The hospital that’s sick of single-use plastic

Covid-19 reportedly created huge demand for disposable items like cutlery and plates in hospitals. David Burrows finds one that is pioneering reusables across its catering operations.

In 2018, NHS England bought at least 163m cups, 16m pieces of plastic cutlery, 15m straws and 2m plastic stirrers. “It’s right that the NHS and our suppliers should join the national campaign to turn the tide on plastic waste,” said chief executive Simon Stevens when he published the figures in October last year.

At the time, Stevens urged retailers and in-house caterers operating in hospitals to pledge that they’d stop using plastic stirrers and straws by April 2020 (in line with a government ban that has since been delayed until October) and no longer purchase single-use plastic cutlery, plates or cups made of expanded polystyrene or oxo-degradable plastics by April 2021. They should also “go beyond” these commitments and cut back on disposable plastic food containers and lids.

But has the covid-19 pandemic knocked the ambition off-track? Footprint caught up with Amy Johnston, sustainability officer at Newcastle-upon-Tyne Hospitals NHS Foundation, to find out.

What has been going on across two hospitals in Newcastle – Freeman Hospital and Royal Victoria Infirmary – is impressive. Around 2m patient meals are served across two hospitals, while 340,000 people visit the restaurant at the Freeman every year. Breakfast used to be served in disposable bowls, as did soup and desserts. Cutlery was single-use, which patients didn’t really like. Now they have “real” cutlery and the bowls are reusable.

The result? Across the RVI there has been a 2m reduction in single-use items, including 513,600 polypropylene bowls, 490,800 polypropylene lids for those bowls, 312,000 polystyrene bowls and close to 600,000 pieces of cutlery. “All those items wouldn’t have been recycled because they would have been contaminated with food,” said Johnston, during Healthcare Without Harm Europe’s (HCWH) “Towards plastic-free healthcare” webinar last month.

Splashing out £12,000 on cutlery alone seemed a bit excessive, she admitted, but the savings from moving to reusables actually came in at £80,000 a year. She hasn’t costed in the energy and water use yet but the likelihood is that the bottom line looks much healthier than it did. “It’s not often you get a sustainable investment that pays back within two months”, she explained adding: “As one of the UK’s largest procurers and consumers of goods, the NHS has a responsibility to act wisely in how we use resources and dispose of our waste.”

Emailing Johnston after the event she explains how covid-19 has impacted the many food and drink packaging-focused initiatives under the foundation’s “Shine” (sustainable healthcare in Newcastle) programme. “At the start of the pandemic we stopped staff from using reusable cups in our two staff-only bistros [one located within the RVI and the other in an office block that houses the likes of the finance and HR teams] as the set-up there involves handing over your cup to a member of staff to fill with coffee. We are still not allowing reusable cups to be used in these areas, however people who turn up with their own cup still get the 25p discount.” There isn’t yet a timeline for when they will start allowing reusable cups to be used again: “[it] will depend on ongoing risk assessments.”

Something else on hold is the plan to remove disposable cups altogether from the office block bistro. “Once we pick this back up we will need to consider contingency measures for potential pandemics in the future, which we had honestly not considered up until this point,” Johnston explains.

However, at the Freeman Hospital in the restaurant (open to staff, patients and visitors) and in the coffee shop, reusable cups “could always be used as they have a coffee machine operated by the customer. There has been no change to the system because of covid-19.”

How about those reusable bowls and cutlery used on the wards? They have continued to be used throughout. “We have not switched to disposable plates and cutlery for our wards,” she says. “Catering staff wear appropriate PPE and the items are appropriately cleaned. This is the same system we use when we have a norovirus outbreak or flu. Although covid-19 is novel, having patients with infection at our hospital is not.”

The foundation has also continued using reusable plates and cutlery in the Freeman restaurant as normal. Johnston is also keen to point out that she is not anti-plastic – “not all single-use plastics are necessarily ‘bad’”. Indeed, within a hospital setting plastic plays a vital role in infection prevention, and patient comfort. “We have many medical instruments that rely on plastic. As a trust we are looking at reducing our single-use plastic where possible (including clinical and non-clinical settings), but I do not foresee a time when we would ban all single-use plastics.”

What is necessary is a wider discussion about single-use materials in healthcare. “I feel that there is too much focus on replacing one single-use plastic with another single-use item, says Johnson.” She highlights the considerable “disparity” across the NHS, let alone the public sector as a whole. “There are no clear targets for plastic reduction within the NHS and the NHS plastic pledge is voluntary. The NHS long-term plan included a commitment to reducing single-use plastics, but this is still relying on individuals to drive it within trusts.”

The conversation needs to be about “how we can change the way we do things” she adds, and the public plays a big role in this: the throw away culture has created the system we are in now. The public currently perceives plastic as the safest option but Arianna Gamba, procurement policy and projects officer at HCWH Europe, says this has been the “prevailing opinion in the healthcare sector for a long time, and has resulted in overuse of plastic – especially single-use or packaging”.

The Foodservice Packaging Association has reported a number of times that “sets of plastic cutlery that are wrapped and delivered in a totally hygienic and safe condition, are currently in huge demand, alongside single-use cups, plates, straws and bowls”. But healthcare workers are increasingly aware of the waste being created, says Gamba, and the chance to save money and improve resilience could spur interest in alternatives to single-use.

“This pandemic could actually be an opportunity for reusables to regain momentum, as many healthcare professionals have to adapt to shortages and be creative in their use of equipment without risking patient and employees safety,” Gamba explains. “…when people are doubting the safety of reusables because of hygiene concerns, healthcare practitioners could offer reassurance that for instance, using clean reusable cups is safe.”

Johnston says that to really reduce our reliance on single-use plastics, “we need to change the system”, but this doesn’t necessarily mean giving things up or going without. “[It] could be an opportunity to reassess priorities and create a more enjoyable eating/drinking experience.”

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