Managing pharmaceutical waste

Defining pharmaceutical waste

Pharmaceutical waste is medicines that cannot be returned or reused. It includes medicines that are out-of-date, damaged, no longer required or unsuitable for their intended use. In addition, it includes part-filled and empty medicine containers.

Identifying types of pharmaceutical waste and disposal containers (SPS page) contains further information on specific types of waste.

Legislation and guidance

Healthcare settings must ensure that pharmaceutical waste is disposed of or destroyed in a safe and secure manner. This should be in accordance with legislation, regulations, and organisational policies or procedures.

NHS England

There is both legislation and regulation that underpins how healthcare waste (including pharmaceutical waste, sometimes called ‘medicinal waste’) should be handled, including the use of approved containers. This is summarised in NHS England’s Management and disposal of healthcare waste (HTM 07-01).

Royal Pharmaceutical Society

The Royal Pharmaceutical Society’s Professional guidance on the safe and secure handling of medicines covers all potential activities that are associated with the handling of a medicine, from obtaining the medicine through to use and the disposal of any waste.

Environment Agency

The Environment Agency has further guidance on healthcare-related waste.

Disposal principles

NHS England’s clinical waste strategy supports NHS providers to deliver sustainable waste management.

Pharmacy services need to consider these principles wherever possible, while keeping the nature of pharmaceutical waste in mind:

• reduce
• reuse
• reprocessed
• renewable
• recyclable

Ultimately, all pharmaceutical waste is for incineration. To reduce our carbon impact, it is important to ensure only pharmaceutical waste is classified as such.

The NHS is committed to reducing its carbon footprint. NHS England’s Delivering a ‘Net Zero’ National Health Service gives more information on the interventions that can be taken on inhalers and anaesthetic gases.

Handling pharmaceutical waste

The following practical considerations should be taken into account when handling pharmaceutical waste.

Wearing appropriate personal protective equipment (PPE)

Following a local risk assessment, gloves and an apron may be deemed necessary PPE when handling pharmaceutical waste.

Segregating waste

There is a requirement to segregate pharmaceutical waste into hazardous and non-hazardous waste. Where it is unsafe or not possible to do so, it should be consigned as mixed hazardous and non-hazardous waste medicines. The relevant European Waste Catalogue (EWC) codes (available from the Environment Agency) for each type of waste should be included on the consignment note.

There is usually no requirement to segregate different types of formulations, for example tablets from liquids. Some waste contractors will require that medicines in aerosol form must be segregated. If this is not done, the presence of aerosols must be identified on the accompanying waste documentation.

Disposal containers

Pharmaceutical waste must be placed in a leak-proof container, which has been UN-approved for liquids.

The container should be clearly labelled to identify the waste type using a black permanent marker pen before filling.

The container must not be filled beyond the fill line. Once the container is filled, it should be securely sealed and the appropriate consignment note completed.

Storing pharmaceutical waste

Pharmaceutical waste should be dealt with promptly to avoid accumulation. Ideally it should be disposed of where it is generated.

If pharmaceutical waste is not disposed of immediately, it must be stored securely until it can be further managed. This also applies to containers in use.

Transporting pharmaceutical waste

This applies to waste that is in the disposal container.

Only licensed carriers can transport pharmaceutical waste. Ideally pharmaceutical waste should be collected by the licensed waste contractor from the site where it is generated.

Pharmaceutical waste created away from the registered site

Healthcare workers are responsible for managing the waste generated from treating an individual. For example, when administering an injection to an individual in their own home, the sharps waste should go into the sharps bin held by the healthcare worker.

Every healthcare organisation whose staff generate and transport waste off-site must register with the Environment Agency as a waste carrier. Lower Tier Registration applies where the organisation only transports waste it produces itself. Direct employees of an organisation registered with the Environment Agency are covered; organisations will need to consider the position of agency or non-directly employed locums or other non-directly employed staff depending on the contracts in place. Contractors must register in their own right.

Working with waste contractors

The organisation producing the waste bears the legal responsibility of ensuring that waste documentation is complete and accurate.

There are two different types of documentation required for pharmaceutical waste:

• waste transfer notes for non-hazardous waste
• consignment notes for hazardous waste

Both the consignment note and the waste transfer note require the wastes to be listed, together with the six digit EWC (European Waste Catalogue) code(s) (available from the Environment Agency).

The organisation producing the waste is legally required to correctly describe the waste produced, including appropriate codes. Waste contractors may supply pre-printed consignment or waste transfer notes.

Record retention

Stock handling, waste and recall records in pharmacy (SPS page) contains further information regarding record retention.

Patient-generated pharmaceutical waste

The following advice supports the management of pharmaceutical waste that has been generated by patients themselves.

Unwanted medicines

Patients, relatives or carers should be encouraged to dispose of unwanted medicines by returning them to a community pharmacy in their original packaging. See the disposal of unwanted medicines service specification, available from Community Pharmacy England.

Sharps waste

Sharps generated from an individual self-administering in their own home should be managed by the individual.

Managing sharps contaminated with pharmaceutical waste (SPS page) contains further information.

Illicit substances

Occasionally, pharmacies may receive illicit substances for disposal. Where this is considered pharmaceutical waste, this guidance may be followed in line with local standard operating procedures (SOPs). Appropriate documentation should be kept and organisations might want to use their controlled drugs register. Local policies on when to involve the police should also be followed.

Where this waste is not considered to be pharmaceutical waste, it is suggested that the organisation’s waste manager is contacted. Alternatively, the local council waste department may be able to assist.

RPS Greener Pharmacy Guide

This article relates to the RPS Greener Pharmacy Guide domain: Resource Use; Level 2 (Silver); Ensure effective segregation of all waste.

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