INSTRUMENT STERILISATION AND DECONTAMINATION
Right: Paul Chivers wearing the Hello Face transparent respirator and Bollé eye protection.
Far right: A typical washer-disinfector for hospital use.
Paul Chivers
Paul Chivers was the head of PPE Reuse, Innovation and Sustainability at the Department of Health & Social Care and the NHS Supply Chain through the pandemic, and managed the development of the Transparent Face Mask (TFM) Specification, (EN14683-2025). He supported nine companies in achieving compliant TFMs, trialled the first ever reusable Type IIR mask, and the design, development, and launch, of the online Glove MOOC (Massive Open Online Course). A frequent presenter at national and international conferences on sustainability and innovation, he is now an independent consultant at PCC Sustainable Solutions, who works with organisations including Bollé Safety, Envirosmart, Mackwell Health, Hello Face, and Brighton and Sussex School of Medicine (BSMS), At the latter he is managing a number of studies ‘evidencing the benefits of innovation for wider adoption’, and is also involved in work to demonstrate improved environmental cleaning, ‘to reduce CO2
e, waste,
spend, and hospital- acquired infections.’
that there is no standard for the cleaning of eye protection or respirators in health and care settings, reprocessing PPE is much simpler, but is it safe enough?
Wiping with wet wipes Currently, wiping PPE with wet wipes is still common practice, despite no evidence of the efficacy of wet wipes on silicone, rubber, and soft materials. This is an area where I and PCC Sustainable Solutions continue to press for a relatively simple amendment to the standards for reusable PPE to include a cleanliness level. This would provide clarity for manufacturers, to allow consistent and appropriate testing to evidence that the cleaning and disinfection in their Instructions for Use (IFUs) meets the standard. The suggested products and standards include half-face respirators (EN140, EN1827), and, for eye protection, EN166. This is timely given the drive for sustainability and more reusable PPE, as stated in the PPE Strategy8
near-shore production for future pandemic preparedness, alongside the Greener NHS Net Zero plan,9
in 2022, for more reusable PPE from on- or also
launched in 2022, to reduce the NHS carbon footprint to Net Zero by 2040 and 2045. It also supports the Waste Strategy,10
launched by the NHS on 7 March
2023, where £11 m annual in revenue savings should be achieved if successful.
Detailed SOPs In fact, given the lack of a standard, the work that I undertook, to integrate devices and processes, with Hello Face respirators, Bollé Safety eye protection, Mackwell Health UV-C, and Rollins Consulting, to adopt the cleaning and disinfection developed for reusable MDs provides a safe, reusable product. This includes detailed SOPs and training material, with reprocessing record cards, and HSG 53 records for compliance to monthly inspections of the respirators. Collectively, this enables the move to safe, sustainable high-quality PPE. The Hello Face P3 Protect, and soon-to-be transparent Hello Face P3 Connect respirators, are currently in use in NHS Trusts trials, and for user/patient feedback to reduce the use of single-use visors and FFP3s. Given that reusable products pay for themselves in
less than a month, typically last 2-5 years, and address poor fitting and poor quality compared with many single use devices, they have many clear benefits, yet despite learnings from the pandemic and the ongoing COVID-19 enquiry, there remains much more to be done to move away from single-use products and PPE. With the success of the trials, and more ongoing – including on other medical devices and PPE, combined
66 Health Estate Journal June 2025
with the significant reduction of the UV-C cycle time from 20 minutes to 5 minutes within a year from first certification, the time appears ready to deploy more certified UV-C to reprocess MDs requiring HLD. This will ease pressure on SSDs, reduce reprocessing costs, and significantly cut CO2
of MDs and other devices. The UV-C cabinets are ‘plug and play’, and lightweight, with the Minibox weighing 7 kg, and a cycle costing £0.10, compared with a WD cycle costing £1.72.2
e, while potentially extending the life This work will also build confidence
that other devices can be safely reprocessed, as has been the experience in site trials, where people have asked, ‘What about this or that device?’ In the mid- to longer term, undertaking further testing and analysis of the cleaning of devices using innovative equipment, to then subject them to UV-C for disinfection, rather than WDs or autoclaves, could go a long way to reducing power and water consumption across the NHS. Equally, looking at the option of sterilisation with UV-C would also prove beneficial from a capacity, cost, and environmental standpoint. Given the recent rapid advancements in LED UV-C technology, which are ongoing, and will improve along a similar trajectory to when fluorescent lights and normal light bulbs were replaced by LED lighting, is UV-C, certified to the appropriate standard, about to revolutionise decontamination, and – ultimately sterilisation?
References 1 Rizan C, Lillywhite R, Reed M, Bhutta MF. Minimizing carbon and financial costs of steam sterilization and packaging of reusable surgical instruments. Br J Surg 2022; 109(2):200-210.
2 Energy Trends and Prices statistical release: 22 December 2022. Department for Business, Energy & Industrial Strategy.
https://tinyurl.com/yf56c5vr
3 In accordance with ISO15883 series. 4 As defined in the Spaulding scale. 5 BS8628-2022 – Disinfection using ultraviolet radiation. Methods for quantitative testing of automated ultraviolet disinfection activities by direct illumination. Determination of bactericidal, mycobactericidal, sporicidal, yeasticidal, fungicidal, virucidal and phagocidal activities. https://tinyurl. com/mw9he3dj
6 NHS Supply Chain FOI for 2023/24. 7 Eco Medic
https://www.ecomedic.co.uk/ 8 The Personal Protective Equipment at Work (Amendment) Regulations 2022.
https://tinyurl.com/yfr9dxrv
9 Delivering a ‘Net Zero’ National Health Service. NHS England, 4 July 2022.
https://tinyurl.com/2wbprwmz
10 NHS clinical waste strategy. NHS England, 7 March 2023.
https://tinyurl.com/yfhasfyy
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