Exclusive: Officials admitted clinical waste incineration shortage

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NHS Improvement and Environment Agency officials have previously privately acknowledged problems with England’s incineration capacity
Healthcare Environment Services says it will take legal action against trusts which cancelled contracts
Company’s director says other firms have increased incineration prices further
Temporary waste storage units outside hospitals ’pose a risk to public health’

National officials have privately acknowledged there may be a shortage of incinerator capacity for burning clinical waste – contrary to the government’s public assertions this week – documents seen by HSJ show.

Documents seen by HSJ show an NHS Improvement chief noting a “national market capacity issue” in August, while a senior Environment Agency officer admitted in May there were “unprecedented challenges” with hazardous waste incinerators.

On Tuesday, health minister Stephen Barclay dismissed claims by Healthcare Environment Services that a huge clinical waste backlog at its sites was caused by a reduction in incineration capacity.

Mr Barclay told the Commons: “There is significant additional capacity within the incinerator landscape to process the waste generated by this contract, and therefore the suggestion in some quarters that this is an issue of a lack of capacity is simply not valid.”

However, at a meeting of NHS officials in August, Fiona Daly, national sustainability lead at NHS Improvement, “acknowledged there appeared to be a national market capacity issue”, according to minutes obtained by HSJ.

The minutes also state that the meeting, also attended by officials from NHS England and the Environment Agency, “agreed that there was longer term issues to address around waste management” including “further investment to increase national capacity and changes in the approach to offensive waste”.

And in May, Paul Fernee, a senior advisor on hazardous waste for the Environment Agency, wrote in an email that he was “aware of the unprecedented challenges we have with hazardous waste incinerators at this moment in time”.

Garry Pettigrew, managing director of HES, told HSJ: “The only thing we’re guilty of is storing waste above our permit levels, which is a consequence of the problems with incineration capacity that we’ve been highlighting for the last few years.”

A spokesman for the Environment Agency said there is “industry-wide agreement” that there is enough capacity to deal with clinical waste. “Our site inspections show the rest of the sector is performing well,” the spokesman said.

The backlog prompted the government to order the termination of contracts held between HES and 15 NHS trusts last week. Mr Pettigrew told HSJ the company would take legal action against these trusts because, he insists, it has not breached any contract terms.

Mr Pettigrew also criticised other waste management companies, whom he said claimed increased prices for incineration since HES’s difficulties came to light.

He called the government’s contingency plans – which include installing temporary storage units at hospitals – “a nonsense”, and claimed they posed a larger risk to public health than continuing to let the company transport waste to sites which have breached permitted levels.

A spokeswoman for the Department of Health and Social Care said the accusation was “baseless” and “false”, adding the Department for Environment, Food and Rural Affairs “estimates that annually there is more than 30,000 tonnes of spare capacity in the system, and that there is significant capacity over and above that required by HES to perform its contract”.

Waste contracts were ‘jewel in crown’ for region’s procurement

HSJ spoke to Mr Pettigrew about his account of the situation yesterday, which includes criticism of the government’s handling of it.

The terminated contracts were won by HES in 2010 and relate to 15 trusts in the Yorkshire and Humber region.

The procurement was run by North of England Commercial Procurement Collaborative, which hailed the deal as a “jewel” in its “crown” as it would save the NHS millions of pounds during the ten-year contract.

Mr Pettigrew said HES carried out the service without problems until 2015, when NHS trusts began to re-classify some clinical waste as “offensive”, which meant it needed incineration.

This caused a surge in demand for incineration, and coincided with a shortage of incineration capacity – caused by a lack of investment in infrastructure and a focus on zero- landfill waste policy, Mr Pettigrew said.

‘No room at the inn’

Between 2017 and 2018 there was a 62 per cent drop in the tonnage of waste accepted by companies running incinerators from HES, according to HES’s figures.

Mr Pettigrew said he warned the Environment Agency in October 2017 of the company’s problems, and in February this year sought a permit to expand HES’s Normanton site’s maximum waste storage level from 70 tonnes to 250 tonnes.

But the request was rejected by the EA, which told him that would not solve the excess waste problem.

Mr Pettigrew told HSJ he repeatedly told the EA that other waste management companies were not able to offer incineration capacity because there was “no room at the inn”.

Companies take steps to cash in on the problems

This autumn, after Matt Hancock chaired a COBRA meeting about the problem, NHSI and EA contacted other companies to ask if they had capacity to burn HES’s excess waste.

According to Mr Pettigrew, some of the companies then dramatically increased the prices of incineration when approached by HES again. He cited one example where the cost per tonne rose from £420 to £1,000.

“If we did what the government wanted us to do, we would have been put out of business,” Mr Pettigrew said. “It would have cost us £300,000 to get rid of the extra waste at Normanton alone.

“Companies were offering the same capacity as before, but at a much higher price.”

He said the government’s contingency plans, for which £1m has been set aside, posed a greater public health risk because temporary containers which it proposes to use are not suitable to store waste in.

Hazardous and non-hazardous waste are stored together, and the amounts taken away from hospital are smaller than HES’s service, he said.

“We’ve had people at hospitals getting in touch with us after they stopped our contract saying their waste is piling up,” Mr Pettigrew said.

“The NHS used to pay around £450 per tonne, but it is now paying up to £1,000 – that’s taxpayer’s money.”

Meanwhile, the company has been ordered to take its excess waste to seven other sites.

“Some of the places they are displacing this waste to are too small, and so that waste will be sitting at those sites for four months,” Mr Pettigrew said.

He said the company planned to remove the excess waste by using its new incinerator at its Scottish headquarters, which opened in April. HES continues to transport waste to other incinerators which Mr Pettigrew said were lower.

Trusts face legal action

He vowed the company would continue to provide the rest of its contracts to the NHS, which includes more than 30 other trusts in England, and a waste disposal contract with NHS England for primary care and pharmacy.

“We will fight the termination of contracts because we’ve not breached the terms. It’s a straight-forward one for us,” Mr Pettigrew said.

“It will be [legal action] against each trust because they all held individual contracts with us.”

The 15 trusts are all in Yorkshire and the Humber and contracted with HES in 2010.

NHS Improvement has been approached for comment.

Another waste management provider, Stericycle, said on Friday it would help reduce HES’s backlog but warned it could not commit to processing all the waste in the UK.