Sustainability
is also critical to assess the data and evidence supporting a proposed medical device to prove its potential impact.
Antimicrobial resistance: a sustainability crisis in disguise and the role of medical devices As well as supporting other NHS economic challenges in combination with sustainability / Net Zero, it is worth noting that medical devices can also contribute to fighting other Global threats – namely antimicrobial resistance (AMR). In 2019, AMR was directly responsible for 1.27 million deaths and associated with nearly 5 million.9
Forecasts estimate 39 million deaths
between 2025 and 2050.10 Quality improvement projects focusing on infection prevention over treatment utilising different medical devices is one strategy that can be explored to help combat both AMR and the climate crisis – as the Vascular surgery example demonstrates. When focusing on wound dressings, it is worth noting that there is an increasing number of studies identifying antimicrobial resistance or tolerance to silver. In a recent systematic scoping review, it concluded that while silver remains a crucial tool in wound care, the emergence of resistance necessitates a careful and informed approach to its use, alongside ongoing research into alternative therapies.11 AMR is also deeply intertwined with sustainability: l Unsustainable practices, specifically the overuse of antibiotics, which accelerates resistance really emphasises the need for prevention of healthcare acquired infections.
l Environmental reservoirs (soil, water, wastewater) act as breeding grounds for resistant bacteria.12
l Climate change and extreme weather events further spread resistant pathogens.
This again demonstrates the need for the NHS to measure the impact of sustainability projects using the Triple Bottom Line framework to capture the wider financial and societal impact, rather than as a siloed KPI only focusing on kgCO2e generated.
Appropriate and safe: circularity is more than reusable only The vascular surgery example demonstrates how by choosing a better performing single use medical device, and implementing the change correctly, can also be more sustainable – preventing resource use across Scopes 1-3 for SSI treatment. NHS and UK Government (Design for Life)13
strategies focus on moving to a circular economy with an emphasis on
Choosing superior single use products that deliver better outcomes or using existing single use products more effectively can also be more sustainable.
reducing single use products, but only when safe and appropriate. Switching from single use must not negatively impact or compromise quality of care or patient safety. Wound care, especially infection management products, are contaminated after use. Clinically, these products can be single use
only to prevent transferring contaminants / bioburden to the healing wound site or other patients (negatively impacting safety and treatment outcomes). Therefore, when considering Scope 3 Medical Device projects, it is critical to not solely focus on reusable solutions. Choosing superior single use products that deliver better outcomes or using existing single use products more effectively can also be more sustainable.
Conclusion: sustainable care is smarter care Fundamentally, everything discussed in this article falls under value-based procurement (VBP), priority action 14 of the UK Government’s ‘Design for Life Roadmap’.13
from a reduction in product costs to working in collaboration with industry to consider technologies that can influence a reduction in total costs within the patient pathway.14
teams, clinicians and industry must work together to drive positive value-adding change
However, to achieve this, a mindset shift is also needed - sustainability and care quality go hand in hand, sustainability must not be considered isolation. Adopting the mindset that by making a service (delivery of care) more sustainable, will often make a service more efficient is key. With this mindset and measuring the impact of QI projects using the Triple Bottom Line framework, by working towards achieving Net Zero the NHS can: l Reduce emissions l Improve patient outcomes l Save money / reduce costs l Protect public health l Safeguard future generations
VBP is a shift in focus
Additional support materials and training, including the CleanMed Europe 2025 talk, is available through PATH, Essity’s free clinical education platform.
CSJ Another
example demonstrating the benefits of VBP within continence care from NHS Supply Chain is here:
https://www.supplychain.nhs.uk/news- article/delivering-better-continence-care/ As the NHS continually evolves its sustainability strategy to reach Net Zero, the below recommendations should be considered: l Supplement high-cost NHS Carbon Footprint Scope 1 & 2 projects with more NHS Carbon Footprint PLUS Scope 3 projects
l Embrace the opportunities presented from Medical Devices – especially within infection prevention
l Utilise the wealth of knowledge and experience clinicians have within each clinical area to identify and implement sustainability quality improvement (SusQI) projects
l Single use products in some cases are the only option. Therefore, using superior products and/or using existing single use products better can deliver significant sustainability outcomes – supported by strong data and clinical evidence
l Collaboration is key. NHS Sustainability 46
www.clinicalservicesjournal.com I December 2025
References 1. NHS (2020) Delivering a ‘Net Zero’ National health Service. Available: https://www.
england.nhs.uk/greenernhs/wp-content/ uploads/sites/51/2020/10/delivering-a-net- zero-national-health-service.pdf
2. NHS England (2025) Five years of a greener NHS: progress and forward look. Available:
https://www.england.nhs.uk/long-read/five- years-greener-nhs-progress-forward-look/
3. NHS England (2025) Green Plan Guidance – February 2025. Available: https://www.england.
nhs.uk/long-read/green-plan-guidance/
4. Lathan R, Daysley H, Ravindhran B, Lim A, Cutteridge J, Sidapra M, Long J, Hitchman L, Beltran-Alvarez P, Carradice D, Smith G, Chetter I. Environmental and financial cost of surgical-site infection by severity after lower limb vascular surgery. BJS Open. 2025 May 7;9(3): Environmental and financial cost of surgical-site infection by severity after lower limb vascular surgery - PMC
5. Wallace et al. (2025) Leukomed Sorbact to Reduce SSI in Vascular Surgery. SIS-E 2025 Dublin
6. Department of Transport UK (2023) Journey emission comparisons: interactive dashboard. Available:
https://maps.dft.gov.uk/ journey-emission-comparisons-interactive- dashboard/
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