OPINION: If we’re serious about a circular economy, we need to move beyond asking people to do better and create systems that make better choices feel like the only option.
I’ve recently spent a lot of time in hospitals, and while my professional background is in waste and resource systems, this visit was personal. I’ve spent years working on resource efficiency and circular economy systems across sectors, but seeing the disconnect up close in a healthcare setting – where so much else is so well organised – was striking. It reminded me just how much I – and so many of us – owe to the NHS. That’s exactly why what I saw was so frustrating. In a service under immense pressure, we can’t afford to waste resources unnecessarily.
While walking the corridors of two different NHS hospitals, I couldn’t help but notice the bins. Or rather, the absence and misuse of them. In one ward, the only option available was a yellow-lidded clinical waste bin, despite the contents being general rubbish like plastic bottles and coffee cups. In another, there was a single clinical bin full of paper towels positioned beside a sink. Elsewhere, no bin at all.
It’s not that NHS staff don’t care about waste, but waste management simply isn’t a priority in these high-pressure environments – and rightly so. The focus should always be on patient care. But that doesn’t mean we can’t design systems that make better choices easier. If choosing a bin takes even a second of mental effort in these high-pressure environments, it’s already too complicated.
Currently, it feels as if clinical waste bins have become the default option – a kind of “catch-all”. That may be convenient, but it comes at a cost.
NHS England generates around 600,000 tonnes of waste a year, including 156,000 tonnes of clinical waste. According to a 2023 NHS England report, up to 60% of that clinical waste could be reclassified. With the right systems in place, it could instead be managed through less carbon-intensive and more cost-effective routes. In other words: we’re spending more to do worse.
Clinical waste disposal is often up to five times more expensive than general waste, placing unnecessary financial strain on Trusts. It also puts pressure on specialised disposal services, creates unnecessary carbon emissions, and normalises practices that run counter to the NHS’s own Net Zero ambitions. Addressing this through better segregation and infrastructure would be a tangible, low-barrier way to support the goals outlined in the NHS’s “Delivering a Net Zero Health Service” strategy.
Simpler Recycling may have already been implemented in some areas, but not all, and rollout continues. In one of the hospitals, there were clear attempts to support recycling in communal areas. In the other, it seemed like an afterthought – or hadn’t happened at all. That inconsistency reflects a deeper issue: from what I saw, there is no unified, systemic approach to resource management across NHS settings.
If we want circularity to work in healthcare settings – really work – we need to focus more on designing systems where the sustainable option is the obvious one. That means integrating waste infrastructure seamlessly into clinical workflows. It means thinking beyond the bin. And it means treating resource management as something that supports, not distracts from, frontline care.
I don’t claim to be a clinical waste expert – and I’m no doctor – but even as an outsider, some opportunities seem obvious. Could more consideration go into how bins are placed in communal areas or near patient bays? Clear, standardised signage could reduce confusion around what goes where. And could procurement processes be adapted to ensure that clinical bins aren’t the only default simply because they’re the only ones provided? These changes wouldn’t require major reforms – just a mindset shift that treats resources and waste as a systems challenge, not an afterthought.
Resource and waste management may not be the most urgent issue the NHS faces, but it’s one of the few that touches every corridor, every ward, and every person whether staff, patient, or visitors. Improving the system wouldn’t just reduce cost and environmental impact; it would make life easier for the people who work so hard to keep everything else, including us, up and running.
Because in the end, the best systems don’t ask for attention. They just work.
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