‘For a Greener NHS’ – what does this mean for the role of HealthTech?

Despite the pressure and challenges facing the NHS and wider health and social care sector in tackling the Covid-19 second wave and winter pressures, the NHS remains committed to playing its part in tackling climate change. The role that technology can play in this fight is very much in its sights. Indeed we can expect to see an increased focus on the NHS’ aims in this area in future public procurement processes.

For a Greener NHS

In January of this year the NHS launched its ‘For a Greener NHS’ programme with a call for evidence to inform its thinking on a plan to hit Net Zero in terms of its carbon emissions. In support of this objective a Net Zero Expert Panel was also established to provide advice and set out a ‘practical, evidence based and quantified path’ to achieving this ambition. That work has culminated in the NHS’ ‘Delivering a ‘Net Zero’ NHS Service’ report which was published in October (Report). The Report can be accessed here.

The scale of the challenge facing the NHS is evident in the pages of the Report and the numbers which underpin it. According to the Report the NHS is believed to account for 4% of England’s total carbon footprint. However, its stated ambition is to reach Net Zero in respect of:

• the NHS Carbon Footprint (i.e. the emissions it directly controls) by 2040; and

• the NHS Carbon Footprint Plus (i.e. those emissions the NHS can influence) by 2045.

Key areas for intervention identified in the report include:

• estates and facilities;

• travel and transport;

• the supply chain (including medical and non-medical equipment);

• medicines;

• research, innovation and off-setting.

What role is HealthTech expected to play?

The short answer is, potentially, a very big one. The role ‘tech’ can play is pervasive almost throughout the entire Report whether in terms of being core to direct interventions to decarbonise the NHS (i.e. developing/extending the range of low-carbon alternatives to current supply chain products) or by providing and/or enhancing the tools the NHS needs to deliver other interventions and address its plan (e.g. providing the technology needed for smart hospitals).

Amongst a number of interventions the NHS is looking at with regard to the supply chain is how it can change/adapt its purchasing habits to support the green agenda and this includes a focus on reducing the number of single-use plastics in use and reusing and refurbishing medical devices where possible. However, these purchasing (and in some case prescribing) practices cannot be changed unless the NHS has access to suitable alternatives which can be put to effective use more than once. There is an honest recognition that the response to the Covid-19 pandemic has potential to exacerbate this issue given the sizeable increase in the use of single-use pieces of PPE which have gone through the system. The news that a recyclable PPE glove is in the running for the James Dyson award must surely be welcome news in this regard but the NHS no doubt wants and will need to see more.

There is also a role for technology to play in enabling the NHS to bring forward the identified interventions across other focus areas, for example in terms of its estates and facilities and travel and transport. The Report highlights that going forward opportunities within the framework of digital transformation include digitising the estate and smart hospitals – something which can only be achieved with the support of a successful and aspirational tech market. There is also a detailed explanation of the ambition to deliver a zero-emissions NHS fleet through the electrification of the NHS fleet and the development of the world’s first hydrogen-electric hybrid double-crewed ambulance - something in which technology plays a key part.

The Report also acknowledges that the changes the NHS is seeking could lead to an increase in carbon emissions due to an increase in ICT infrastructure. The NHS is, therefore, proposing that its digital transformation agenda will take account of the trajectory to a net-zero health service. Further policy advice is expected in this area. For ambitious and ‘green focused’ businesses there are plenty of opportunities to support this programme.

Is it just about what we can give the NHS?

No. The Report focuses not just on the interventions the NHS has identified as being key to pushing its carbon footprint towards Net Zero but also where it can influence the carbon footprint of others and, in general, this means its suppliers. The Report does not shy away from making it clear that the NHS can use its considerable purchasing power to influence the behaviours of its own supply chain in terms of how it manages and drives down its own carbon footprint. Suppliers have, very clearly, been put on notice that they need to look at and take action to address their own carbon footprint.

The power of procurement

There are clearly many aspects to the plan and a number of actions and initiatives which are within the control of the NHS itself. However, where the NHS interacts with the market, it can use the public procurement process to its advantage to drive the agenda.

As the customer, the NHS will be in a position to specify exactly what it wants in terms of medical devices, medicines and other forms of technology and we expect to see an increased requirement for zero- or low-carbon alternatives where possible - really challenging the market to step up and deliver. For those suppliers not engaged with the green agenda there is a real risk that they could see an impact on their future business and being successful in competitive procurement situations could become significantly more challenging.

Those procurement processes are likely to be even more uncomfortable for any suppliers who are not taking action to address and mitigate their own carbon footprint as we expect to see an increased focus on suppliers’ own actions in this regard within tenders themselves. We are already actively advising clients within the public sector on tenders which ask probing questions of suppliers in terms of their approach to managing and mitigating the environmental impact of their service/supply proposals. We expect to see an increase in clients addressing these issues in procurement processes themselves and focusing on how they can achieve contractual commitments on the part of suppliers to support this agenda.

It should also be noted that this focus is not unique to the NHS or the health sector in general. The Government has recently announced its new social value model (applicable to procurements caught by the Public Contracts Regulations 2015 and run by central government from 1st January 2021) which identifies a number of key priorities and themes which the contracting authority will be required to evaluate as part of a supplier’s social value offering. Fighting climate change is one of the five key themes and the Government has indicated what it considers ‘good’ to look like in terms of a supplier’s effective stewardship of the environment. The detail of the Report together with the further guidance to be issued in respect of the social value model will provide further insight as to the actions and steps suppliers need to be thinking about now.

If you have any queries with regard to public procurement processes in the health sector please contact Rachel Whitaker - Partner, Commercial Health.