• Clinical waste chief lifts lid on stockpiling scandal 
  • Former major supplier to NHS stopped one in three collections ahead of regulatory action – a claim the previous supplier denies
  • Mitie’s waste chief says UK does have enough incineration capacity but suppliers are “insular”
  • Waste backlogs at NHS trusts “to be cleared by end of next week”

Backlogs of clinical waste outside NHS hospitals will be cleared by early May, according to the new provider of waste services for nearly a quarter of all English trusts.

Michael Taylor, managing director of waste management at Mitie, told HSJ there would be “no backlogs on site by the end of the first week in May”, as the NHS continues to deal with the fallout from the collapse of Healthcare Environmental Services.

HES entered liquidation last week, more than six months after HSJ revealed regulatory action was taken against the company following the stockpiling of hundreds of tonnes of NHS clinical waste – including human body parts – at its sites.

As a result of the regulatory action, around 45 trusts switched from HES to Mitie for clinical waste management.

The first 17 trusts moved to Mitie within five days of HES’ problems being publicly reported in early October 2018.

Prior to the switch, Mitie was only providing the service to around five NHS trusts, but Mr Taylor said the company’s model – which involves using subcontractors to collect and dispose of the waste – meant they were able to take on the challenge at very short notice.

“The whole industry was aware there was an issue with the incumbent and a lot of calls had been made to a lot of people saying, ‘Can you step in?’,” Mr Taylor said.

“The honest answer was there wasn’t one company that could do that because they could only do different bits, and we were approached because we were the ones who could bring all those bits together.

“We ended up working on the contract over that weekend, and we were signing contracts at 11pm in the evenings.”

Bins

He said taking over the services had been complicated by the fact that – in the month leading up to October’s events – HES had stopped one in three collections at its trusts, meaning there were already backlogs of waste piling up.

“[The backlog volume] was a couple of hundred tonnes – it was probably three to four weeks’ worth of waste,” Mr Taylor said.

“They were also picking which waste streams to take. They were taking the waste they could treat easier such as things that didn’t need incinerating.”

Attempts to shift the backlogs were also hampered by HES not giving Mitie thousands of its bins, despite Mitie paying for them, Mr Taylor said, adding that Mitie only had access to half the bins purchased.

“Therefore, we didn’t have the capability of offering a like-for-like service,” Mr Taylor said.

Garry Pettigrew, owner of HES, denied his company had stopped making collections and withheld bins. 

He said: “We were collecting up to 6 October when security stopped our guys from collecting. There was no backlog on any of the sites. 

On the issue of bins, Mr Pettigrew said: ”The bins they purchased were not HES assets, they belonged to Starryshaw Consultants Limited and the monies were not paid to SCL.” Companies House lists Mr Pettigrew as a director of Starryshaw Consultants Limited.

Several trusts have reported their clinical waste costs rising steeply after switching from HES to Mitie, and there have also been concerns about backlogs building up at hospitals again.

Market rate

Mr Taylor said HES was charging trusts “below the market rate” and said those trusts that are paying much higher prices are the trusts which are not segregating their waste as well as they should be.

“The principle of charging one price for everything meant hospitals weren’t encouraged to segregate,” he said.

“If you take the four or five waste streams, then offensive waste and orange bag waste (infectious) are considerably cheaper than what they were paying, but incineration is more expensive.

“If you look at some hospitals which segregate very well, 70 per cent of their waste is orange/offensive whereas some hospitals which are not very good will incinerate it all.”

He added: “By the end of the first week of May there will be no backlogs on sites.”

Mr Taylor said Mitie wants to work with trusts to reduce their waste levels and encourage better segregation.

“Now they’re [trusts] seeing a transparent pricing model that breaks down what everything costs they are motivated because they can see the commercial as well as environmental benefit,” he said.

Incineration capacity

Asked if there is enough incineration capacity for NHS clinical waste in the UK, Mr Taylor said there is “more than enough” from an “analytical point of view”.

However, he said the clinical waste market comprises “competitors working in a very insular way because they’re competing for business so things around [incineration plant] shutdowns and maintenance things were kept company-specific because why would you tell your competitors when you were going to have shutdowns”.

“What you end up with, and March is a good example of that, was the majority of them all have shutdowns at the same time,” he said.

“There is enough capacity to incinerate the material. It has peaks and troughs and shutdowns cause major issues without doubt, but we’re trying to control that.”

Mitie has, therefore, developed an IT platform which companies can use to inform Mitie when shutdowns are going to happen, as well as displaying how much capacity is available to deal with clinical waste.

“It’s only been working for a couple of weeks so it’s not perfect yet, but it’s an example of how we’re identifying issues and putting IT or smart solutions in to correct them and stop this happening again,” Mr Taylor said.

Asked how NHS clinical waste services should be procured in future, Mr Taylor said the NHS must move away from simply choosing the supplier with the lowest price for disposal.

“I think everyone is saying what has happened has highlighted that’s not the best way to do it in future,” he said.

“The lowest price for a blended material doesn’t suit the NHS and that’s how it’s been procured in the last decade. If you’re basing it on what’s your price per tonne, that doesn’t build any benefit of reducing the price per tonne.

“Prevention is more important than processing. The biggest way of saving cost is to reduce waste.”