No assessment has been made.

Health Technical Memorandum 07-01: Safe and sustainable management of healthcare waste provides the principal National Health Service technical guidance, supported by the NHS Clinical Waste Strategy, statutory waste-duty-of-care requirements, and infection-prevention expectations.

Responsibility for the provision of clinical waste services rests with the practices and the local integrated care boards (ICBs), who will agree to the relevant contracts for its supply.

Through the implementation of the NHS Clinical Waste Strategy and the National Standards for Healthcare Food and Drink, NHS England is actively working to reduce both clinical and food waste across the system.

The Clinical Waste Strategy promotes appropriate waste segregation and treatment to minimise unnecessary incineration and environmental harm. Meanwhile, the food standards encourage healthcare providers to reduce food waste through improved planning, monitoring, and sustainable practices. It is widely accepted that any medication that is provided via clinical provision should be disposed of as offensive waste. Any unused food products that are still in their packaging can be disposed of through the agreed food waste system.

NHS England continues to monitor the implementation of these strategies and welcomes further evidence or insights that could inform future assessments or policy development in this area.

The information is not collected in the format requested. However, the National Health Service collects data for all of England in the Estates Returns Information Collection, which is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/england-2022-23

We do not hold the information in the format requested.

The Department does not currently hold this information. However, the national guidance for the National Health Service’s clinical waste strategy is available at the following link:

https://www.england.nhs.uk/long-read/nhs-clinical-waste-strategy/

Organisations across integrated care systems, such as NHS trusts, would have their own policies on how to enact this guidance.

The information requested is not collected centrally. Contractual decisions are made by individual trusts locally and the Department does not mandate terms of each contract.

As of 21 January, the UK has delivered 23.3m doses to countries in need of which 17.8m have been delivered via COVAX. A further 7.5m doses have been received by COVAX and will shortly be allocated and shipped in line with COVAX's fair allocation model. COVAX works with governments to monitor equitable distribution, allocation, and delivery of vaccines in line with National Deployment and Vaccination Plans and the World Health Organisation's 'equitable allocation framework.' We also delivered 5.5m doses on a bilateral basis. We are monitoring the distribution of these vaccines.

There are ongoing discussions at the OECD Development Assistance Committee (DAC) regarding how donations of vaccine doses should be reported in ODA in 2021. No decision has yet been made.

Avoiding vaccine expiry and wastage is a core UK objective, and determines when and where we share or deploy doses. Vaccines delivered by COVAX are delivered in consultation with recipient countries, and distributed in line with the World Health Organisation's 'equitable allocation framework.' For all bilateral donations, we have sought assurances from recipients that they have the capacity to roll out the quantity of doses offered in line with National Deployment and Vaccination Plans ahead of their expiry dates.

Avoiding vaccine expiry and wastage is a core UK objective in determining when and where we share or deploy doses. COVAX works with African governments, including Nigeria, Malawi and South Sudan, to monitor equitable distribution, allocation, and delivery of vaccines in line with National Deployment and Vaccination Plans and the World Health Organisation (WHO)'s 'equitable allocation framework'. For all bilateral donations, we have sought assurances from recipients that they have the capacity to roll out the quantity of doses offered in line with their National Deployment and Vaccination Plans and ahead of the vaccine expiry date.

We are working through the governing boards of Gavi and the World Bank to ensure funding available for in-country delivery is approved and disbursed in a timely manner. We are also working with COVAX, technical partners (WHO and UNICEF), bilateral programmes and the UK's diplomatic network to tackle immediate bottlenecks that can be addressed through focused funding, provision of equipment or technical assistance. We are aware of the recent media reports of large volume of expired vaccines in Nigeria. However, I can confirm that no UK-donated doses are among those expired.

The effective management of clinical waste is an essential part of ensuring that health and social care activities do not pose a risk of injury or infection. It encompasses several statutory areas, including infection control and health and safety legislation; environment and waste legislation; and transport legislation.

Health and Safety Executive (HSE) guidance on the management of healthcare waste advises dutyholders, including local authorities, to pay particular attention to:

• Managing the waste and ensuring compliance with legislation
• Types / classification of waste and how it should be safely stored
• Transportation of waste

Detailed UK wide guidance from the Department of Health and Social Care is provided by Health Technical Memorandum 07:01 Safe management of Healthcare Waste. This guidance provides a framework for best practice waste management to help healthcare organisations, and other healthcare waste producers, meet legislative requirements, identify opportunities to improve waste minimisation and reduce the associated environmental and carbon impacts of managing waste.

While this Health Technical Memorandum includes specific sections on sharps waste, HSE has also produced an HSE information sheet to assist employers and employees in complying with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013. This includes the requirement to have clearly marked and secure containers placed close to areas where medical sharps are used, and that instructions for staff on safe disposal of sharps must also be placed in those areas.

Medical waste is being disposed of in line with local clinical waste disposal arrangements. Through Local Resilience Forums, health and care leaders with managers of vaccine sites and other vaccines delivery facilities are working collaboratively with local authorities to ensure there is sufficient capacity for this essential function. All staff involved in vaccinating patients in all types of vaccination facility are fully trained in the vaccination process including the disposal of medical waste.

Defra and the Environment Agency are working closely with colleagues across government, including DHSC and PHE, and the waste sector to ensure that waste arising as a result of COVID-19 protection, testing, and vaccination is managed and disposed of safely.

Clinical waste and offensive waste are legally defined in The Controlled Waste (England and Wales) Regulations 2012. Other than general waste and any packaging waste, waste from Lateral Flow Devices (LFDs) and the testing process is classified as non-hazardous healthcare offensive and chemical waste ( https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-tests-waste-codes/waste-codes-for-mass-testing-with-lateral-flow-antigen-testing-devices). DHSC has confirmed that this waste does not present any increased risk compared with, for example, personal care waste. Assessments of the chemicals used in LFD tests have been made by DHSC and have confirmed that this waste should not be classified as 'clinical waste' and does not need to be managed as such. Waste management operations should continue to follow appropriate guidance for hygiene and health and safety practices.

Householders undertaking home COVID-19 testing using a LFD test kit should dispose of the LFD test kit, in its packaging, in their residual waste bin, in a similar fashion to home pregnancy test kits.

Where a number of tests are being undertaken at the same place (e.g. mass population testing sites, workplaces etc.), LFD wastes should be segregated in accordance with DHSC guidance above, to ensure efficient and safe management of this waste. This waste must be collected from the testing location by an appropriately licensed waste carrier, such as those providing washroom services, or a general waste contractor. This waste must then be either taken directly to a municipal waste incinerator temporarily permitted to accept this waste by the Environment Agency under a Regulatory Position Statement (RPS C23: Incinerating specified healthcare wastes at a municipal waste incinerator); or to a waste transfer facility that has demonstrated to the Environment Agency that they can store these wastes in a safe and controlled manner, and have been granted a temporary formal local enforcement position to safely store and then transfer these wastes to municipal waste incinerators.

Vaccination waste will be managed within existing healthcare waste management systems. Clinical waste handling remains a devolved matter under the respective health bodies. In addition, a four nation cross government working group maintains active monitoring of the waste flows being generated and resilience measures have been put in place to support NHS Test and Trace, the vaccination programmes and PPE waste flows.

Defra and the Environment Agency are working closely with colleagues across government, including DHSC and PHE, and the waste sector to ensure that waste arising as a result of COVID-19 protection, testing, and vaccination is managed and disposed of safely.

Clinical waste and offensive waste are legally defined in The Controlled Waste (England and Wales) Regulations 2012. Other than general waste and any packaging waste, waste from Lateral Flow Devices (LFDs) and the testing process is classified as non-hazardous healthcare offensive and chemical waste ( https://www.gov.uk/government/publications/coronavirus-covid-19-lateral-flow-tests-waste-codes/waste-codes-for-mass-testing-with-lateral-flow-antigen-testing-devices). DHSC has confirmed that this waste does not present any increased risk compared with, for example, personal care waste. Assessments of the chemicals used in LFD tests have been made by DHSC and have confirmed that this waste should not be classified as 'clinical waste' and does not need to be managed as such. Waste management operations should continue to follow appropriate guidance for hygiene and health and safety practices.

Householders undertaking home COVID-19 testing using a LFD test kit should dispose of the LFD test kit, in its packaging, in their residual waste bin, in a similar fashion to home pregnancy test kits.

Where a number of tests are being undertaken at the same place (e.g. mass population testing sites, workplaces etc.), LFD wastes should be segregated in accordance with DHSC guidance above, to ensure efficient and safe management of this waste. This waste must be collected from the testing location by an appropriately licensed waste carrier, such as those providing washroom services, or a general waste contractor. This waste must then be either taken directly to a municipal waste incinerator temporarily permitted to accept this waste by the Environment Agency under a Regulatory Position Statement (RPS C23: Incinerating specified healthcare wastes at a municipal waste incinerator); or to a waste transfer facility that has demonstrated to the Environment Agency that they can store these wastes in a safe and controlled manner, and have been granted a temporary formal local enforcement position to safely store and then transfer these wastes to municipal waste incinerators.

Vaccination waste will be managed within existing healthcare waste management systems. Clinical waste handling remains a devolved matter under the respective health bodies. In addition, a four nation cross government working group maintains active monitoring of the waste flows being generated and resilience measures have been put in place to support NHS Test and Trace, the vaccination programmes and PPE waste flows.

This year 31 containers of waste have arrived back in England. The containers, which were shipped to Sri Lanka in 2017, were found by the Sri Lankan authorities to contain waste described as mattresses and carpets exported for recycling. This is part of a shipment totalling 263 containers all of which are due to be returned to England soon.

Despite media reports suggesting that medical waste was illegally shipped from England to Sri Lanka, the Environment Agency (EA) as the competent authority for waste shipments for England, has not received any indication or evidence from the Sri Lankan authorities to corroborate those reports. Unless or until the EA receive such evidence to the contrary or come across it, it is the view of the EA that these media reports are incorrect and misleading.

The Environment Agency (EA) as the competent authority for waste shipments for England, is proactively engaging with the authorities in Sri Lanka regarding the 263 containers of waste being returned to England and is leading the investigation on this matter. Despite media reports suggesting that medical waste was illegally shipped from England to Sri Lanka, the EA has not received any indication or evidence from the Sri Lankan authorities to corroborate those reports. Unless or until the EA receive such evidence to the contrary or come across it ourselves, it is the view of the EA that these media reports are incorrect and misleading.

With 31 containers now back on English soil, EA enforcement officers will seek to confirm the types of waste shipped, who exported it and the producer of the waste. Those responsible could face a custodial sentence of up to two years, an unlimited fine, and the recovery of money and assets gained through the course of criminal activity.

There are 57 male toilets in the Palace of Westminster. Currently only one male toilet - in the House of Lords ground floor cloakroom - has a disposal bin; however the bins are generally only provided if requested. We have not to date received any requests for bins of the sort specified, but would be happy to respond if made aware of any demand.

It is prohibited to export hazardous waste from the UK to countries, such as Sri Lanka, which are not members of the Organisation for Economic Cooperation and Development (OECD). The export of non-hazardous healthcare wastes for recycling to countries outside the OECD is permissible when following a prior written notification and consent procedure, and would require the consent of the competent authorities in the countries of import and export prior to shipment. No such consent has been issued in respect of exports of healthcare wastes to Sri Lanka.

The UK environmental regulators take a proactive, intelligence led approach to checking compliance with the legislation, targeting exports which pose a high risk and intervening to stop illegal exports. In 2017/18, the Environment Agency issued 158 stop notices, prohibiting the export of unsuitable waste. It stopped 367 containers of waste destined for illegal export at ports and intervened further upstream to prevent 8,974 tonnes of waste from reaching our ports. Any UK operators found to be illegally exporting waste can be fined and/or imprisoned for up to two years.