SUSTAINABILITY IN THE NHS Product Gloves


All Trusts All users Top 10


Glove Dispenser


All Trusts All users


Reduction (%)


30% 15% 30% 10% 10%


Procurement saving


£18,335,905 £24,150,000 £3,557,462 £6,111,968


£16,100,000


Plastic reduction (Tonnes)


3,587 4,725 696


1,196 3,150


Waste saving (£)


£1,076,238 £1,417,500 £208,808 £358,746 £945,000


Table 1: Potential cost and carbon and savings via the Glove ‘MOOC’ and glove dispenser pilot.


gloves across the health and social care sector across England would bring a £24 m saving, and a 27,000 tonne carbon reduction. His team was now piloting a new dispenser – from which the user simply pulls the glove out, cuff first, from the bottom of the unit, puts it on, and then pulls out the next one. He said: “The dispenser only dispenses one glove at a time – rather than five dropping onto the floor, and the user then putting four of them in the bin.” Paul Chivers said the indications were that such a dispenser could reduce waste by about 10%, equating to a year-on-year financial saving of another £16 m. He added: “In fact the 15% figure is probably higher, because Great Ormond Street achieved that 33% reduction before the pandemic, and there is probably a lot more glove wearing now. So, that’s a 27,000 tonne potential carbon reduction via the Glove MOOC, and an 18,000 tonne saving from the dispenser.”


Reusable mask being piloted Turning to the team’s ‘other achievements’, he said: “As Becky explained, we have identified a reusable Type IIR mask – which is currently being piloted in an acute setting at the Royal Devon & Exeter Hospital in Exeter, and we’re also looking at doing a community pilot – because community settings don’t readily have access to compliant laundries. We’re thus going to the laundry to try and make it compliant. This doesn’t, however, entail thousands of pounds’ worth of capital investment, but rather it’s about their processes, and making sure that they have got a quality management system in place. They have all the infrastructure and equipment, but we need to make sure they can be compliant with HTM 01-04, so we can ensure that these masks are laundered safely. They’re not allowed to be laundered at home, because they are classed as medical devices.”


‘‘


Reusable eye protection Paul Chivers said the team was also working with Bollé on developing reusable eye protection, with the eyewear specialist designing and making a product specifically for health and care. He explained: “Bollé came to a lot of meetings with us, discussing the possible production of suitable reusable eye protection. It’s in fact a very smart development; we have seen four prototypes so far, and they look like cycling glasses. Designed to last at least two years, they’re scratch and fog- resistant, but we are currently looking at how we clean and decontaminate them safely.” The standard for eye protection, the


speaker explained, is EN166. Paul Chivers said: “At the moment, we know people use wet wipes – some of which are harsher than others – to clean eye protection, and that some are damaging the seals that are incorporated for the aerosol-generating procedures.” Meanwhile he explained that he was due to meet later in the week with the Health and Safety Executive, to discuss some test scenarios for the Ozone cabinets, UVC cabinets, and hypochlorous acid sprays and cloths for cleaning masks, and the protection that the team was looking into.


P3 mask decontamination guidance He continued: “I can’t take any credit for the P3 mask decontamination guidance that has been produced and signed off. Recently, Sulisti Holmes, head of Decontamination and Incident Reporting at NHS National Services Scotland, has undertaken a lot of testing with P3 dust masks, which I believe came from a building site, and are much used in heavy industry and construction. However, they are also now being quite widely used in healthcare, because people don’t like the FFP3, and you get a better chance of a Fit Test with them.” Paul Chivers noted that


If you have a product or a novel idea, or want to manufacture something new in the way of, say, a reusable mask, and don’t know whether it’s PPE, or a medical device, you don’t really have anywhere to go to get that advice and guidance


18 Health Estate Journal March 2023


there was currently no specific cleaning requirement in the standard (EN140 mask and EN143 filter) for P3 masks. He said: “You can wear one for four hours. You’ll sweat in it a lot, and will have condensation and saliva in it. You can then wipe it with a wet wipe, go on holiday for two weeks. and hopefully when you come back and put it on, it might be clean.” This was, he said, “all part of the conversation with HSE” – ‘what is a good way to clean and decontaminate these products to make sure they’re safe and clean for users to use?’


His next topic was the development of a Decontamination catalogue, which he noted had been discussed ‘for a long time’. He said: “We’ve got many different health and care settings across the industry, and one size will not fit all. While the Decontamination guidance works on a washer-disinfector, many staff won’t have access to one, so it’s about looking at alternatives. While some UVC decontamination cabinets are compact, and work well for masks, in, say, a dental surgery, whether these will be effective for masks in a large acute healthcare setting is part of testing that we want to do.”


Recycling Here Paul Chivers turned to recycling of PPE. He said: “So we’ve done the ‘reduce’ and the ‘re-use’, and we then have the ‘recycle’ part. The people making these products will be taking them away at the end of their life; they will not be classed as waste. Thus, if the mask has been washed 40 times, it will be going away for assessment and reprocessing.” He added: “Sometimes they’re made into blackout blinds, sometimes into mattresses for homeless people, and sometimes they’re shredded and made into other materials. Bollé also works with a recycling partner, and they will take away the products as well.” Looking at some of the potential benefits of the team’s work, Paul Chivers said: “We saw the sort of procurement savings you’d get from the glove reduction. Looking at re-use, and in terms of the Type 11R masks we currently use, you’d save 5,184 tonnes of plastic going into waste, and – working on a £300 / tonne disposal cost – also save over £1.5 m,


Carbon reduction (Tonnes)


20,728 27,300 4,021 6,909 18,200


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