Infection Prevention and Control
Guidance for the Segregation and Management of Clinical Waste
Version: V1
Ratified by: Infection Prevention and Control Group
Date ratified: 02/06/2025
Job Title of author: Infection Prevention and Control Team
Reviewed by Committee or Expert Group Infection Prevention and Control Group
Related procedural documents
EPOL05 Healthcare Waste policy
MMSOP34 Standard Operating Procedure for the Management of Pharmaceutical Waste in Community Hospitals and Community Clinic
IPPOL21 Standard Precautions for infection Prevention and Control including TBPs and Isolation Precautions.
Review date: 02/06/2028
It is the responsibility of users to ensure that you are using the most up to date document template – ie obtained via the intranet.
In developing/reviewing this procedure Provide Community has had regard to the principles of the NHS Constitution.
Version Control Sheet
Version
1. Introduction
All staff working in health and social care must follow the safe management and handling of waste:
Training needs vary depending on job role. All employees involved in handling or producing healthcare waste must demonstrate safe practice in relation to:
• Risks associated with clinical waste.
• Segregation of waste.
• Handling, storage and collection.
• Personal hygiene.
• Procedures for spillages and accidents/incidents.
• Use of protective equipment.
2. Segregation of Healthcare Waste
All healthcare waste must be correctly segregated at the point of use. Healthcare waste includes clinical waste and all waste produced by the health care worker. Correct waste segregation can ensure safe management of waste and helps control associated hazards.
1. Infectious waste
When assessing whether the healthcare waste should be classed as infectious or not, consideration must be given to the medical history of the patient, and any clinical signs and symptoms indicating a potential infectious risk. The assessment for infectious properties of the waste must be made at the time the waste is generated and is defined as:
• it came from a patient being treated for infection or from contact with a patient carrying a transmissible disease, for example PPE items that have come into contact with an infectious patient
• it came from a patient with a history of a known infection, for example a bloodborne virus or Clostridioides difficile
• it has been identified as infectious by a clinician
N.B
Orange bag is for waste which are only infectious and do not have any other hazardous properties.
Yellow bag is for waste which are to be infectious and also contain chemical or pharmaceutical contamination.
2. Offensive waste
Offensive waste is non-hazardous and may be generated both within healthcare facilities and in the wider community or social care provision. - If an item is known to be infectious, contaminated with chemicals/medicines, is radioactive, or is sharp, it is not offensive waste.
Offensive wastes generated by healthcare facilities will fall into one of two categories:
• healthcare offensive wastes which would not be generated outside of a healthcare facility: – single-use instruments (tongue depressors, specula) – used gowns – used PPE which has not been contaminated with bodily fluids – dressings from non-infectious patients
• household and municipal offensive wastes (community) which could be generated outside a healthcare setting: – nappies and adult continence products, colostomy bags, catheters – used personal hygiene products – non-infectious dressings.
NB
Yellow and black tiger stripe bag is for Offensive waste.
3. Sharps
All sharp objects that have been contaminated with body fluids or medicinal products must be placed in approved UN 3291 specification rigid containers.
Sharps bins/Containers that are in use must be located in a safe place, off the floor (though not on high surfaces), where the container aperture is within sight i.e. between waist/shoulder height and/or fixed to a wall or on a trolley, flat surface and must be sited in the area where the clinical work takes place, and the temporary closure mechanism in place when not being used. Containers should be sealed when the fill mark is reached.
Sharps or pharmaceutical boxes must not be placed into a clinical waste bag for disposal.
It is the responsibility of the employee to ensure that sharps containers are clearly labelled and must not be removed from area unless clearly marked and label completed.
Sharps containers must follow correct segregation of waste.
4. Waste in the community
Waste produced when patients are treated at home by a visiting healthcare worker is considered as healthcare waste. If the waste is non-hazardous, and is appropriately bagged and sealed, it is acceptable for the waste to be disposed of with household waste. This is usually the case with non-infectious dressings, personal hygiene products, nappies and incontinence pads.
Community Staff may transport Sharps Bins in their cars. Clinical waste should only be transported in UN approved containers (i.e. UN 3373).
If the waste is classified as hazardous (infectious, cytotoxic, sharps, medicinal):
• remove that waste from the home and store it in approved containers. Healthcare workers conducting home visits should carry suitable containers as part of their equipment if there is potential for the removal of hazardous waste.
• check that a suitable area for waste storage is available in the home, where it will not harm residents, and is not accessible to pests and pets; inform the patient of the relevant risks and obtain their informed consent; and arrange for the waste to be removed by the local authority or an appropriate contractor.
5. Handling Storage and Collection
Sharps and diagnostic specimens (swabs/blood/urine samples etc.) are classified as infectious substances under the healthcare waste regulations. Infectious substances as per Dangerous goods require transporting in a way that ensures compliance with a wide range of waste regulations (not just healthcare) when transported in a vehicle (inc. a private car) on a public road.
Specimens to be transported must be placed in a sealed plastic specimen bag with the form placed in the second compartment to avoid accidental contamination of the form. The plastic bag should then be placed in a rigid leak proof container in a designated collection area until ready for collection.
Sharps containers must be placed in boot of car and have lid closure in place. If temporary closure in place sharps bin must be transported in a secure leek proof UN container to prevent risk of spill of contents. Where sharps container closure mechanism has been secured shut and placed securely in boot of vehicle it can be transported to waste collection site/location.
Sharps and specimens in transport must follow (as well as infectious PPE clinical waste):
• Must be placed into rigid, secure, leak-proof outer packaging (bin/box) in boot of vehicle
• Packaging (bin/box) requires a label stating the UN number (of the substance in the package) placed inside a diamond shape.
• Relevant UN codes for the labels are:
o UN3291 – clinical (infectious) waste
o UN3373 – category B substances inc. sharps (blood) and diagnostic specimens
3. Mobile Deliver Unit
Waste disposal
Services must dispose of all clinical and non-clinical waste generated following each use of the mobile delivery unit. There is clinical and non-clinical waste disposal at each storage location (Kestrel, Crouch Vale).
There are clinical and non-clinical bins on board the vehicle. These must be secured using the bungees to the right of the bulkhead door while the vehicle is in transit.
Sharps
There is a transportable sharps container onboard the vehicle. These can hold both small sharps packaging and/or small cytotoxic/cytostatic packaging which will fit into the compartments at either end. While in transit, the bin must be securely shut and contained using the in-vehicle bracket in the cupboard next to the sink in the rear clinic room.
The container compartments can hold sharps bin which is compatible for the Sharpsguard 0.6 litre sharps bins, which must be provided by the service where required.
https://my.supplychain.nhs.uk/catalogue/product/fsl317 (yellow) https://my.supplychain.nhs.uk/catalogue/product/fsl367 (purple)
4. Legislation
National Infection Prevention and Control Manual for England 2022 updated 2024.
https://www.england.nhs.uk/national-infection-prevention-and-control-manualnipcm-for-england/
Health and Social Care Act 2008: code of practice on the prevention and control of infections and related guidance - GOV.UK
Health Technical Memorandum 07-01: Safe and sustainable management of healthcare waste
https://www.england.nhs.uk/publication/management-and-disposal-of-healthcarewaste-htm-07-01/
