This paper is concerned with an examination of the key socio-economic, institutional and environmental factors that influence sustainable waste management within an organisational setting. The case study employed an ethnographic study and a quantitative survey of employees in the Cornwall National Health Service (NHS) in the United Kingdom (UK) . The results suggest that socio-economic and institutional factors act as major drivers for the incorporation of sustainability in the sustainable management of waste. Alternatively, environmental drivers did not play a key role. Based on these findings a number of recommendations for improved incorporation of sustainability are included in the paper. With the increasing importance of more sustainable environmental management practices, the results of this study should greatly enhance the development of policies and programmes for improved sustainability within both public and private sector organisations.