Are you willing to swallow a recycled pill?

Pills An estimated £300m of medicines are wasted in England each year

The NHS needs to save £20bn, so making ends meet is going to be tricky and big changes will be needed.

In this week's Scrubbing Up, Dr David Pencheon, director of the national NHS Sustainable Development Unit, says recycling medicine could be part of the answer.

The cuts facing the NHS are like you or I losing around 20% of our salary over the next three years - while trying to lead the same sort of lifestyle.

We'd have to make some big changes. And that's exactly what the NHS will have to do, particularly if it wants to keep improving the quality of patient care.

So what can it do? One positive change is for the NHS to become more sustainable, not just financially but also environmentally.

It's not difficult to be sustainable. In fact, at home it's quite natural. We recycle, we don't leave the taps running needlessly, we don't leave the TV, radio and the lights on when we go to work, or even when we pop out to get the paper from the newsagents.

We also don't throw away a packet of headache pills just because they have been opened.

But yet, when we go to work it can be a different story, with lights left on, windows opened rather than thermostats turned down and medicines wasted and put in the bin.

Public interest

NHS staff are no more wasteful than anybody else. But working in a high-pressure environment where lives can be on the line often means that waste isn't always at the top of the agenda.

Recently, we commissioned research looking at ways of saving carbon, as well as money, across the NHS in England.

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Sustainability must become core to the way the NHS operates”

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The results showed that energy efficiency with improved heating and lighting controls was one important way of saving cash, more than £7m a year.

However, the biggest financial and carbon savings came from reducing drugs wastage.

An estimated £300m of medicines are wasted each year in England, but around £89m could be saved by making a 2.5% reduction in medicines wastage.

That's a big saving. Of course we have to ensure the drugs are safe to be reused. But these problems can be solved.

The issue is not so much how we reuse drugs but rather whether the public want us to do it.

Are they willing to swallow the pill - in this instance a recycled pill?

When we polled 1,000 people, we found 52% would be likely to take pills that had been returned unused by other patients and checked for safety, while only 19% said they would be very unlikely to do so.

Carbon footprint

Combining financial sustainability with environmental sustainability is a win-win situation.

The carbon footprint of manufactured drugs, which are often shipped from the other side of the world, is huge - if these drugs can be recycled then so much the better.

In addition, medicines should be prescribed for shorter periods of times so people have fewer unused medicines in their cabinets, and we must put greater efforts into preventing illness rather than always worrying about curing it.

Most people prefer to be healthy and not have to go to hospital or see their GP.

So if the NHS spent more resources on illness prevention for diabetes, obesity, cancer and heart disease then less people would end up needing drugs.

That's better for the NHS and better for the public.

However, until we are in that position we need to consider other ways of making the NHS more sustainable.

The fact that the public are thinking more positively about recycling medicines should be welcomed. It shows that people have a great deal of faith in their health service, despite headlines to the contrary, and that they want to help the NHS become more cost effective and more sustainable.

Sustainability therefore must become core to the way the NHS operates and be part of every decision making process if it is to be truly fit for the future.


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  • rate this

    Comment number 132.

    I think this would be eminently sensible. When my elderly mother died last summer, I must have taken over £500 worth of drugs to the local chemist, all to be destroyed. Most were unopened. People do often 'hoard' medication, for fear of problems with supply. Also, sometimes hospital and GP are both prescribing a given medication. Probably a scenario repeated all over the country, daily.

  • rate this

    Comment number 131.

    One of the biggest problems involves taking stuff back to a pharmacy. I was accidentally given 24 cans of a thickener medicine instead of just 1. When I took the unopened ones straight back I was told they had to be destroyed. I gave them to the district nurses to use as samples so they could be used. This applies to any drugs which are returned unused. A huge waste of resources.

  • rate this

    Comment number 130.

    Perhaps the Pharmacist could just ask when issuing a repeat prescription "Do you still take these pills, and if you do how many unopened boxes do you have at home?" if the patient said "No", or "20 boxes." (10 months supply the Pharm. works out) then they get refereed back to their GP to have their needs reassessed, and are told to take the unused pills with them (to check they are in date.)

  • rate this

    Comment number 129.

    "104. But it requires GP's taking more of a risk and spending more time really diagnosing problems."
    Yes, & 'budget' is king. How much gets rejected out of hand?? It's no wonder that when people get something tangible from their lame GP (hampered, crippled-by-budgets-and-rules), they horde it. That's ironically, a mental-illness. Something the NHS is very poor at dealing with, historically...

  • rate this

    Comment number 128.

    "101. If people with serious mental health problems aren't taking their drugs it can have fatal consequences."

    The mentally-ill (including seriously) are 4x more likely to be a VICTIM of violence! Perhaps if they don't take their medication; they will attract it by acting 'weird'! Is that what you were referring to, or the old cliché of the 'psycho'?

  • rate this

    Comment number 127.

    @ "75. Even in the first place they're often not 100% safe, much as some do help, with Big Pharma probably willing to bribe drug regulators - or gloss-over the statistics on risk and side-effects? Thalidomide...

  • rate this

    Comment number 126.

    53. Greg
    "I say we scrap the NHS AND STOP THE INEFFICIENCY!
    Private healthcover is the way forward! Thatcher was (and always is) spot on."

    Come on nieuw, you'll have to try harder than that. If you're going to troll, do it properly.

  • rate this

    Comment number 125.

    This is another reason to challenge the holy cow of the 'free' NHS. 'Free at the point of use' does not mean 'costs nothing', but too few people seem to understand that. A modest charge at the point of use for all except the genuinely poor (which doesn't include most pensioners) would focus the mind on what is really needed. I'll bet 90% of wasted drugs are from free prescriptions.

  • rate this

    Comment number 124.

    "So if the NHS spent more resources on illness prevention for diabetes, obesity, cancer and heart disease then less people would end up needing drugs."

    Or maybe even FEWER people??? Shame there isn't a pill to cure bad grammar...

  • rate this

    Comment number 123.

    sounds like a good idea but the logistics of such a scheme would be difficult ,who would recycle the drugs and assure they are safe and not contaminated and what about liabilty if something goes wrong say if the drugs had been stored incorrectly surley the best way is to educate people to have prescribed only 28 days treatment and only to order what they need.

  • rate this

    Comment number 122.

    A better idea may be to give out smaller amounts - for example one month's supply rather than 3. Following which you need to renew your prescription.

  • rate this

    Comment number 121.

    There are people claiming disability benefit and they prove their right by showing how many drugs they need.

    They don't need the drugs for any other reason than to make the claim. Take a look in their medicine box (or suitcase) and you will find thousands of pounds worth of drugs which will be thrown away.

    Cure this disease please.

  • rate this

    Comment number 120.

    In the UK, Antibiotics are used on a try this..., try that.. approach.

    Overseas, samples are taken and the right antibiotic found in the lab. Before the first course is completed, the Lab. has not only determined whether the first antibiotic will work, it has found the antibiotic that will work!

    The lab may cost, but it saves it from the try this, try that, now we really have to think! approach

  • rate this

    Comment number 119.

    I would agree that it is difficult to be completely sure that returned medicines are safe to reissue. But there is another aspect of this question. The pharmacist has been paid by the NHS for the original dispensing of the medicine. How is payment for re-cycled medicines to be calculated and who polices pharmacist claims for payment?

  • rate this

    Comment number 118.

    The biggest flaw? That the reason these pills are wasted is that IT IS NOT SAFE to reuse them. Any box that has been out of official eyesight and control could have been tamperred with. The majority of drugs are wasted because patients collect scripts they never used. These drugs CAN NEVER BE REDISTRIBUTED because of the possibility they are contaminated, stored wrongly, deliberately poisoned.

  • rate this

    Comment number 117.

    #27 'Recycling is using again something that has already been used'.

    Actually, that's reuse, strictly speaking. To recycle something means turning it back into fresh product. An item doesn't have to have been used in the first instance to become waste, by the way. The salient case law is the European case 'Palin Granite Oy' (this'll be summarised on the web somewhere.)

  • rate this

    Comment number 116.

    Many drugs are safe well beyond their advertised use by date. A few years ago the US military announced, having commissioned research on the shelf-life of common drugs, (some being safe for 10-15 years) that it was saving billions by no longer regularly throwing perfectly good medicines away. Of course it's not in big Pharma's interest to prove the stability of their biggest selling products.

  • rate this

    Comment number 115.

    if you have to take one pill a day then you should get one pill a day, and likewise if you have to take 2 or 4 or 20 etc, only give enough to last the course of the treatment and if you change pills then wait until old ones are used up first. this should help reduce waste in most cases

  • rate this

    Comment number 114.

    i order my repeat prescription online, the surgery in their wisdom issue me with medication i no longer take, this has happened for the last 3 months, i have advised them of this but it makes no difference.i appreciate that doctors are,like teachers next to god and always know best, but how many times do they have to be told that they are giving me too much?

  • rate this

    Comment number 113.

    Re-cycling medicines is neither safe nor acceptable. If a supermarket gives a refund for a returned bottle of milk would you want to buy it not being certain if it were stored properly?


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