This paper explores the effectiveness of employing the concepts of corporate social responsibility (CSR) and environmental citizenship in the management of healthcare waste in England and Wales. The study employed interviews and literature surveys of four award winning case study National Health Service (NHS) Trusts in both countries. The paper discusses the main drivers for the use of the concepts, factors governing their effective implementation such as senior management support, and key benefits to be accrued including costs savings, waste minimisation and closer links between the Trusts and their communities