{"id":5771,"date":"2026-06-16T09:09:45","date_gmt":"2026-06-16T09:09:45","guid":{"rendered":"https:\/\/www.initial.co.uk\/blog\/?p=5771"},"modified":"2026-06-16T09:09:48","modified_gmt":"2026-06-16T09:09:48","slug":"energy-from-waste-facilities-explained","status":"publish","type":"post","link":"https:\/\/www.initial.co.uk\/blog\/energy-from-waste-facilities-explained\/","title":{"rendered":"What are Energy from Waste (EfW) facilities?"},"content":{"rendered":"\n

Many items used in everyday healthcare, veterinary and dental practices are disposed of immediately after use. Others may be autoclavable, but inevitably will reach the end of their lifespan. This results in high levels of daily clinical waste creation.<\/p>\n\n\n\n

Where these items end up is important, as it affects public safety and impacts the environment. More green alternatives, such as recycling, are preferred but not always possible.<\/p>\n\n\n\n

Energy from Waste (EfW) facilities aim to bridge the gap by ensuring clinical waste can serve our communities long after disposal. This is especially the case for items that may not be able to be recycled and repurposed, and would otherwise be condemned to landfill or incineration with no additional benefits; only a detriment to the environment.<\/p>\n\n\n\n

So, what should clinicians know about the practice that has been described as turning \u2018trash to treasure\u2019<\/a>?<\/p>\n\n\n\n

What happens at an EfW plant?<\/strong><\/h2>\n\n\n\n

Breaking down the waste components it receives, an EfW facility produces<\/a> energy, and sometimes heat, whilst also recovering metals from bottom ash. This is the product left behind after incineration at around 1000\u00baC, and can be recycled into aggregate, which is then used in construction. This level of heat is equivalent to or hotter than lava<\/a> in many cases.<\/p>\n\n\n\n

Incinerator bottom ash can be used when building<\/a> roads, cycleways and pathways, as well as pipe bedding. Upon incineration, waste typically loses 80\u201390% of its volume and 70\u201380% of its mass,<\/a> but can still make a significant difference in these construction workflows. This is just one way that EfW facilities begin to give items a second life.<\/p>\n\n\n\n

As a by-product of incineration, the waste also creates a hot flue gas, which is used to boil water. This creates steam that drives turbines, generating electricity. Through this process, items such as used non-infectious PPE can therefore be reprocessed to power households, businesses, and healthcare practices across the country.<\/p>\n\n\n\n

Before the hot flue gas is exposed to the environment, it is cleaned. Acidic gases are neutralised, and dioxins and heavy metals are removed, before the gas passes through a fine fabric filter that captures any remaining particles.<\/p>\n\n\n\n

As a result of these processes, EfW facilities produce electricity and building materials as well as recycling metals that would otherwise go to waste if left untouched. Health Technical Memorandum 07-01 (HTM 07-01)<\/a> notes that in one case study, London North West University Health NHS Trust implemented staff training on correct segregation, ensuring appropriate waste items ended up at EfW sites. This also required collaboration with their waste contractor, who ensured offensive waste was sent to EfW facilities. In turn, approximately 8MWh of energy is produced per year, the equivalent of powering 35 houses.<\/p>\n\n\n\n

Of course, all NHS Trusts differ in size, but with 202 operating as of mid-2025<\/a>, a potential 7,070 homes could be powered through this approach year-round.<\/p>\n\n\n\n

Are there other ways to produce EfW?<\/strong><\/h2>\n\n\n\n

Cold plasma pyrolysis is an alternative form of EfW, a process which decomposes waste material at temperatures of around 600\u00baC, with limited oxygen. It is currently targeted at plastics and, therefore, will not be suitable for all waste items, but awareness of it is important nonetheless.<\/p>\n\n\n\n

According to researchers at Newcastle University<\/a>, facilities that perform cold plasma pyrolysis can convert waste plastics into hydrogen, methane and ethylene; the first two are clean fuel sources, and ethylene can be re-entered into the plastic creation cycle.<\/p>\n\n\n\n

Plasma technologies used to manage hazardous waste typically operate at temperatures exceeding 3,000\u00baC. When this system operates at lower temperatures, facilities can conserve energy, maximising the benefits of their work.<\/p>\n\n\n\n

Which items can be sent to EfW facilities?<\/strong><\/h2>\n\n\n\n

In line with current regulations, only some clinical waste items can be sent to EfW sites for disposal and reprocessing.<\/p>\n\n\n\n

HTM 07-01<\/a> uses the waste colour code to highlight products that are suitable for this workflow. It includes domestic\/municipal waste, placed in black bags, and offensive waste, which is signified by yellow and black (tiger-striped) containers.<\/p>\n\n\n\n

More hazardous waste types, such as highly infectious and anatomical items, are not suited to EfW workflows. Often, eliminating the risks created by these items requires a higher level of energy, meaning straightforward incineration without energy production is implemented.<\/p>\n\n\n\n

Landfill is an alternative waste management option for both offensive and municipal waste; however, whilst it is legal, it is not recommended in the case of offensive waste workflows. Here, EfW is clearly preferred.<\/p>\n\n\n\n

Offensive waste produced within healthcare environments includes items that are typically unpleasant, but not hazardous. For example:<\/p>\n\n\n\n