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The concept of waste and how it can be reduced, recycled, refurbished or reused in its current form has been widely discussed in industry. The importance of waste reduction from an environmental and economic perspective has also heightened in both industry and within the research arena. Thus said, stringent steps have been taken to facilitate the collection of and capture residual value in waste items. This article explores this premise in relation to medicines waste as part of the wider medicines optimisation agenda.

The National Health Service (NHS) Five Year Forward View in 2014 issued a grave warning that if healthcare demand in the UK continued to grow as its current rate, and efficiency or funding changes were not instigated there could be a mismatch between the service (in terms of resource provision) and patients of up to £30 billion a year by 2020/21. The report asserted that in order to “sustain a comprehensive high-quality NHS; action will be needed on all three fronts – demand, efficiency and funding” (2014:5). Based on this escalating issue, and with a focus on the expanded and value-added role of Community Pharmacists, this study chooses to focus on this service operation in light of the pressures as highlighted above by examining what Sustainability means and how it is applied in Community Pharmacy as a service provider in the NHS (UK).

The concept of corporate and social responsibility (CSR) has gained increasing momentum and importance in business operations today and companies have globally responded to this philosophy. To what end though? Product Stewardship (PS) and the corporate, social and environmental responsibilities associated within this term are a key part of a business’s CSR agenda. In the extant literature, it is a challenge to clearly identify the boundaries of responsibility for PS - who sets these boundaries for governance and what are the actions taken under the guise of PS. This paper aims to start the process of demystification in responding to the title of this work, stimulate further musings and outline a future research agenda.

The effective disposal of medication and more specifically accidental exposure to fentanyl via transdermal patches has recently been highlighted in two key documents [1, 2]. Whilst the volume of unused medicines cost the NHS over £300 million every year [1], the volume of transdermal patch waste is unknown. There is a need for greater pharmacy intervention in the effective disposal of medicines to resolve issues such as hospital (re)-admissions, stockpiling leading to patient self–prescribing/dosing, and land and water pollution. The aim of this study was to examine transdermal patch disposal systems and practice amongst private sector care providers in the UK. This was part of a larger study focusing on transdermal patch application.

The role of the pharmacist as we know it has altered substantially over recent years. No longer is the expectation that they are a dispenser of pills and potions and nothing else (Richardson and Pollock, 2010). Skills/competencies mapping and associated performance have been examined from a supply chain perspective e.g. Kauppi et al., 2013; Sohal, 2013; but there is limited evidence of such exploration within the pharmacy profession and healthcare operations management. The aim of this study is to explore the critical management skills needed by pharmacists to effectively perform their role within the National Health Service (UK).

This research aims to design a green Pharmaceutical Supply Chain (PSC ) that reduces preventable pharmaceutical waste and effectively disposes of inevitable pharmaceutical waste. The main output of this study is the formulation of an integrated green PSC model involving all critical stakeholders, leading to improved environmental, economic and safety performance in medication management and delivery. The research is based on literature and on secondary resources. To green the PSC, every producer of waste is duty bound to facilitate the safe handling and disposal of waste. A Cross boundary Green PSC (XGPSC) approach is proposed to identify participants’ contribution to the PSC. Peripheral influences are also recognised from professional and regulatory bodies. This study focuses solely on community PSC in the UK where patients receive medication from local community pharmacies and thus may be limited. The proposed XGPSC approach also needs to be tested and validated in practice. It may also be difficult to transfer some of the environmental practices proposed in this research into practice. The environmental practices and actions proposed provide invaluable insight into various PSC activities, including purchasing, product design, prescription patterns and processes, medication use review, and customer relationship management. The proposed environmental actions encourage firm commitment from everyone to reduce, recycle or effectively dispose of pharmaceutical waste, with patients becoming stewards of medication rather than only consumers. A cross boundary approach is developed to green the PSC, and it encourages total involvement and collaboration from all participants in PSC.

Medicines management is only one part of NHS (UK) procurement and management, but essentially a very expensive part. In December 2012 the Department of Health issued an action plan to improve the use of medicines and reduce waste. There is an onus therefore on the NHS to ensure that they are as efficient in the medicines management as possible in all aspects of the supply chain in order to ensure sustainability (economically and operationally). To do this consideration must be given to medicines optimization, from procurement, through to storage, dispensing, compliance and finally waste prevention and reduction and waste retrieval. As part of the larger National Health Service (UK), hospital pharmacy places strong emphasis on contributing to the efficiency targets through reductions in waste and drug spending, and best practice. The purpose of this study is to examine medicines reverse logistics practice within the NHS hospital pharmacies, and the operational strategy which drives such practices. The overarching aim is to explore through qualitative analysis the variance and commonality in strategy and practice in what is a standard logistical activity. The outputs offer transparency of medicines RL as practiced by NHS professionals and contribute to ongoing discussions within the Department of Health (NHS UK) on best practice governing waste medicines recycling processes. A qualitative approach was adopted in undertaking this research study, utilizing a purposive study sample. The survey examined practice in 45 hospitals as individual cases across all stages in the medicines reverse logistics system. The findings indicated there is some commonality in the strategy employed in conducting medicines recycling, and all 3 drivers are prevalent in undertaking recycling and encouraging a more sustainable approach, i.e., economic, corporate citizenship, and legislation. However, the means by which the same objective was achieved differed, such as resource utilisation, training etc.

The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK). Through a combination of literature review and empirical work, this research investigates the existing household waste medicines reverse logistics (RL) system and makes recommendations for improvement by benchmarking it against household waste batteries RL. The viability and feasibility of these recommendations are evaluated through in-depth interviews with healthcare professionals and end user surveys. The batteries RL system appears to be a more structured and effective system with more active engagement from actors/stakeholders in instigating RL practices and for this very reason is an excellent comparator for waste medicines RL practices. Appropriate best practices are recommended to be incorporated into the waste medicines RL system, including recapturing product value, revised processing approaches, system cooperation and enforcement, drivers and motivations and system design and facilitation. This study offers academics and professionals an improved insight into the current household waste medicines RL system and provides a step towards reducing an existing gap in this under-researched area. A limitation is that only a small sample of healthcare professionals were involved in subjectively evaluating the feasibility of the recommendations, so the applicability of the recommendations needs to be tested in a wider context and the cost effectiveness of implementing the recommendations needs to be analysed. Reducing, reusing and properly disposing of waste medicines contribute to economic sustainability, environmental protection and personal and community safety. The information retrieved from analysing returned medicines can be used to inform prescribing practice so as to reduce unnecessary medicine waste and meet the medicine optimisation agenda. This paper advocates learning from best practices in batteries RL to improve the waste medicines RL design and execution and supports the current NHS agenda on medicine waste reduction (DoH, 2012). The recommendations made in the paper not only aim to reduce medicine waste but also to use medicines effectively, placing the emphasis on improving health outcomes.