Aim / research question

This theme examines how alternative purchasing and contracting models in healthcare can support decarbonisation while improving value, efficiency, and long-term sustainability.

Healthcare procurement is typically based on buying products, even though the organisation purchasing equipment is often not the one using it. This disconnect contributes to high levels of waste, short product lifetimes, and the widespread use of single-use devices, particularly in medical electronics.

Theme 3b focuses on servitization, an approach where healthcare providers purchase outcomes or services rather than products alone. By shifting responsibility for maintenance, reuse, and performance back to manufacturers, servitization has the potential to reduce carbon emissions, improve resource efficiency, and counter planned obsolescence in medical devices.

Objectives

The research will:

• Evaluate alternative purchasing models based on servitization, comparing them with traditional procurement approaches to understand impacts on cost, carbon emissions, resource utilization and patient outcome.
• Focus on medical electronic equipment, where single-use products and planned obsolescence are major contributors to environmental impact.
• Model different servitization approaches, including:
  • All devices in an operating theatre provided under a service-based model
  • Selected devices fully supported and maintained by suppliers
  • Hybrid models where suppliers provide services but some reuse and processing is carried out within hospitals
• Generate robust evidence to inform policy and commissioning, supporting national decision-making on sustainable procurement and reuse of medical equipment.

Methods

The research will combine economic analysis, digital modelling, and close collaboration with clinical and industry partners.

• Analysis of current procurement and use
  The team will assess how medical devices are currently purchased, used, and disposed of, with a focus on medical electronics where short lifetimes, single-use labelling, and software-driven obsolescence are common.
• Servitization modelling
  Alternative purchasing models will be developed and assessed to understand how shifting to service- and outcome-based contracts can incentivise longer product lifetimes, better maintenance, and reduced material consumption.
• Digital twins of operating theatres
  Computer-based simulations of operating theatres will be created as experimental test beds. These digital twins will allow different procurement and usage scenarios to be tested safely, including impacts on carbon emissions, costs, asset utilisation, and potential risks.
• Stakeholder engagement
  The work will be co-developed with healthcare professionals, procurement teams, and industry representatives to ensure that proposed models are realistic, scalable, and aligned with clinical practice.
• Policy-focused evaluation
  Findings will be translated into clear evidence and guidance to support policy development, helping commissioners and national bodies understand where servitization delivers benefits and where safeguards are needed.

Why it matters for NHS

The NHS is one of the largest contributors to greenhouse gas emissions in the UK, responsible for around 4–5% of the country’s total emissions – roughly equivalent to the annual output of a small European nation.

• In 2024/25 the NHS’s direct carbon footprint was estimated at 4.7 million tonnes CO₂e and continues to be tracked against its target of net zero by 2040.
• A large portion of this footprint comes from supplies and clinical care, not just buildings and travel.

Operating theatres are especially carbon intensive:

• Theatres use 3–6 times more energy than other hospital areas and can account for 50–70% of hospital waste.
• A single operation can generate roughly 150–250 kg of CO₂e, due to energy use, consumables, anaesthetic gases, and single-use devices.

Servitization – buying outcomes and services rather than products – can help the NHS reduce these emissions by encouraging longer-lasting, better-maintained equipment, reducing waste and unnecessary replacement, and strengthening incentives for suppliers to decarbonise their products and services.