NHS Suppliers Guide to Greener Operations

Greener NHS
What NHS Suppliers and Innovators
need to know

• Unless asked to speak, please stay on mute with video off
• Ask all questions in the chat bar
• Only use the chat for questions

PPN 06/21
• Guidance on adopting and applying 06/21
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1054373/Guidance-on-
adopting-and-applying-PPN-06_21-_-Selection-Criteria-Jan22__1_.pdf
• Technical Standard for completion of Carbon Reduction Plans
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/991625/PPN_0621_Tec
hnical_standard_for_the_Completion_of_Carbon_Reduction_Plans__2_.pdf
• Carbon reduction template
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1053009/PPN-0621-
Carbon-Reduction-Plan-Template-Jan22.odt
• FAQ on PPN06/21
• https://www.gov.uk/government/publications/procurement-policy-note-0621-taking-account-of-carbon-reduction-plans-in-
the-procurement-of-major-government-contracts/ppn-0621-frequently-asked-questions

Greener NHS » Delivering a ‘Net Zero’ National Health Service
(england.nhs.uk)
https://www.longtermplan.nhs.uk/wp-
content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf
https://www.health.org.uk/about-the-health-foundation/get-
involved/events/webinar-after-cop26-what-will-it-take-to-get-the-
nhs-to-net-zero

Environmental Consultants
As the NHS embraces Net Zero, we expect there may be an increased
number of environmental consultants offering advice. Take care that any
such consultant is credible, with a strong track record in this area.

Calculating Carbon Footprint – Where to Start?
The UK Government provides the MacKay Carbon Calculator:
https://www.gov.uk/guidance/carbon-calculator
This is a useful tool which can help map out a pathway for a company to reduce their green house
emissions across a range of sectors.

Useful sources
 Carbon Trust: SME Carbon Footprint Calculator:
https://www.carbontrust.com/resources/sme-
carbon-footprint-calculator
 Carbon footprint: http://www.carbonfootprint.com/
 Carbon Footprint: Small Business calculator:
https://www.carbonfootprint.com/small_business_c
alculator.html
 avieco: https://avieco.com/
 Ricardo-AEA: https://ee.ricardo.com/?stage=Live
 CDP partners: https://www.cdp.net/en
 Waste Resources Action Programme (WRAP):
http://www.wrap.org.uk/
 Greenstone:
http://www.greenstoneplus.com/services/
 Ecometrica: http://ecometrica.com/
 Anthesis Group: https://www.anthesisgroup.com/
 IEMA: http://www.iema.net/
 Verco: http://www.vercoglobal.com/
 Loreus: http://www.loreus.com/
 WS Group: http://www.wspgroup.com/en/WSP-UK
The following list is not exhaustive and is not officially endorsed by government but may prove useful:

Delivering Health Sustainably
NHS Supply Chain Sustainability Strategy
Martin Toomey FCIPS – Sustainability Manager

14
Sustainability is a key priority within the NHS and
NHS Supply Chain
NHS Supply Chain are working closely with NHS E/I to
align our plans

15
2021/2022 Business Plan – Sustainability and Supply chain Resilience

16
NHS Supply Chain Sustainability Goals
Human
rights &
labour
standards*
‘NHS Supply Chain are committed to delivering health sustainably’
 Ensure basic rights for
everyone across entirety of
NHS supply chain
 Response to Intl Issues e.g.
Modern Slavery, Child
Labour, Forced Labour,
Trafficking
 Support Labour Standards
e.g. Health and Safety,
Employment terms
Targets
 360 New suppliers registered
on LSAT module
 15% Colleague volunteers
for charity day
 33% SME’s traded by value
Waste &
Circular
Economy
Targets
 3 Feasible projects undertaken
and concluded
 50% Office waste recycled
Plastic
Products &
Packaging
 Reducing use of plastics
across NHS supply chain and
our supply chain for procured
/distributed products
 Reducing plastics in
packaging and single use
plastics
 Understanding the cumulative
effect of these on the
environment
Stretch Targets
 350 Single use plastic tonnes
reduced
Climate
Change,
Energy &
GHG
emissions
 Holistic response to climate
change, air pollution, carbon
agenda
 Includes: Energy
consumption, fuel usage,
carbon footprint, GHG
emissions
 Across NHSSC operations,
infrastructure & Fleet.
Excludes our suppliers.
Stretch Targets
 5,100 tonnes CO2 Emissions
removed
 Management of waste across
entirety of NHS supply chain
 Impact of packaging, food
waste and other waste across
offices and distribution
centres etc.
 Circular economy principle to
minimise resource input and
further reduce waste
*Includes efforts to support the SME strategies of central government and encourage our staff to pursue charitable goals in their local communities

17
Draft for Discussion
Our Suppliers and Supply Chain are a big contributor
to Carbon and therefore critical to our success
3.3. Supply chain
The NHS Carbon Footprint Plus considers an expanded scope
of emissions, covering the products procured from its 80,000
suppliers. While the NHS does not control these emissions
directly, it can use its considerable purchasing power to
influence change.
A summary of the broad range of interventions considered is
presented in Figure 9, for reductions of emissions from
medical and non-medical equipment (18%), food and catering
(6%), other procurement (18%), commissioned healthcare
services outside the NHS (4%) and medicines and
pharmaceuticals (20%).
Supply Chain
Contribution
to Carbon
Emissions

18
16,531
865
4,203
4,458
785
533
525
220
498
1,488
92
417
202
157
224
1,865
0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000
Present day emissions
Research, innovation and offsetting
Pharmaceuticals suppliers meet NHS commitments
Non-pharmaceutical suppliers meet NHS commitments
Comissioned services meet NHS commitments
Electrified freight transport
Decarbonising construction
Switch to plant-forward diets
Switch to bio-based polymers
Process and product innovation
Reduced food waste
Reduced use of paper
Device reuse and refurbishment
Metal instrument reprocessing
Reduced single-use plastics
Forecasted change in activty
CO2 emissions (ktCO2e)
Present day emissions
Emissions reduction
Residual
Interventions to reduce supply chain emissions
In the Net Zero report, there are 13 interventions that were identified within the Supply
Chain workstream. These form the foundation of the Supply Chain workstream programme plan for the next
five years.

19
Building net zero into NHS procurement
Jan
2022
NHSE&I will launch the Sustainable Supplier Framework
NHS will adopt PPN 06/20 so that all NHS tenders include
a minimum 10% net zero and social value weighting
April
2024
April
2027
All suppliers* will be required to publicly report
emissions and publish a carbon reduction plan
aligned to the NHS’ net zero target for their direct
emissions, irrespective of contract value
April
2028
All suppliers* will be required to publicly report
emissions and publish a carbon reduction plan
aligned to the NHS’ net zero target, for both their
direct and indirect emissions (Scope 1, 2, and 3)
April
2030
All suppliers will be required to demonstrate
progress in-line with the NHS’ net zero targets,
through published progress reports and
continued carbon emissions reporting
April
2023
NHS will adopt PPN 06/21 so that all
contracts above £5m will require suppliers*
to publish a carbon reduction plan for their
direct emissions as a qualifying criteria
April
2022
2045
New requirements will be introduced
overseeing the provision of carbon footprinting
for individual products supplied to the NHS
• Net Zero Supply Chain
• Net Zero NHS
*To account for the specific barriers that Small & Medium Enterprises and Voluntary, Community & Social Enterprises encounter, a two-year grace period on the requirements leading up to
the 2030 deadline, by which point we expect all suppliers to have matched or exceeded our ambition for net zero.

20
The NHS Supply Chain Sustainability KPI Dashboard
Notes: CO2 in month tonnes removed corresponds to delivery of discreet projects
Office waste collections on hold

21
Supplier Registration Service
Government Portal – Why is it an enhancement?
https://supplierregistration.cabinetoffice.gov.uk/
• Online Data across Supply Chains with Group Scores and answers with the ability to drill down into the questions and individual scores
• Suppliers also get a report of the assessments and an improvement plan
• NHS SC can track and report on improvements over time – both internally and externally, demonstrating our added value
The modules provide more detailed information and action plans for improvement
NHS SC have invested in the portal to
supports us to assess:
• Labour Standards and Modern
Slavery
• Carbon Reporting
• Supply Chain Mapping
Through these assessments we are
able to look at these themes in a

22
Supplier Registration Service – NHS Supply Chain
NHS SC is using a series of Assessments on UK Government
Online Portal to collate detailed information from our
Suppliers on Modern Day Slavery, Labour Standards, Carbon
Waste and Water
NHS SC have Risk Assessed all their Procurement
Frameworks for key
Sustainability Themes and will be using the Portal to engage
our Suppliers on this key issues.
For more information and to registered as a Buyer visit.
https://supplierregistration.cabinetoffice.gov.uk/

23
Social Value Overview
NHS SC are already working on implementation of Social Value
• Issued on June 6, 2020, PPN 06/20 applies to all NHS procurement from April 1 , 2022 and mandates that a
minimum weighting of 10% of the total score for the tender evaluation should apply to social value. A higher
weighting can be applied if justified. The NHS is adopting this approach as well.
Covid-19 Recovery - Helping local
communities to manage and recover
from the impact of COVID-19
Tackling Economic
Inequality - Investing spend in
a way that drives an equitable
society
Fighting Climate Change -
Effective stewardship of the
environment through net zero
delivery
Equal Opportunity – Provide
equal opportunity and tackle
modern slavery
Wellbeing – Encourage
wellbeing
and cohesion
Wider Determinants of Health

24
Procurement Policy Note 06/21 – Carbon Reduction Plans
• https://www.gov.uk/government/publications/procurement-policy-note-0621-taking-account-of-carbon-reduction-
plans-in-the-procurement-of-major-government-contracts
• Suppliers are required to submit plans to reduce Carbon in Contracts over £5
million
• Confirming the bidding supplier’s commitment to achieving Net Zero by 2050 for their
• UK operations.
• Providing the supplier’s current emissions for the sources included in Scope 1 and 2
• of the GHG Protocol, and a defined subset of Scope 3 emissions.
• Providing emissions reporting in CO2e (Carbon Dioxide Equivalent) for the six
• greenhouse gases covered by the Kyoto Protocol4
• Setting out the environmental management measures in effect, including certification
• schemes or specific carbon reduction measures you have adopted, and that you will
• be able to apply when performing the contract and that support achieving Net Zero by
• 2050.
• Publication of the CRP on the supplier’s website.

25
Thank you
Questions?
• Martin.toomey2@supplychain.nhs.uk

Leanvation
A decade in surgical gloves.
www.leanvation.com

Leanvation - “I’m terribly sorry to hear that. However,
you are still wearing your old gloves. We don’t start
the trial in this theatre until tomorrow.”
A real encounter with an
orthopaedic surgeon.
Surgeon - “These gloves are ******* crap! They’re uncomfortable
and so slippery that I keep dropping my instruments!”

Background
• Former senior management team of leading global surgical
gloves brand
• Start-up business in 2013, supported by PE and NW Investment
Fund
• Have grown to sell over 40 million gloves in 2020-21
• Headquartered in St Helens
www.leanvation.com

Head of Procurement - Erasmus Hospital,
Netherlands
“Please don’t come here bringing me even more products to
consider. We already have more than we need. Every surgeon has
their own preferences, making stock control almost impossible. We
have little storage space and gloves take up more than anything
else.”

Typically, how many SKUs are
offered by the leading brands?

Category Traits
• Dominated by few key players
• Remains predominantly latex based (>90%) c.f 53% latex-free in
US
• Product development focuses on incremental improvements in
competitive claims for marketing advantage

Opportunity
Innovate to deliver greater value.

How do we innovate to
add value?
• Recognise that customers want fewer gloves, not more
• Strip-out ‘luxury’ additives from formulations (e.g. aloe
vera)
• Use fewer chemicals together with a brand new
manufacturing facility to deliver health benefits and
efficiencies
• Substitute expensive chemical formulations for generic
alternatives without impacting quality or performance.
• Focus on delivering multi-functionality by reducing
thickness, increasing softness, improving tactile
sensitivity, all while retaining strength / performance
www.leanvation.com

Launch Range - 2014
• ‘Three gloves, one message, no latex.’
• Class-leading fit/feel/comfort without compromising protection
• Engineered to service specific needs of all surgical specialties, offering a thin,
thick and puncture indicating glove variant of the same poly(isoprene)
formulation
• Multi-functionality across surgical specialties made possible by innovation
• Performance removes need to carry latex variants

Feedb
ack
Assessment Attribute -
Fit
0
25
50
75
100
Good or
Better
Bad
95
%
5%0% 0
25
50
75
100
Good or
Better
Bad
10
0%
0%0%
Comfort
0
25
50
75
100
Good or
Better
Bad
95
%
5%0%
Sensitivity
0
25
50
75
100
Good or
Better
Bad
95
%
5%0%
Strength
0
22.5
45
67.5
90
Good or Better
Bad
90
% 10
%
0%
Assessment Attribute - Donning
Ease
0
22.5
45
67.5
90
Yes No
86
% 14
%
'Would you be prepared to
use Leanvation for all
cases?'

2015. A
realisation.
• Budget pressures dominate
• Even at reduced pricing v competitors, latex-free gloves
present an unacceptable cost pressure in direct
comparisons with latex variants
www.leanvation.com

2016. Change.
www.leanvation.com
Answering market need & opportunity.

Our product range approach:
keep things simple.
• 2 different thickness levels
• 2 different grip levels
• Puncture indication / double gloving solution
• 2 alternative fits (finger length & palm width)
• Chemical resistance
• Latex range mirrored in latex-free
www.leanvation.com

Leanvation in 2019
www.leanvation.com
• Greater focus on efficiency & cost effectiveness
• Core message of using innovation to deliver a rationalised product range now offered
across both latex and latex-free variants in response to customer demand
• Continue to offer class-leading fit/feel/comfort and quality without compromising
protection
• Engineered to service specific needs of all surgical specialties
• Low allergenicity

Leanvation Eco
Innovation to deliver
reduced costs
• Leverage latest coating technology to
reduce donning coating thickness without
compromising function
• Engineer to be crease resistant, allowing
greater folding
• Reduced packaging size and volume
(50%)
• Reduced packaging costs (size, colour,
non-corrugated)
• All without reducing quality
www.leanvation.com

Clinical Feedback from
Alder Hey
www.leanvation.com

Orthopaedic Surgeon, Aintree NHS Trust
“Having worn my current glove for 20 years, I was contemplating
penning a letter to the Medical Director, refusing to be forced to
change my gloves against my will. I then, yesterday, arrive at the
RCS to educate medical students on a course I was leading only to
be provided with Leanvation gloves there in London. So I guess I
will have to accept that you guys are taking over the world and just
accept it.”

So, the path ahead is easy
then, is it?

Attitudes to ‘Change’
Remain a Hurdle
• Serving the NHS with products still currently plays to the
strengths of ‘Goliath’ not ‘David’
• SME’s can make impact, but continued traction is
hampered by attitudes to change when change offers few
incentives for individual NHS stakeholders
• Global enterprise will always attempt to defend it’s
position - that’s pure economics!
• However, agile SME’s can often be more innovative,
more quickly, particularly with respect to environmental
sustainability
www.leanvation.com

Leanvation Eco
Innovation to deliver reduced costs &
improved environmental
sustainability!
• Leverage latest coating technology to reduce
donning coating thickness without
compromising function
• Engineer to be crease resistant, allowing
greater folding
• Reduced packaging size and volume
(50%)
• Reduced packaging costs (size, colour,
non-corrugated)
• By reducing packaging size by 50%, we
can pack 2x quantity in 40’ shipping
container
• Reduces CO2 associated with transit by
half
• Reduces CO2 associated with
www.leanvation.com

NHS Supply Chain Gloves
Framework Tender 22-24(26)
• Significant weighting towards CSR & ES
• Requires bidders to showcase what plans they have to
reduce their carbon footprint over the next decade
• Leanvation showcase the vast savings in CO2 that have
already been realised from development of Leanvation Eco
and spin-off products, adoption of EV’s across the
business, adoption of clean energy at manufacturing sites
• Leanvation validate that we are industry leaders for
environmental sustainability and have already
implemented change to realise an environmentally
sustainable business
• Leanvation preliminarily receive the lowest bidder score for
environmental sustainability on account that ES is
essentially scored on the basis of not where a business is
now in terms of ES, but what increment of change you will
www.leanvation.com

Dialogue is Essential!
• Supported by the NWC AHSN (Innovation Agency) and
Valuematch, Leanvation worked with NHS Supply Chain to
look at the detail behind Leanvation’s tender submission
• NHS Supply Chain subsequently acknowledged that
Leanvation had been scored ‘harshly’ on account of having
already made huge strides to improve ES across the
gloves category
• NHS Supply Chain acknowledged that Leanvation
presented an opportunity to swiftly aid the NHS to attain
it’s net zero goals by adoption of Leanvation products
www.leanvation.com

Considerations
• Many NHS Trusts still strive to irradicate latex from
operating theatres
• Cases of latex-allergy remain lowest for over a decade; no
reported cases of fatal anaphylaxis in over 5 years
• Latex-free surgical glove adoption across the NHS remains
steady at around 6%
• Latex-free surgical gloves cost typically 2x the cost of their
latex counterparts
• Latex gloves are produced from a renewable resource with
a net positive impact on CO2; the opposite applies to latex-
free gloves
• Should NHS trusts revisit their latex policies in support of
the goal to attain net zero by 2040?
www.leanvation.com

Learnings
• Listen, adapt, challenge and communicate
• Recognise that common sense does prevail with NHS
Supply Chain, although you may have to fight for it!
• Understand what customers / end users want - using
technology to realise ‘simplification’ can typically:
• Improve environmental sustainability
• Reduced costs / improve profitability
• Provide strong competitive advantages that are easy to
sell and easy for end users to understand
www.leanvation.com

Greener NHS –
What Suppliers….
And Innovators
need to know
Mike Kenny
Acting Co-Director of Enterprise and Growth, Innovation Agency (NWC AHSN)
16th March 2022

Summary
Points
• Climate change is the
biggest and most
pressing challenge of our
generation; worlds best
scientists say we have less
than 10 years to fix it
• The NHS is the largest
emitter of CO2 in the UK
• NHS responsible for 5%
emissions in the UK

The Opportunity for Innovation
• Multiple NHS “Digital First” polices & programmes
• Improving Care
• Improving Outcomes
• Bridging Workforce Gaps
• Saving Money
• Improving Experience for patients and workforce

• Covid 19 Pandemic
• Social Distancing
• Reduced capacity in Primary and Secondary Care
• Remote Monitoring “stood up” at Scale
• Virtual Consultation provided at Scale in Primary and
Secondary Care
• Not for everyone, but for many – a better experience
• A chance to be at home
• Workforce – better care for more patients within capacity

• AHSNs have been driving such change for years
• The Pandemic changed behaviours of patients and NHS &
Social care staff due to necessity
• Covid created the “use case” for greater digital provision of
care… virtually overnight
• Digital and Remote is not for everyone - it can and has
driven health inequalities
• So Digital and Remote not the whole “answer” – but has
become embedded as part of the way care is delivered
right?

What Can be the NHS “Call to Action”?

With 5% of NHS CO2 emissions due to
patient travel – can we really justify this?

The Opportunity For Innovation
This Photo by Unknown Author is licensed under CC BY-SA
This Photo by Unknown Author is licensed under CC BY-SA

The
Opportunity
For Innovation
• Leanvation started out
trying to make the NHS
Latex free
• But have realised a
much bigger
opportunity through
innovative approaches
to manufacturing,
packaging and raw
material use – reducing
carbon emission
• Whilst increasing value

Thank You
Mike Kenny – mike.Kenny@innovationagencynwc.nhs.uk
@innovation_mike

NHS Suppliers Guide to Greener Operations

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