Sandwell & West Birmingham NHS Trust

Clare Nash

Clinical Procurement Authority

Clare Nash is Head of Clinical Products Management for the Black Country Alliance covering Sandwell and West Birmingham NHS Trust and The Dudley Group of Hospitals NHS Foundation Trust. She is an expert in the field of sustainable procurement in the National Health Service (NHS) in England and has authored several papers including “It’s not easy being green – a tool for choosing sustainable clinical products” and most recently “Reusable tourniquets: their impact on patients, planet and public purse.” She is an international speaker focusing on how clinical staff can contribute towards net zero and a greener healthcare system.

Through this article Nash highlights the importance of resilience, collaboration and sustainability to drive change in clinical procurement.

Building Resilience in Healthcare Supply Chains                           

Since Covid-19 and subsequently the impact Brexit has had on importing of goods, clinical procurement has been an extremely challenging role. Internationally, the lack of resilience of supply (PPE, as well as thousands of other product lines) has led us to look to new ways of working. This has presented us with opportunities that have brought our profession closer together and spotlighted the incredible resource our colleagues bring to the collective healthcare table.

We now have a robust system of mutual aid in place when supplies are impacted. We share products between organisations and across regions or we can offer alternatives to the current product lines based on our clinical experiences, without compromising on patient safety.

Procuring reusable clinical products to last, rather than having to constantly replenish single-use items, will ensure the stock is always there. When we have a circular economy, we are no longer reliant on shipping containers arriving on time or the transporting of goods through war-torn regions or depleting the planet of its natural resources.

Embracing Collective Expertise

I have built up a strong network and alliance of many clinical, managerial and external stakeholders over the years of working for the NHS. Implementing change means ensuring you are open and transparent and are collaborative in your approach. Acknowledging I may not be the expert in the room, but opening the floor for others to contribute ensures you take your stakeholders with you on the journey. Finding the why (thank you Simon Sinek!) for each stakeholder is also a vital step.

Procurement to Drive Change

Procurement staff are the collaborators and front-line enablers of the process of getting products to the patient care setting. Without interdisciplinary collaboration, there can be no decisions made. Setting up strong governance processes approved at board level or C-suite is essential in supporting clinically safe, sustainable and financially robust procurement. Without this, we would just become a team that processes orders, task oriented, back office.

"Setting up strong governance processes approved at board level or C-suite is essential in supporting clinically safe, sustainable and financially robust procurement. Without this, we would just become a team that processes orders, task oriented, back office"

The biggest challenge we now face is undoubtedly the climate emergency. The slower we are to respond globally, the more our populations are getting sicker as a result. Polluted air, water, seas, increasing temperatures, wildfires, drought, hurricanes and floods are all impacting on the health of those living in affected regions, as well as this impacting on the manufacturing of products we need to deliver care.

We know that about 62% of the NHS carbon footprint comes from our supply chains so it’s absolutely in our clinical procurement and collective nursing gift to influence and reduce this. If we can procure locally, from suppliers who are genuinely committed to reducing their carbon emissions and net zero targets and we move back to reuse where safe to do so, we can begin to tackle the growing threats of global logistics challenges.

We cannot do this alone though; strengthening the decontamination facilities, investing in research and innovation and procuring for patient outcomes and climate mitigation and adaptation, not for savings are all critical pieces of the jigsaw.

Key Advice for Aspiring Leaders

I have spent all of my career in the NHS. I believe it’s not what you know (although clearly important!) it is WHO that makes the difference. Keeping your relationships and networks close is the key to getting things done. Reciprocity, resilience and reliability are the three things I think I pride myself on most, along with a huge dose of enthusiasm for what I do. I love my job; it allows me to improve patient care, reduce the impact on the planet and every day I genuinely feel my contributions make a difference.

Sustainable Future with Clinical Procurement Nurses

We have an established network of fabulous clinical procurement colleagues across the NHS, including NHS England and Wales. As we see financial pressures grow and climate emergency worsen, I strongly believe that the Clinical Procurement Nurse is a critical invest-to-save role to save money, save patients and help save the planet.