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The opportunity to innovate: why procurement is key to the success of the NHS green agenda

Published: Tue, 26 Apr, 2022

David Lawson, Chief Procurement Officer, Guys and St Thomas’ NHS Foundation Trust, and Neil Hind, Sustainable Procurement Lead, NHS England North West Region, explain how transforming NHS procurement can help the NHS to achieve its net zero target by 2045.

Over the past five years or so, attitudes towards sustainability in the NHS have shifted. At last, executive boards are taking sustainability seriously, reflecting the more widely held belief that we are all responsible for redressing the environmental damage that humans have inflicted on the planet. The significance of this shift in attitude should not be underestimated: accounting for between 4-5% of the nation’s carbon footprint, health and social care has a significant role to play in any climate change mitigation efforts. Further to this, a reduction in carbon emissions can bring vast and significant benefits to population health, from preventing the initial health impacts of climate change, to easing the burden on NHS services by improving wellbeing through health co-benefits, such as cleaner air, increased physical activity, and more nutritious diets. 

Having finally recognised the importance of reducing carbon emissions, in October 2020, the NHS published the Greener NHS programme, setting out its aim to become the world’s first net zero national health service by 2045 at the latest. With more than 60% of the NHS carbon footprint based within the NHS supply chain, to achieve this lofty ambition, one of the key areas of focus will be NHS procurement and the products provided by more than 80,000 suppliers – encompassing medical equipment, food, business and office goods. Of course, a lot of responsibility for improving sustainability in procurement will fall into the hands of these suppliers, who will need to play their part in reducing carbon emissions and improving health now and for future generations, but there is a lot more that the NHS procurement teams can be doing too. 

Given the current health climate, a lot of attention will be paid to reducing the volume of long-lasting, single-use plastics. Over the course of the COVID-19 pandemic, emissions generated by the UK’s Personal Protective Equipment (PPE) supply are equivalent to more than 850,000 transatlantic flights, with more than 12 billion items of PPE purchased by the NHS between March and May 2020 alone. The numbers become even more concerning when we consider them on a global scale, and outside of the health and care context where PPE is also being used to negate the risk of contracting the virus. For procurement teams seeking to combat the issue, one of the biggest challenges is actually identifying the items that are single-use plastic, because often, there is no way of knowing. At least, not without the aid of a digital tool, which is where companies like AdviseInc, who specialise in the analysis of procurement data, can add real value, given their ability to identify single-use plastics from historical spending patterns. 

Reducing the number of single-use plastics used is a good place to start, but to get even close to meeting the NHS’s net zero target, the effectiveness of procurement data and analytics needs to be reconsidered across the sector. A large part of the problem is the variation in levels of digital maturity that exists between procurement teams in different NHS organisations: some hospitals have full visibility of their data, they have good inventory management systems, and high-levels of purchase order compliance; others have limited systems, high levels of non-compliance and low levels of investment in data and analytics. To ensure the success of any green NHS initiative, it is therefore critical that organisations with low-levels of digital maturity have the funding to work with innovative partners, like AdviseInc, or recruit appropriate levels of in-house resource.

For NHS procurement teams, having the time and ability to take a closer look at their procurement data will empower them to challenge established processes and work with suppliers to explore how to reduce carbon emissions. With more time (and hopefully resource) on their hands, they can also begin to reimagine the supply chain from switching from single-use to reusable, to reducing the risk of unnecessary inventory waste, to modelling alternative processes that reduce or even fully design out emissions, like some of the initiatives being piloted by SmartTogether at the GSTT Supply Chain Hub. More broadly, the NHS also needs to pursue more renewable energy supplies, provide carbon literacy training to employees, and look to minimise carbon waste across the board – from forks in the canteen, to medicine packaging and supplies.

Sustainability presents a real opportunity to innovate, challenge the status quo and work with clinical teams and suppliers in a different way, beyond the consideration of unit cost. And as the NHS moves to a model of integrated care, we have the chance to transform procurement, to build a better, greener, more sustainable NHS.