Why would you make something that you’re going to use for a few minutes out of a material that will last forever?

It’s an interesting question, and one that many people will be pondering this July. Plastic Free July® is a global initiative that helps millions of people be part of the solution to plastic pollution. It’s run as a challenge, to ask people across the world to think about what single-use plastics they’ll cut out of their daily life, by simply avoiding them or by choosing durable, reusable alternatives.

For everyone who works in primary care, this is something that we’ve all been trying to do for a while now. According to NHS Providers website, the percentage of plastic waste in NHS waste streams is significantly higher than other industries, with plastic making up 22.7% total of all waste, with 13.7% being plastic film and 9% being hard plastic. The really startling fact is that, whilst the NHS disposes of around 133,000 tonnes of plastic each year, only about 5% of this plastic waste being currently recovered and recycled. Back in 2019 the NHS did run an NHS Single-Use Plastics Reduction Campaign Pledge, but more needs to be done each and every day forever to really make an impact.

What can we do in primary care?

Rather than trying to remove all plastic you use in one go (which might leave you feeling more stressed and less inclined to sustainability than ever), stop, think, and decide what you’re most excited about changing, and what can be most easily swapped. Make a list of the plastics you use or come into contact with, and take it one step at a time.

Remember that plastics don’t just come from packaging and the products themselves, but they also come in catering (cups/cutlery/stirrers), building structures, and furniture too! Medical products like inhalers and catheters are also made out of it. There are some schemes already in place which can help:

• RecoMed is a recycling scheme for single-use PVC medical devices such as oxygen masks and tubing - the first scheme of its kind in Europe.
• You can recycle blister packs and PPE with Terracycle but check their website for details of local availability.
• All inhalers should be returned to a pharmacy for safe disposal rather than going in household waste, according to the Journal of Medicines Optimisation. (Inhaler recycling schemes need to be more widely available; Glaxo Smith Kline did have a ‘Complete the Cycle’ Scheme which was operation from 2011 to 2020).
• Don’t rely on so-called biodegradable or compostable plastics. They’re certainly better than standard non-degradable plastics, but they often don’t actually break down that well. For example, the UN Environment Program has concluded that biodegradable plastics are not the answer to reducing marine litter – using less plastic in the first place is a better solution.

Masking the problem

The recent Covid pandemic has only exacerbated the plastic problem. According to the BMJ, six months after the initial outbreak of Covid-19, the UK government had procured 32 billion items of personal protective equipment, and between February 2020 and February 2021, the NHS used more than 1 billion surgical masks. This would generate nearly 3 million kilograms of waste, little of which could be recycled. But there is some good news; Imperial College Healthcare and Globus are working together to recycle PPE into new products for the NHS like operating theatre clogs, plastic bed pans, medical scrubs and even prosthetic finger joints.

So what are some simple ways of reducing plastic I can start doing right now?

• Avoid using straws and plastic cutlery unnecessarily when out and about.
• Invest in a reusable water bottle or fabric shopping bags.
• Don’t use disposable coffee cups! You can sometimes get a discount in store if you use your own reusable cup.
• Switch to low/zero plastic cleaning products.
• Don't use the single-use coffee pods.
• Buy loose fruit and veg to avoid excessive packaging.
• Be mindful with how PPE is used and disposed of.

In 2020, the BMA reported that almost six out of ten hospital trusts don’t have plans in place to manage or reduce their consumption of single-use plastics. That just isn’t good enough. To really make headway in to solving the plastic problem will require strong and clear leadership from the NHS to hold the corporate and suppliers accountable. Everyone in primary care must share best-practice, and be vigilant all of the time, and think about the decisions they make day to day around plastics. The vital, lifesaving and heroic work primary care staff do every day shouldn’t be undermined by a legacy of plastic waste or environmental damage.

Other resources

Healthcare Without Harm have produced a webinar on the reduction of Single Use Plastics in the NHS. For information on how to reduce environmental impact in term of carbon reduction, please visit https://seesustainability.co.uk/. You can read the NHS Suppliers position on plastic in the supply chain here.