Royal Liverpool University Hospital

How effective clinical waste management helped one trust meet the regulations for dealing with a highly contagious viral disease.

Patients with highly contagious and infectious diseases are cared for on the Tropical and Infectious Diseases Unit at the Royal Liverpool University Hospital. When a patient has tested positive for a highly contagious disease, strict infection control techniques are used to prevent the spread of infection.

These measures are used both during the care of the patient and in the disposal of any products that the patient or staff have come into contact with. Waste is categorised into levels of hazardous waste so that it can be disposed of safely, with Category A being the most hazardous.

Andy Johnson, environmental service manager at the trust, says: "We are one of few hospitals in the UK that have the facilities for treating patients who have a Category A disease. When the trust is notified from the High Consequence Infectious Diseases Network, comprising five NHS trusts, that a ‘Category A’ patient will be admitted to hospital, the team begin to prepare the unit to receive the patient.

"Our tropical and infectious diseases team are highly trained to look after the patient safely and prevent the spread of further infection. In addition to this, our waste management services have the responsibility and expertise to safely remove the waste from the hospital.

Category A waste management

"We’ve never had to consign Category A waste for disposal before so this process was new to us, however the support from Stericycle has been invaluable."

All patients identified as having a high consequence infectious disease are treated in hospital isolation units. 

Personal protective equipment is worn by every health professional that comes into contact with the patients whilst they are in our care. Therefore, this personal protective clothing needs to be disposed of to maintain patient, staff and visitor staff safety.

This includes ensuring the clothing and linens or cleaning materials used in the patient’s room is disposed of as Category A waste and must be transported in specialist packages and boxes. The packaging must consist of three components: primary receptacle, secondary packaging and outer packaging.

Andy adds: "As soon as we find out the patient is suspected of having a ‘Category A’ disease, we make contact with Stericycle and their response so far has been fantastic. If we need any advice, someone is always on the end of the phone or an email. Together with Stericycle we make applications to the department of transport to prepare for the consignment of the Category A waste."

Andy says the trust has given consideration to treating the waste on site but, ultimately, decided it was much safer to use Stericycle’s services: "Stericycle collect the Category A waste in a safe manner, and then transported and disposed of it in complete compliance with the ADR regulations (the European agreement concerning the international carriage of dangerous goods by road).

"The support from Stericycle is phenomenal. With the internal pressure that goes on when something like this occurs, having that level of support from an external company was brilliant. There’s a lot of legislation and guidance that we have to adhere to, and all that is put into place and it runs very smoothly."