Sustainability
The requirement for all the theatre textiles to be laundered and sent to sterile services following their cleaning puts stress on the capacity both of the laundry to wash, dry and fold and sterile services to accommodate greater numbers of packs to be sorted and sterilised.
Procurement Sustainable procurement is a process whereby organisations meet their needs for goods, services, works and utilities that achieve value for money on a whole life basis in terms of generating benefits, not only to the organisation, but also to the economy, while minimising damage to the environment. Many of the suppliers to the NHS are small and medium sized businesses. They have been set a huge challenge, which many may not be able to meet. From April last year, if a potential product or medical device contract is worth more than £5m, the NHS requires that supplier provide a carbon reduction plan for their UK scope 1 and 2 emissions. These requirements will be expanded over the next few years to include all the 1, 2 and 3 emissions, as well as new requirements by 2028 to identify the carbon footprint of every product being supplied to the NHS. This is a big ask for the companies. NHS England tenders for medicines will
require, at the point of submission, a valid evergreen sustainable supplier assessment, as well as a compliant carbon reduction plan. The assessment serves as a mechanism to show alignment with the Net Zero target and wider sustainability efforts. Companies that belong to the Association
of British Healthcare Industries have reported that to conduct a lifecycle analysis for one product would cost $30,000 and a team of people. Expanded to their whole portfolio, this would equate to $30 million. The time and cost to undertaking these assessments is not considered reasonable or sustainable.2
Scope Scope 1 Definition GHGs directly
emitted from and controlled by an organisation
Example
Anaesthetic gases Hydrofluorcarbons or
chlorofluorocarbon propellants from metered dose inhalers
Direct emissions
from combustion of petrol or diesel from NHS owned or leased vehicles
Combustion of fossil fuels onsite such as within gas boilers
Scope 2 Scope 3
GHGs indirectly emitted due to
energy purchased All other GHGs
Purchased as
electricity, steam , heating or cooling.
Supply chain including
Pharma and chemicals Medical equipment Non-medical equipment
Patient, visitor and staff travel Water and waste disposal Commissioned services
Table 1. Scope 1,2&3 emissions categorised.
Reprocessing There are many medical devices used during surgery and healthcare procedures which, over the last twenty years, have become single use disposable items. To move away from them in a wholesale way is an unknown process for procurement and also the capacity of the reprocessing facilities may be very difficult. Single use products may be the best option from many different aspects i.e. sharpness, durability, clinically and environmentally. For example, many have different components, which cannot
be reproduced in a reusable item. It is not uncommon practice in the US, for example, to send single use disposable items to companies set up specifically to be experts in reprocessing. Many complex instruments, such as cardiac catheters, which cost a great deal of money, are reused on a different patient when they are returned to the hospital. The UK has long standing advice that this is not acceptable practice and will not be done, due to physical changes to some inherent components, particularly to plastics within the
10% 5% 4%
62% 10% 4%
Responsible for % of NHS England GHG emissions
5%
16
www.clinicalservicesjournal.com I August 2024
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