Summary: Mrs X complained the Council provided an inadequate refuse service for her clinical waste. The Council was at fault for poor record keeping, failing to investigate Mrs X’s concerns appropriately and for providing inaccurate information about changes to its service. This caused Mrs X avoidable frustration and uncertainty for which the Council will apologise and pay £150. It will also update the information available to residents on what waste can go in general waste bins.

The complaint

1. Mrs X complained the Council provided an inadequate refuse service for her clinical waste. She says this caused her stress, put her at risk of infection and meant she had to go to the trouble of reporting missed collections frequently.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused significant injustice, or that could cause injustice to others in the future we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
3. When considering complaints we make findings based on the balance of probabilities. This means that we look at the available relevant evidence and decide what was more likely to have happened.
4. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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What I have and have not investigated

5. The law says we cannot normally investigate a complaint unless we are satisfied the organisation knows about the complaint and has had an opportunity to investigate and reply. However, we may decide to investigate if we consider it would be unreasonable to notify the organisation of the complaint and give it an opportunity to investigate and reply. (Local Government Act 1974, section 26(5), section 34(B)6). Mrs X did not complete the Council’s two-stage complaints procedure after either of her complaints in 2021 and 2023 and she did not make a complaint to the Council about its service in 2024. I have nonetheless decided to investigate Mrs X’s complaint. That is because the issue has been ongoing, Mrs X has contacted the Council repeatedly about her concerns and received replies to them and because one of those responses, in August 2024, was effectively a complaint response.

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How I considered this complaint

6. I have considered:
• All the information Mrs X provided and discussed the complaint with her;
• The Council’s comments about the complaint and the supporting documents it provided; and
• The Council’s policies, relevant law and guidance and the Ombudsman's guidance on remedies.
7. Mrs X and the Council had an opportunity to comment on my draft decision. I considered any comments received before making a final decision.

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What I found

Relevant law and guidance

8. Councils have a duty under the Environmental Protection Act 1990 to collect household waste and recycling from properties in their area. Councils are not required by law to collect clinical waste.
9. The Controlled Waste (England and Wales) Regulations 2012 lists three types of waste which are classed as clinical waste. This includes waste that contains viable micro-organisms or their toxins which are infectious to humans or other animals, or which could be infections.
10. Stoma bags are a pouch which attaches to the body to collect urine or faeces. Most councils and health organisations which collect clinical waste treat stoma bags as non-infectious. This means they can go in black bin bags with general domestic waste. However, until April 2025, the Council operated a separate clinical waste collection service through a company working on its behalf. People who used stoma bags used the clinical waste service to dispose of the bags.
11. The Council provided residents with yellow refuse sacks to put the waste in. Residents could keep the bags in a yellow wheelie bin they had purchased day-to-day but should have removed the bags from the bin and placed them on the edge of their property ready for collection.

What happened

12. Mrs X has medical conditions which mean she uses two stoma bags. Mrs X produces a large volume of waste as a result, which the Council collected as part of its clinical waste service.
13. Mrs X says when she moved into the area the Council recommended she buy a yellow wheelie bin to contain the yellow waste bags. Mrs X bought the bin, which is located at the edge of her property. Mrs X told me when the Council missed a collection the bin would be full, and she had to keep the waste in her house. This meant she became ill.
14. In January 2024, Mrs X complained to her MP about the clinical waste collection service. She said she was unhappy she was having to contact the Council when it missed a collection.
15. In response, Mrs X’s MP asked the Council to arrange a meeting with her. The Council did not arrange a meeting or explain why it would not do so.
16. In mid-August, Mrs X told the Council she was unhappy it had missed a collection that week. She said it said it would do a recollection but that had not happened, despite the waste company saying it had. The Council’s records do not show a missed collection that week.
17. The Council responded to say it would monitor her collections for six weeks to ensure they were being done properly and investigate why she was having issues with her collections. In response to my enquiries about the investigation, the Council said it had comprised of a review of the number of missed collections Mrs X had reported.
18. In late September Mrs X told the Council a collection had been due that day, but the crew had arrived and only took the general waste.
19. Mrs X complained to the Ombudsman in October. Her complaint included that the Council had missed 26 collections since January 2024.
20. Mrs X says that in December 2024, the Council missed three weeks of collections in a row. The Council’s records show one missed collection in December.
21. In January 2025, Mrs X heard from someone else that the Council expected residents to put their bags on the property boundary, instead of a wheelie bin. Mrs X continued to put the wheelie bin out.
22. After Mrs X again asked for a meeting with the Council about the waste, it met with her at home in late January 2025. Following that meeting, the Council said:
• Mrs X and other residents could keep their clinical waste in bins they have bought but they should be presented for collection out of the bin;
• After recent incidents when waste collection crews were pricked by needles, the company was no longer allowing staff to take bags out of bins. If waste was not taken out of the bin, it would not be collected;
• Alternatively, she could put her clinical waste in a standard bin bag and it would be collected with general waste; and
• It recognised putting clinical waste bags on the property boundary was not feasible for people who produce a large amount of clinical waste. It was working with the waste company to arrange a solution for between January and April 2025, when it would change its waste collection system.
23. In early March Mrs X told the Ombudsman the Council had missed another collection although the waste company had marked it as collected.
24. In April 2025, the Council introduced its new collection system. It stopped the separate clinical waste collection service. It sent residents who used the clinical waste service a letter which said, “clinical and hygiene waste, such as stoma/colostomy bags…will not require a special collection”. It said that waste should be included with general rubbish. The letter said some clinical waste is classed as infectious or hazardous waste which should be collected by the person’s healthcare provider.
25. On the other hand, a leaflet issued by the Council to inform residents of the change to its collections said “clinical waste is infectious or hazardous waste such as…stoma bags”
26. The Council’s website says, “hygiene waste is non-infectious or non-hazardous waste such as stoma bags”. It said if residents had a health reason, they may be eligible for a larger bin to dispose of the hygiene waste. On the same webpage, the Council said “clinical waste is infectious or hazardous waste such as…stoma bags”.
27. Mrs X understood this to mean she needed to ask her GP’s practice to remove her used stoma bags. The practice was unaware of the Council’s decision to stop the clinical waste service and told the Council it did not take responsibility for removing waste from patient’s homes.
28. Council records show that between October 2023 and February 2025, the date the Ombudsman began its investigation, the Council missed seven collections.

Findings

29. Mrs X and the Council have different views on how many collections it missed between October 2023 and February 2024. On the balance of probabilities, the number of missed collections was closer to the number Mrs X said. I conclude this because the evidence indicates that on several occasion Mrs X took action to report missed collections to the Council or her MP even when the Council’s records do not indicate a collection was missed. The poor record keeping was fault and caused Mrs X avoidable frustration.
30. Until April 2025, the Council expected people to place their clinical waste in bags on their property boundary. However, Mrs X has been putting her clinical waste in a yellow bin left at the edge of her property ready for collection for years. Although Mrs X experienced missed collections in the past 12 years, more often than not, waste collection crews manually removed the bags from the bin for her. This was of benefit to Mrs X but it also led to an expectation she did not need to remove the bags. It is likely that at least some of the missed collections that occurred in the period I have investigated occurred because Mrs X was not presenting her waste in the way she should have.
31. The Council missed several opportunities between October 2023 and January 2025 to explain to Mrs X that she needed to remove the bags from the yellow bin. The Council failed to hold a meeting with her in January 2024, or explain to her why it would not. Despite agreeing to do an investigation into why the collections were not happening in August, the Council only reviewed the number of collections Mrs X had reported. This was not sufficient. The missed opportunities were fault and caused Mrs X further frustration.
32. In late January 2025, Mrs X heard she needed to remove the bags from the bin and place them on her boundary for collection. Around that time, the Council accepted that approach was not suitable for people who produced large amounts of waste, like Mrs X. It said it was arranging a solution to cover the period until April 2025 and that as an alternative, Mrs X could put her stoma bags in general waste bags. There is no evidence the Council arranged any interim solution, which was fault. It did not cause Mrs X a significant personal injustice because the Council only missed one collection in March and because there was an alternative option open to her.
33. The Council is not required to have a separate clinical waste collection service. In April 2025 the Council stopped that service and decided some of the waste it had previously collected as part of the clinical waste service could now go in general waste. This included stoma bags. However, the information the Council sent to residents and put on its website was confusing and contradictory, which was fault.
34. This caused Mrs X frustration and avoidable uncertainty, particularly as her GP practice refused to collect patient waste which Mrs X thought would mean she would have no way of disposing of the used stoma bags. In reality, Mrs X can dispose of her stoma bags with her general waste and if she needs a larger black wheelie bin to do this, the Council will consider providing one.

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Action

35. Within one month of the date of my final decision, the Council will take the following actions.
1. Apologise to Mrs X for the frustration and uncertainty she experienced because of the faults set out in this decision.
2. Pay Mrs X £150 in recognition of her injustice.
3. Confirm if Mrs X can have a larger black wheelie bin to accommodate the stoma bags alongside her general waste.
4. Issue new letters to residents who used the Council’s clinical waste service before April 2025 to clarify that stoma bags can be included in general waste.
5. Update its website to remove stoma bags from the list of infectious or hazardous waste.
36. The Council will provide us with evidence it has complied with the above actions.

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Decision

37. I have completed my investigation. I have found fault leading to personal injustice. I have recommended action to remedy that injustice and prevent reoccurrence of the fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman