SUSTAINABILITY IN THE NHS Product TIIR Aprons All users
Pre-COVID All
Visors All users Pre-COVID
Reduction (%)
80% 80% 80% 80% 80%
Plastic
reduction (Tonnes)
5184 1620 3264 541 80
Waste saving (£)
£1,555,200 £486,000 £979,200 £162,240 £24,000
Carbon
reduction (Tonnes)
11,520 3,600 9,792 833 24
Table 2: Carbon, waste, and cost-saving benefits of reusable masks, visors, and aprons.
looked down in the course of their work, and Paul Chivers said many existing P3 respirators incorporated sizeable filters on the front, which not only ‘got in the way’, but were also heavy to wear. He said: “Some clinicians can wear one for half a day, and then they get neck ache, and then they go back to the disposable.” The other key element on this mask, however, was how it could be optimally decontaminated, and what level of decontamination would be required. The speaker said he hoped to get some ‘steer’ from the HSE at his meeting with them.
Powered hoods Powered hoods were another area being looked at. Paul Chivers stressed that he would not put a single product into a pilot, and thus onto a healthcare worker’s face, head, or body, until it had been certified. The team thus uses an independent body – currently Surgical Materials Testing Laboratory in South Wales – to provide validation that products submitted are indeed compliant.
Need for funding The speaker said: “Going on to the next point, if people want sustainability and
innovation in the NHS, then education and behavioural changes are also needed.” Expanding on this, he said: “If I ask somebody to don a mask that I wore yesterday, which has since been through the laundry, about a third of people will be happy to do so, a third will ask how and when it was last cleaned, and a third will just say ‘no’.” A part of getting the message across thus needed to be about explaining that the mask in question had been through an approved process. The same would apply to both the P3 masks and the eye protection.
Support for specific health and care specifications and standards The fact that there was no cleanliness standard in EN166, or in EN140 and EN143, pertaining to reusable masks and filters, made it very difficult for manufacturers to know what challenge to put such devices against, and therefore to recommend the products to clean them. Paul Chivers said: “For example, when the visors first emerged, some were deemed ‘reusable’, and somebody asked how to clean them. One answer given was: ‘You run it under a tap for five minutes and air-dry it.’ However, we don’t have many hospitals
with clothes lines in a corridor, and at the end of the shift, you are not going to get clinicians and healthcare workers joining the queue for the sink to wash their visor.” It was thus, he said, ‘about having
appropriate processes that actually return something that’s safe’. The speaker said: “So, part of my conversation with the HSE will be about whether we can have health and care ‘specs’. They don’t take that long; we created the transparent facemask specification back in April last year, and it took just two months.”
Group sessions on the ‘MOOC’ Turning to ‘business as usual owners’ (or BAUs), Paul Chivers reiterated that the MOOC he had earlier referred to was ‘live’, and ‘up and running’, and that his team facilitated group sessions on it. He said: “If people have good case studies, we will upload them and make them live. Improved communication across organisations, meanwhile, was touched on again today. There needs to be a central repository of data about what people are doing – pilots and trials for instance, so that people can share both their learnings and any mistakes, for others’ benefit. It’s something we talk about, but the health service isn’t great at having a central contact point and a central communication channel.”
What are the next steps? The last part of Paul Chivers’ presentation looked at ‘the next steps’. He said: “We are a temporary team stood up during the pandemic. We need to confirm the test scripts for the decontamination using ozone, UVC, and hypochlorous acid.” These were the ongoing conversations he and his colleague were having, so that it could be recognised what testing both the team, and suppliers, needed to undertake to demonstrate that each product is safe with the various components the team wants to put through it. He said: “We want to pilot the renewable
eye protection using Ozone and UVC; we will choose two sites, installing an Ozone cabinet on one, and UVC on the other. We can then start to put them into a pilot to demonstrate that they’re safe, and get some user feedback, and all the other data too.” Paul Chivers explained that the
An example of protective eyeware manufacted by Bollé. 20 Health Estate Journal March 2023
team also needed to develop reusable transparent masks, although it already has seven compliant single-use masks, having worked across the four nations and various manufacturers to reach this stage – i.e. meeting the transparent face mask specification on the
gov.uk website, and the Essential Health and Safety Requirements of the MHRA. He said: “Although these transparent masks are quite expensive compared with a single-use mask, if we can make them reusable, the cost per use comes down,
Credit: A Childeric Bollé Safety
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