to dispose of any of their waste. Use of these services would mean you would not be complying with the Duty of Care legislation. All businesses must have a contract with a suitably licenced waste management contractor for the collection and disposal of waste. WHY DO I NEED TO RECYCLE? The law requires all businesses and organisations to separate recyclable material from general waste. If you don't comply you could be issued with a fine. WHAT CAN BE RECYCLED? Items that are usually collected by contractor recycling services include; paper, card, tins, cans and plastic bottles. Cardboard boxes should be flattened to reduce the volume of space they take up in the bin. HOW DO I DISPOSE OF CONFIDENTIAL WASTE? All confidential waste must be securely disposed of. This can be achieved by cross shredding using a shredder of security level 4 or higher. Alternatively you can use a suitably licenced confidential waste contractor. HOW DO I DISPOSE OF WASTE ELECTRICAL (WEEE) ITEMS? When ordering new electrical items, please discuss with the supplier the possibilities for having the old item removed on a like for like basis. If this is not an available option then you will need to make arrangements for a licenced WEEE contractor to remove the items from your site. Please be aware that some WEEE items can also be hazardous e.g. fridges, TV’s and these will need to be stored in a secure undercover location to await collection. HOW DO I DISPOSE OF BATTERIES? It is illegal to place any batteries in the domestic waste. All batteries must be stored up to await collection by a licensed contractor. Ideally the box should be plastic with a lid to prevent any leakages. Hazardous and Non Hazardous batteries must not be mixed in the same container. Non Hazardous Batteries – Hazardous Batteries – AA, AAA, C, D e.g. household type. Lead/acid, Ni/Cd and mercury cells e.g. button cells SECTION 3 – HAZARDOUS WASTE HOW DO I DISPOSE OF HAND SANITISERS? Hand sanitisers, including those containing alcohol must not be rinsed or disposed of without first checking the COSHH data sheets for information on the correct disposal route. Products containing siloxanes must be disposed of via a suitably licenced waste contractor. HOW DO I DISPOSE OF INK AND TONER CARTIDGES? These cannot be placed in the domestic waste bins as they are classed as hazardous waste and must be collected by a suitably licence waste contractor. Page 3 Ink and toner cartridges can be recycled for charity or are sometimes able to be returned to the manufacturer in their original packaging. Many registered charities will supply you with boxes and bags to collect these items. Please check that they are licensed to collect and process this waste. HOW DO I DISPOSE OF AEROSOLS? These cannot be placed in the domestic waste bins as they are classed as hazardous waste and must be collected by a suitably licence waste contractor. Medicinal aerosols e.g. inhalers can be placed in the medicinal waste bins. HOW DO I DISPOSE OF CHEMICALS / PAINTS ETC? Full, partially full or empty items which have an old orange square or new red diamond hazard symbol e.g. Chemicals, paints etc cannot be placed in the domestic waste bins. Disposal arrangements must be made with a suitably licenced waste contractor. Please note that you should have the COSHH data sheet for each item and they must be stored in accordance with the instructions on the sheet. CAN ALL HAZARDOUS ITEMS BE COLLECTED TOGETHER? Some waste contractors provide solutions for the collection of small quantities of hazardous items. This involves the supply and collection of a hazardous waste box which can take various small items e.g. WEEE, batteries, aerosols, toners, alcohol gel, chemicals. The Waste & Environment Team can advise on suitable schemes if required. SECTION 4 - SITE ISSUES WHAT IS WASTE PRE-ACCEPTANCE? Clinical waste is subject to Pre-Acceptance checks as required by the Hazardous Waste Regulations. Waste Producers e.g. the Pharmacy are required to demonstrate that appropriate arrangements and facilities are in place for the collection of all waste types to reduce the likelihood of other types of waste ending up in the clinical waste stream. The waste audits are submitted to the Clinical Waste Contractor and are available for inspection by the Environment Agency upon request. Failure to submit a complete and accurate Preacceptance audit to the Contractor would mean that clinical collections would be required to cease. Pre-acceptance audits are due on a five yearly basis and there is no need to pay the waste contractor to complete this for you. The PSNC have a pre-acceptance audit tool for you to use and KMF will advise you when your next audit is due and will assist with the completion if required. DOES MY SITE REQUIRE A HAZARDOUS WASTE REGISTRATION NUMBER? Possibly, if your site produces more than 500kg of waste per year, you are required to register with the Environment Agency as a hazardous waste producer. Hazardous waste includes clinical waste medicines, fluorescent tubes, computer monitors, fridges etc. You can find more information and register at https://www.gov.uk/hazardous-waste-producerregistration DOES MY SITE REQUIRE A T28 WASTE EXEMPTION? Yes, the T28 is a low risk waste exemption that has to be registered with the Environment Agency. This exemption allows pharmacies and other similar places to comply with the requirements of the Misuse of Drugs Regulations 2001 by denaturing controlled drugs (making them unsuitable for consumption). Under the terms of the exemption, denatured drugs can be stored for up to 6 months before disposal. The exemption is free, lasts for 3 years and can be registered by following the link below; https://www.gov.uk/environmental-permit-how-to-apply WHAT IS AN EWC CODE? A European Waste Classification (EWC) code is a 6 digit reference number assigned to each type of waste. EWC codes can be combined where waste has more than one contaminant and hazardous wastes are denoted by an asterisk* on the end of the number. The waste segregation posters available form the Waste and Environment Team include commonly used EWC codes. CAN I TAKE IN WASTE FROM THE PUBLIC? Sharps – Only if your site is registered as a needle exchange point or providing another sharps service commissioned by NHS England. If not, please direct them to the local council who will advise on the disposal process. Clinical waste – No, please direct them to the local council who will advise on the disposal process. Medicines – Yes, the contract with NHS England is set up to receive Patient Returned Medicines (PRM) from the public. Please call the KMF Waste & Environment Team for advice if you are presented with any waste by a member of the public or if it is fly-tipped on your site. HOW DO I REPORT A MISSED COLLECTION OR ORDER ADDITIONAL STOCKS? If a collection has been missed please inform the KMF Waste & Environment Team by telephone or email the day after the missed collection. Do not contact the contractor direct as performance issues are closely monitored. The contractor should exchange stocks of clinical waste sacks and sharps bins on a like for like basis. If you do not receive sufficient stocks, require additional e.g. flu clinics or are running low then please contact the KMF Waste and Environment Team who will make the arrangements for you. Page 5