20 January 2021 by James Langley

NHS updates Covid-19 waste advice for healthcare facilities

The NHS published the fourth version of its briefing on standard operating procedures for managing Covid-19 waste from healthcare facilities on 18 January. 

The document sets out the waste management approach for all healthcare facilities in England, including primary care facilities and testing facilities. The most recent update includes information on how to handle waste from vaccinations and lateral flow testing.

The NHS document sets out the Covid-19 waste management approach for all healthcare facilities in England (picture: Shutterstock)

The document’s introduction reads: “A simple and pragmatic approach will be implemented to ensure that waste is managed in a safe manner and critical waste disposal resources are not exhausted during the Covid-19 emergency response. 

“We need to work together across organisations to collectively deliver waste management services during this period of expanded demand.” 

The document can be read in full here. 


According to the document, vaccination waste from hospitals or GP surgeries should be classified 18-01-03* o18-01-09, while vaccination waste from vaccination centres, the community and care homes should be classified 18-01-01 or 18-01-09.

According to the document, vaccination waste from hospitals or GP surgeries should be classified 18-01-03* or 18-01-09 (picture: Shutterstock)

This means it is non-hazardous and can be moved with a Duty of Care Note and without a consignment note. 

Sharps waste is non-hazardous but must still be disposed of at a hazardous waste or clinical waste incinerator or other suitably permitted facility. 

The NHS document says theft of the vaccine’s outer packaging poses a significant security risk and it must be destroyed through the confidential waste stream. 

All personal protective equipment (PPE) must be consigned as offensive waste no matter the site of vaccination delivery. 

Lateral flow testing 

Lateral flow antigen tests are used to try and identify a higher proportion of asymptomatic people. Lateral flow devices do not require a laboratory to process the test.

Prime minister Boris Johnson looking at a sample at a lateral flow testing laboratory in November 2020 (picture: Alex Gakos, Shutterstock)

The NHS document contains guidance for sites conducting lateral flow testing. It explains what types of waste institutions such as universities, schools and care homes should classify as offensive, chemical, domestic or recyclable. For example, schools with waste swabs and cartridges should consider them chemical waste and place them into an unmarked yellow bag. 

Healthcare professionals are instructed to follow their healthcare establishment’s waste management policy. 

Letsrecycle.com was advised last week that waste management contractors and similar businesses handling waste items from coronavirus testing in schools may be able to store the material before moving it on for disposal treatment (see letsrecycle.com story). 

Healthcare settings 

As in previous versions of the document, the NHS has provided general advice for how healthcare settings should deal with Covid-19 waste. 

The Advisory Committee on Dangerous Pathogens designates waste arising from Covid-19 patients as infectious clinical waste (EWC code 18-01-03*). It must be packaged in UN-approved orange bags in accordance with the safe management of healthcare waste (HTM07-01). The transport categorisation for this waste is Category B. 

Sharps and pharmaceutically contaminated items should continue to be segregated into appropriate containers sent for incineration and not enter the orange bag stream. 

All outer packaging must be removed and recycled before an item is taken to any ward or clinical area. 

All confidential waste must be put into confidential bins. 

More specific advice is included for hospitals, primary care services, NHS ambulance trusts, and clinical staff working in people’s homes is also included.  

Related links 

NHS COVID-19 waste management standard operating procedure version 4


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