Sustainability
Rethinking surgical textiles in the NHS
Surgical gowns and drapes are often treated as consumables but, in reality, they sit at the intersection of some of the NHS’s most pressing priorities: cost control, infection prevention, Net Zero delivery and supply resilience. As financial pressures intensify and environmental targets tighten, is it time to rethink how surgical textiles are evaluated? Roberta Charlett explores why the conversation around surgical textiles may need to change.
Operating theatres are among the most resource-intensive environments in acute care, yet some of the products used most routinely within them attract relatively little strategic attention. Surgical gowns and drapes are often treated as line items in procurement schedules, assessed through unit price comparisons and managed through stock availability. However, few other product categories touch cost, carbon, compliance and continuity of supply simultaneously. With this in mind, the real question now is whether surgical textiles are being evaluated at the right strategic level – viewed not simply as consumables, but as managed clinical infrastructure.
Looking beyond unit price Procurement teams across the NHS operate in a climate of sustained financial pressure. In this environment, it is understandable that purchase price often becomes a key decision-making metric, particularly in high-volume categories where small differences in unit cost can appear significant at scale. However, this approach does not always
capture total system cost. This is particularly relevant in perioperative settings, where the costs associated with surgical textiles extend far beyond the initial purchase order. Disposable systems, for example, often carry additional operational costs and considerations. These include continuous repurchasing commitments; storage, stock management and logistics requirements; clinical waste management and incineration costs; and exposure to global supply volatility. These costs are not always visible to the same budget holders responsible for procurement decisions as, in many NHS Trusts, purchasing budgets and waste management budgets sit in different parts of the organisation, creating
a disconnect between the apparent cost of a product taken at face value and its wider financial impact. Surgical textile systems should therefore be assessed not only on what they cost to acquire, but what they cost to own, manage and dispose of across the full product lifecycle. Reusable systems operate differently to disposable alternatives. Rather than relying on a continuous purchase and dispose model, they are typically structured around managed inventory systems, validated multi-cycle reprocessing performance (often up to 75 uses), and repair and replacement programmes. The economics of such systems are therefore more appropriately assessed on a cost-per-use or cost-per-procedure basis. When surgical textiles are evaluated on a cost-per-use or cost-per-procedure basis rather than price per item, the financial comparison often becomes more nuanced. This broader ‘total cost of ownership’
approach is already common in other areas of healthcare procurement, particularly where service-based models are involved, yet surgical textiles are not always considered through the same lens. However, that distinction is particularly relevant because, in operating theatre environments, even marginal inefficiencies in stock management, over- ordering, emergency replenishment or waste handling can rapidly accumulate. The conversation therefore needs to move
beyond the narrow question of ‘what does this item cost?’ towards the more strategic question of ‘what does this system cost?’
Sustainability and NHS Net Zero ambitions The environmental case for re-examining surgical textile systems is becoming increasingly difficult to ignore. The NHS has committed to becoming the world’s first Net Zero healthcare system, with targets spanning both direct
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