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How to specify a sewage treatment plant in the healthcare sector

By: Andrew Baird on Mar 1, 2024

Healthcare facilities such as care homes and hospitals produce higher volumes of wastewater and have more complex disposal needs than other organisations. How should these facilities upgrade their wastewater treatment solutions to shrink disposal costs while minimising disruption for patients and carers?

Life in nursing homes and small hospitals can be an endless round of H&S and domestic routines. Required levels of hygiene and different cleaning challenges end in a constant stream of wastewater laced with various detergents, disinfectants, bodily fluids, pathogens, and antibiotics.

How do medical facilities treat their wastewater?

Medical facilities producing high volumes of contaminated water must request and pay for discharge consent if they empty their wastewater straight into the public sewer.  For this reason, many need to install water treatment plants designed to cleanse their effluent before disposal.
Many medical and care facilities in rural settings are not connected to the main sewage network at all.  These facilities must treat their own contaminated wastewater using septic tanks or small treatment plants, ensuring their runoff is adequately cleansed before disposal into the ground.

But this kind of discharge can’t be sent untreated into the world.  

What are the wastewater handling requirements for different medical facilities?

British Water’s Best Practice Guide to Flows and Loads say that nursing home wastewater treatment plants must be capable of dealing with 350 litres of fluid per resident per day, rising to 450 litres per day per patient for small hospitals. Compare that to the mere 150 litres produced per resident per day in a typical domestic setting. 

Accompanying this high volume of discharge can be unusually high concentrations of Chemical Oxygen demand (COD), biochemical oxygen demand (BOD), and ammonia owing to:

  • The presence of antibiotics and other medications
  • Large volumes of disinfection and cleaning chemicals

Such contaminants need a wastewater treatment solution capable of handling large volumes and the complexity of the waste being treated.

Drivers for installing new wastewater treatment plants in healthcare settings

As the population ages, demand for new healthcare and nursing home facilities is exploding.

Brand new medical facilities may be looking to establish water treatment regimes that can grow with them.

Existing medical facilities may be looking to upgrade their water treatment process as their operations continue to expand.

Established care homes in rural areas may already have septic tanks that need to be replaced as they get older or demand on them grows. The general binding rules often prohibit like-for-like replacement of septic tanks. Anything with a population equivalent would require consent to discharge by the Environment Agencies. 

So, what are the critical considerations for healthcare facilities looking to specify new wastewater treatment systems to handle their effluent?

Considerations for specifying wastewater treatment plants for healthcare facilities

1. Variable and shock loadings

The healthcare sector must manage the variable and shock loadings of medicine and other contaminants in wastewater. This requires systems that can adapt to fluctuating waste streams without compromising treatment effectiveness.

2. Emergency and critical circumstances

Facilities must maintain operational continuity in emergencies, such as power outages. This requires systems with robust backup capabilities to ensure continuous treatment and compliance with discharge standards.

3. Compliance risks

Water companies have strict discharge limits around COD, BOD, and ammonia; healthcare facilities face significant compliance risks. Ensuring that wastewater treatment solutions meet these limits is crucial for avoiding penalties while protecting public health and the environment. Choose a supplier with expertise in chemical treatment to ensure fluctuating levels of polluting substances can be adequately controlled.

4. High effluent standards

Many care homes are in rural areas and are not connected to mains drainage. Where discharge may directly impact local water bodies, systems must meet the highest effluent standards to protect the surrounding environment and comply with stringent regulatory requirements. Thanks to changes in regulation and increased pressure from expanding operations, sticking with a septic tank may no longer be an appropriate choice.

5. Minimising impact

Aesthetics and Environmental Consideration: Opt for systems with low visibility and minimal noise and odour emissions to ensure they do not adversely affect the surrounding area or the quality of life for patients and staff. Where possible the system should be integrated into the landscape to minimise visual impact. Ensure you choose a supplier with a track record of sensitive and custom designs for sites with complex needs.

6. Understanding the process guarantee and whole life costs

But what about the ‘whole life costs’ of the sewage treatment system, including installation, operation, maintenance, and potential upgrades. A system may seem cost-effective initially, but if it needs frequent and expensive maintenance can quickly become a financial burden. The scalability of your solution needs to be taken into account. How easily can it be extended as your operations grow, and at what cost? A robust process guarantee will give you peace of mind, ensuring the system will perform as expected over its lifespan.


For healthcare facilities, packaged sewage treatment plants are often the preferred option due to their ability to produce high-quality effluent suitable for discharge.

The difficulty for many is finding partners capable of designing, installing, and maintaining systems in challenging settings that can deal with complex chemical discharge.

They need flexibility of design, ease of maintenance combined with sensitivity to the unique demands of a care setting.

Partnering with experienced installation and maintenance companies familiar with healthcare sector requirements is crucial for ensuring system efficiency and compliance.

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Topics: Wastewater Treatment

Andrew Baird

Written by Andrew Baird

Andrew is the Technical Director at WCS Environmental Engineering. Andrew has worked for WPL (now a part of WCSEE) since 2006 and has nearly 30 years’ experience in the water and wastewater treatment industry. Andrew has a background in traditional engineering and technical business development and has worked on technical projects for BAE Systems, North West Water & Yorkshire Water to name a few. Andrews’s commercial awareness goes hand in hands with his excellent knowledge in industrial effluent treatment and broad knowledge of Europe’s water and wastewater treatment needs in manufacturing and process industries.

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