How can Behaviour Change Theory Contribute to a Reduce, Re-use and Recycle Approach to Waste Management in the NHS: A Feasibility Study

The UK National Health Service (NHS) overall annual carbon emissions is estimated to be around 21 million tonnes; producing 250,000 tonnes of waste a year with 80% of this waste going to landfill. Examples of good practice in addressing sustainability and climate change are found within healthcare. However these require changes in mindset, including values, attitudes, norms and behaviours which are required along with clear definitions of the problems faced in terms of economics, society and culture in order to respond positively to change. Initial investigations of the literature indicate that behaviour change theory may provide a feasible means of achieving constructive changes in clinical waste management; such approaches require further investigation. Aim: This paper describes a feasibility study designed to examine issues that might affect the introduction of a behaviour change strategy improve waste management in a healthcare setting. Methods: Guided by the evidence gained from our systematic review, 25 interviews were carried out with senior managers, clinicians and support staff involved in the management of healthcare waste from a broad range of agencies in South West England. Interviews were audio-recorded and transcribed for analysis. Thematic content analysis was conducted in order to identify key issues and actions. Data extraction, coding and analysis was cross checked independently by the four members of the research team. Findings: Initial findings suggest tensions, between Government and local policies, between organisations and individuals, and between the operational requirements of health and safety and maintaining appropriate and ethical patient care.