Why healthcare needs a circular economy

For NHS Scotland, the Circular Economy represents an opportunity to rethink how products and resources move through healthcare, supporting better value, greater supply-chain resilience and lower environmental impact.

We caught up with Wendy Rayner, NHS Scotland Head of Circular Economy at the Scottish Government, to get her perspective on the bigger opportunity for Scotland and what it will take to turn circular economy ambition into system-wide change.

Across Scotland’s healthcare system, we are seeking solutions that can simultaneously support improved care, quality outcomes, financial sustainability, operational resilience and climate goals.

Circular Economy approaches are fundamental to our success; they help to reduce waste, improve resource efficiency and strengthen supply chain resilience by making key stakeholders rethink how healthcare products are designed, procured, used and managed. They take account of global supply chains, resilience risks, and the availability and affordability of materials and products, as well as their impact on the global environment.  At the heart of circular economy models is the need to support and grow the national economy to support jobs and economic development in Scotland.

Our current practices rely too heavily on linear economy models of supply which require a constant feed of products which are designed in isolation, often with a limited life span. This includes a very high number of single-use products. Some single use products are core to infection control but many are not.

Linear economy models are often described as ‘take-make-dispose’ models as they rely on a constant feedstock of raw materials and an equal, and often expensive, requirement for specialist waste management services.  Whilst such models were sold largely on the basis of convenience and appear lower at the point of purchase, such models have hidden costs (and risks) when the whole life cost is fully considered. Especially when we recognise that raw material extraction accounts for over 90% of global biodiversity loss and that the impact of the extraction, manufacturing and logistics leads to significant carbon impacts, with over 60% of the NHS carbon footprint associated with the products we buy. 

In fact, the carbon impacts of products we purchase in NHS Scotland (manufacturing, supply chain, raw materials, etc), have a greater impact than managing the total carbon impact of our NHS Scotland built estate (utilities, medical gases, transport, etc).

There are also resilience risks. Healthcare relies on complex global supply chains and on critical materials used in batteries, imaging equipment, surgical instruments, implants and pacemakers. Scarcity, energy costs, trade restrictions and geopolitical instability leads to supply and cost volatility making the critical supply chains for global healthcare (including NHS Scotland) vulnerable.

In our current linear system, we have no option but to ride out the volatility with little or no guarantee of improved future availability. Longer-term contracts and commitments offer some mitigation but this only delays future limitations as global demand outstrips supply.

Working with our supply chain partners and other stakeholders, new systems of supply based on increased circularity are being modelled and trialled. In NHS Scotland we are modelling options and gathering data on infrastructure capacity and future requirements for key services which will enable circularity, including laundry, decontamination and sterilisation. We are working with industry to ensure that data systems and product standards not only support continued access to products but they also support innovation and product upgrades, allowing us to access high-quality products and take advantage of new designs and ways of working.

Moving away from liner models requires a system approach, designed around the needs of the healthcare environment. The benefits of the system approach and investments in infrastructure and services can lead to wider economic benefits for Scotland too.

The circular economy ultimately needs to be mainstream as the question is no longer whether healthcare can afford to move away from linear consumption. It is whether it can afford not to.