'Let's Not Waste'. Tackling waste and inefficient practices in Wales' health and care system

Background: As the UK’s National Health System contributes around 4-5% of the country’s total carbon emissions and around 20-30% of healthcare resources are estimated to be misused, it is essential that we tackle waste for both environmental and sustainability purposes.

Approach: The Bevan Commission proposed a 'Let’s Not Waste' programme to the Welsh Government, initiating a 24-month effort to tackle waste across health and care systems in Wales. This programme was shaped by insights from its Conversation with the Public initiative, in which 83% of 2,200 individuals agreed waste reduction was vital for sustainability of services.

The objectives of 'Let’s Not Waste' were to raise awareness, increase engagement, and support waste reduction through practical tools and case studies across six key domains: Workforce, Administration, Services, Treatment, Energy, and Systems.

This multi-faceted initiative brought together diverse stakeholders, including healthcare professionals and senior executives, through workshops, working groups, and surveys. The programme also included a Waste Masterclass led by Prof. Don Berwick, which engaged senior healthcare leaders to identify barriers and enablers for waste reduction. Discussions focused on cultural attitudes, capacity constraints, and digital integration while highlighting opportunities to streamline processes, enhance accountability, and foster a culture of sustainability.

Tools such as behaviour change toolkits and case studies were co-designed to encourage sustainable practices. Engagement efforts resulted in over 320 professionals pledging to reduce waste, fostering a collaborative culture of sustainability within Wales’ health and care systems.

Results: 'Let’s Not Waste' delivered multiple outcomes, including measurable reductions in waste through innovations such as reusable mobility aids, sustainable surgical practices, and the development of Behaviour Change toolkits. These included the Single-Use Plastics Behaviour Change Toolkit, Plastic Bag Reduction Toolkit, and the GP Carbon Footprint Tool, and 'Your Medicines, Your Health' toolkit, which empowered healthcare professionals to adopt sustainable practices.

A standout initiative reduced the carbon footprint of carpal tunnel surgeries by 80%. If adopted nationwide, this model could achieve annual savings of 12 tonnes of CO₂ and £1.33 million in costs.

 

Despite these successes, the programme identified considerable gaps in waste-related data, including inconsistencies in availability, outdated or incomplete records, and a lack of standardised reporting across Wales. These challenges highlighted the need for improved data collection and management to establish consistent baselines, monitor progress, and evaluate the impact of waste reduction initiatives effectively.

Implications: 'Let’s Not Waste' highlights the potential for environmental, financial, and operational improvements within Wales’ health and care systems by reducing waste. Its success underscores the importance of leadership, collaboration, and cultural change in achieving sustainable practices. Future efforts should focus on scaling successful initiatives, strengthening public and professional engagement, and addressing barriers such as inconsistent data and resource constraints. Enhanced partnerships, refined toolkits, and consistent data baselines will be critical to maintaining momentum and ensuring lasting impact. Building on this strong foundation, Wales has the opportunity to lead in sustainable healthcare innovation.