Why Every Healthcare Facility NEEDS a Pre-Acceptance Audit

When was the last time you had a pre-acceptance audit (PAA)? This year? Last year? Five years ago?

Although it might not be the first thing that springs to mind when you think about your compliance, these are a priority for every healthcare facility, small or large, at some point. And it’s not a one-and-done type deal.

So, why does every healthcare facility need a pre-acceptance audit? It’s not only a legal requirement under the Environment Agency guidelines, it’s also a key driver of cost efficiency, safety, and environmental responsibility.

Despite its importance, there are still many healthcare professionals unaware of what a PAA is, why it matters, and crucially, whose responsibility it is to ensure one is in place – read on to learn all you need to know.

TOPICS WE WILL COVER:

1 / What Is a Pre-Acceptance Waste Audit?

2 / Why Are Pre-Acceptance Audits Important?

3 / What’s Involved with a Pre-Acceptance Waste Audit?

4 / How Often Should a Pre-Acceptance Waste Audit Be Carried Out?

5 / Whose Responsibility Is It to Ensure a Pre-Acceptance Audit Is Carried Out?

6 / Need Support with Your Pre-Acceptance Waste Audit?

What Is a Pre-Acceptance Waste Audit?

A Pre-Acceptance Audit (PAA) is a formal waste review of your facility’s waste management practices, carried out before a licensed contractor is permitted to collect your healthcare waste. It’s a legal requirement that ensures your waste partner fully understands the types of waste you generate and that it’s being handled in a way that’s both safe and compliant.

A PAA assesses your facility’s waste streams to confirm that:

The short version is this – it ensures the right waste is being disposed of in the right bin, and the right documentation is in place to prove it.

Why Are Pre-Acceptance Audits Important?

There are three main reasons why PAAs matter:

#1 It’s the law

The Environment Agency mandates that all healthcare facilities must complete a PAA before a waste contractor can accept or treat their waste. Without one, your waste cannot be legally collected.

#2 It ensures correct waste segregation

A PAA provides a snapshot of how well your facility segregates its waste. It can reveal missed recycling opportunities, non-compliance areas, or risks related to misclassification.

#3 It protects people and the environment

Improperly managed waste can result in environmental pollution, sharps injuries, infection risks, and exposure to hazardous substances. A PAA ensures your processes are safe, compliant and defensible if challenged.

What’s Involved with a Pre-Acceptance Waste Audit?

A pre-acceptance audit is a structured, multi-step process designed to assess how healthcare waste is generated, handled, stored and documented within your facility. Whilst every audit will be tailored to the specifics of your site, we can wrap it up in five core steps:

Step One: Pre-Assessment

In this preliminary stage, we’ll ask you to provide some essential documents, details and data. These include your waste management policy, your most recent PAA report, your Green Plan and your waste volume data.

Step Two: On-Site Audit

At this stage, we start our on-site audit process with a review of your documentation and training records. This also provides the time to ask any questions we may have from the pre-assessment stage.

Step Three: On-Site Walkthrough

The on-site walkthrough stage is conducted across all departments due to be audited and includes a review of your current waste segregation practices, container placement, staff interactions with waste, etc.

Auditors will assess whether different waste streams are being correctly separated at the source – for example, ensuring offensive waste isn’t being mixed with infectious waste.

Step Four: Waste Compound Checks

This includes a physical inspection of your waste compound, looking at waste storage, packaging, labelling, how long your waste is held on-site, where it’s stored, and to ensure it’s stored in accordance with HTM 07-01 guidance.

Step Five: Reporting and Action Planning

The PAA concludes with a written report that summarises the findings, highlighting non-conformances or risk areas, and provides clear, actionable recommendations for improvement. This report can also be used to demonstrate due diligence to regulators and internal stakeholders.

Many healthcare facilities are surprised by how much operational insight a PAA can provide, and how often it reveals gaps in training, documentation, or waste management processes that could otherwise go unnoticed.

How Often Should a Pre-Acceptance Waste Audit Be Carried Out?

The required frequency of pre-acceptance audits you need to conduct depends both on the volume of waste you produce and the type of healthcare organisation you are. The Environment Agency outlines different intervals based on risk and quantity.

Annual Audits

Facilities producing more than 5 tonnes of healthcare waste per year must complete a PAA every 12 months. These are typically larger sites such as hospitals and large health centres.

Every Two Years

Certain high-risk producers generating less than 5 tonnes per year are still required to conduct audits more frequently. This includes:

Every Five Years

Organisations that are deemed lower risk and produce under 5 tonnes per year are required to complete a PAA at least once every five years. This category covers a wide range of healthcare settings, such as:

It’s important to note that regardless of schedule, audits should be renewed sooner if significant changes occur, such as service expansion, relocation or new clinical processes.

Whose Responsibility Is It to Ensure a Pre-Acceptance Audit Is Carried Out?

This is the part that often gets overlooked or misunderstood. The responsibility for organising and maintaining a valid PAA lies with the producer of the waste – you.

Not necessarily you personally, dear reader, but it means it’s your facility’s responsibility, not the waste collector’s. If you’re generating healthcare waste, you must ensure a valid PAA is conducted, documented, and kept on record for three years.

Typically, within healthcare, this falls under the remit of:

If there’s one key takeaway from this entire blog, it’s this: Don’t wait for your waste contractor to chase you for a PAA – it’s your obligation to be proactive.

Need Support with Your Pre-Acceptance Waste Audit?

If you can’t remember the last time your facility conducted a PAA or you’re unsure whether your documentation is valid, now is the time to act.

Sharpsmart offers a complete Pre-Acceptance Audit service designed to simplify the process, reduce your compliance burden, and give you total peace of mind.

We don’t just provide containers and collect waste, we support healthcare staff within the four walls to strive for Continuous Improvement and Optimisation – transforming waste management from the inside.

Our team of waste experts can help you:

Want to ensure your documentation is compliant and your processes are robust? Get in touch!