Clinical Waste Colour Codes: The HTM 07-01 Guide for UK Practices

In this guide

• What is HTM 07-01?
• The clinical waste colour code at a glance
• Sharps bin lid colours
• Orange or tiger: the most common (and costly) mix-up
• Which colours does your practice need?
• Segregation checklist
• FAQs

What is HTM 07-01?

HTM 07-01, Safe and sustainable management of healthcare waste, is the Department of Health and Social Care's technical guidance on how healthcare waste should be classified, segregated, stored and treated in England. Its colour-coded system tells everyone in the chain, from the nurse at the bedside to the carrier and the treatment plant, what is in each bag or bin and how it must be treated.

The colour code is best practice rather than a law in itself, but it is how practices show they are meeting their legal duty of care and the hazardous waste rules. Inspectors, carriers and treatment sites all expect it. Scotland, Wales and Northern Ireland have their own versions of the guidance built on the same colour system.

The clinical waste colour code at a glance

Two rules sit behind the whole system. First, infectious waste is hazardous, so orange, yellow, purple and red streams travel with a consignment note. Second, each colour is a promise to the next person in the chain, so a single wrong item can mean a whole load is rejected or re-routed at extra cost.

Sharps bin lid colours

Sharps bins use the same colours on the lid. The body of the bin is usually yellow, so always check the lid.

• Yellow lid: sharps contaminated with medicines that are not cytotoxic or cytostatic, such as needles and syringes from vaccinations, most injections and dermal fillers. Incinerated.
• Orange lid: sharps with no medicinal contamination, such as needles used only for taking blood or for acupuncture. Can go to alternative treatment.
• Purple lid: sharps contaminated with cytotoxic or cytostatic medicines. Most carriers also classify botulinum toxin (Botox) waste as cytotoxic. High-temperature incineration.

Need them collected? See our sharps bin collection service.

Orange or tiger: the most common (and costly) mix-up

The single biggest segregation error in small practices is putting everyday, non-infectious waste in orange bags. Gloves, aprons and couch roll from routine appointments are usually offensive waste, which belongs in tiger bags, unless a patient has a known or suspected infection.

It matters for three reasons:

• Cost. Infectious waste needs specialist treatment and costs more per kilo to dispose of than offensive waste.
• Paperwork. Infectious waste is hazardous and needs a consignment note. Offensive waste is non-hazardous and needs a waste transfer note.
• Sustainability. NHS England's clinical waste strategy pushes for more waste to move from the infectious streams into the offensive stream, where it is safe to do so.

The test is simple: is there a known or suspected infection risk? If yes, orange. If no, tiger.

Which colours does your practice need?

Most small practices only use four or five of the eight colours. A typical set-up looks like this:

• GP surgeries: orange, tiger and black bags, yellow-lid and orange-lid sharps bins, and a blue-lid medicines container. Purple only if you give cytotoxic or certain hormonal medicines.
• Dental practices: orange and tiger bags, yellow-lid sharps bins, a blue-lid medicines container and white amalgam containers.
• Aesthetic clinics: purple-lid containers for toxin needles and part-used vials, yellow-lid sharps bins for filler needles, a blue-lid container for other medicines, and tiger bags for consumables. See our aesthetic clinic waste guide.
• Tattoo, piercing and acupuncture: mainly orange-lid sharps bins and tiger bags.

Segregation checklist

1. Put the right bins at the point of use, not in a back room.
2. Display a colour-code poster above each waste station.
3. Fill bags no more than three-quarters full and close them with a swan-neck tie.
4. Never fill sharps bins past the fill line, and lock the final closure before collection.
5. Label every bag and bin with your practice name.
6. Store full waste in a secure, locked area away from the public.
7. Keep every waste transfer note and consignment note together.
8. Train new staff on the colour code during induction, and refresh it once a year.

Frequently asked questions

What colour bag is clinical waste?

It depends on the type. Infectious clinical waste goes in orange bags, infectious waste that is also contaminated with medicines or chemicals goes in yellow, and non-infectious offensive waste goes in tiger (yellow and black striped) bags.

What is a tiger bag used for?

Tiger bags are for offensive waste: items that are not infectious but may be unpleasant, such as gloves, aprons, couch roll and incontinence pads with no known infection risk.

What goes in a purple-lid sharps bin?

Sharps contaminated with cytotoxic or cytostatic medicines, including some cancer treatments, certain hormonal medicines and, for most carriers, botulinum toxin. They are sent for high-temperature incineration.

Is orange bag waste hazardous?

Yes. Infectious clinical waste is hazardous waste, so every collection must travel with a consignment note, which you keep for at least three years.

What goes in a blue-lid container?

Unwanted medicines that are not cytotoxic or cytostatic, such as expired tablets, part-used vials and returned medicines. They are sent for incineration.

Sources

• Department of Health and Social Care, Health Technical Memorandum 07-01: Safe and sustainable management of healthcare waste.
• NHS England, NHS Clinical Waste Strategy.
• Environment Agency, Healthcare waste: appropriate measures for permitted facilities, GOV.UK.