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'Involving nurses in purchasing will make the NHS greener'

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The NHS has a large carbon footprint, emitting the equivalent of 21 million tonnes of carbon dioxide each year.

Janet Richardson

The majority of this - 65% - is related to the procurement of goods and services.

So the recently launched Royal College of Nursing initiative to involve nurses in procurement is to be welcomed. Bringing together the process for purchasing items used in clinical practice with the people who use them every day should pave the way for smarter and more sustainable decision making around how we spend valuable NHS resources.

Practitioners will need to secure equipment to deliver efficient and effective healthcare in the future.

Much of what we use every day in clinical practice is made from potentially scarce natural materials, such as lithium. Oil is a finite resource and we need to seriously consider the impact on care should oil no longer be available to make the significant number of items we use that are based on plastic.

In thinking about the future availability of these resources and looking for possible alternatives, we can be creative, drawing on other disciplines such as engineering and design. Opinions on which items are essential for care can vary among clinicians and non-clinicians, so multi-disciplinary approaches need to be taken to minimise the risk of supply interruption of essential items.

Government policies such as purchasing items in bulk can inhibit sustainable practices, with excess packaging leading to significant waste that needs to be incinerated or disposed of by landfill. Strategies have been developed to support sustainable procurement.

Infection policies that prohibit sustainability, such as those specifying that single-use items such as plastic medicine pots should be used, allow manufacturers to make significant money from the NHS and require excess use of scarce natural materials. Such policies may need to be reviewed if we are serious about reducing the financial and environmental cost of NHS purchasing.

Seeking creative solutions and raising awareness about procurement and resources must begin with educating health professionals.

If nurses are to be engaged fully in an informed and creative way, they need education and training. Tools such as the Health Environment and Resources Toolkit (HEaRT - have been developed to train health and social care professionals to raise awareness about sustainable procurement and the use of potentially scarce natural materials in clinical practice.

The development of teaching and learning materials that raise awareness about the health effects of climate change will further enhance nurses’ ability to engage in decisions about managing healthcare resources.

On NHS Sustainability Day held on Thursday 26 March, around 400 NHS organisations conducted activities to raise awareness about climate change and health. Such approaches, based on research evidence and using group discussion, can engage health professionals in meaningful ways and provide inter-disciplinary opportunities to develop innovative solutions.

Procurement is one aspect of the challenges we face in delivering healthcare in a changing environment, and the RCN initiative will contribute to meeting these challenges. Nurses are opinion leaders who can use evidence to change practice, so this is a very timely project.

Janet Richardson is professor of Health Service Research, Faculty of Health and Human Sciences, Plymouth University

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