Healthcare waste and sharps management

Engineered sharps safety devices have delivered a substantial reduction in sharps injuries to healthcare professionals but disposal-related errors and subsequent injury to ancillary and support staff have remained largely unchanged. Obligations placed on employers by existing health and safety legislation, and more recently by the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013, are welcome developments for healthcare professionals though the protection for subcontracted support staff and agency workers may be less than adequate. Outsourcing ancillary services creates unforeseen problems. Remarkably, the sharps injury rate for support staff, when measured against employment statistics, greatly exceeds that for frontline healthcare professionals. Though the business model of outsourced NHS support services has been successful, subcontracted hourly paid, sessional and casual support workers will receive neither sharps safety training nor the support of an effective occupational health service. Working dice-by-side with a trust staff, and at risk of being stuck by the same needles, this creates a two-tier system for sharps incident management, investigation and follow-up, that may be difficult to defend. A common programme of tailored sharps safety training, incident reporting, and investigation, and shared access to the specialist urgent care facilities necessary in the event of sharps injury, will ensure that both trusts and their subcontractors can address their obligations to sharps safety for all of those working in their hospitals, in full compliance with the requirements of The Sharps Directive and more general health and safety legislation.