Traditionally risk averse and facing considerable financial pressure, the healthcare sector is perhaps not the most obvious showcase of circular economy principles. But while new business models involving refurbishing and sharing equipment have felt like a step too far in the past, things are changing – with straitened budgets proving one of the driving factors.
There is much scope to keep equipment in use for longer, says Brett Reed, CEO of Cohealo, a US-based technology company that helps health systems share medical equipment. Not only could circular principles help save the sector money, it could also better serve patients, he believes.
“The opportunity is large and for the most part, as of right now, untapped,” says Reed. He points to US research (pdf) that suggested only 42% of medical equipment in hospitals was being used at any one time, meaning more than half lay idle yet still accrued expenses. The findings, by GE Healthcare, also found that despite the oversupply, availability was inconsistent at best, with nurses spending an average of 21 minutes per shift searching for mislaid equipment.
Cohealo has stepped into this space by helping health systems share equipment across facilities. The Cohealo model urges health groups to centralise and rationalise their equipment inventories then share pieces out to sister facilities on demand. One hospital may not have the money or volume of patients to justify buying a particular piece of surgical equipment, meaning they either rent it expensively or avoid carrying out that procedure at all. Meanwhile a linked facility nearby may already own it and use it only occasionally. It is about doing more with less, says Reed.
“The biggest challenge is really around culture and change management. So many hospitals and health systems have adapted work flows and practices that are inherently inefficient, not because they want to, but because they have had to. Technology is improving rapidly and is being diligently applied to healthcare for the first time so it will take some time to unlearn ingrained inefficiencies. That is OK, because we, as patients, do not want healthcare to adopt the latest fad – we want them to be slow to change in some regards. Our health is in their hands.”
That said, much is already being done. Philips is working with hospitals all over the world to help them innovate sustainably. When Sweden’s Karolinska University Hospital decided to open a new site in Solna, Philips came on board for a 14-year partnership. As well as improving care, the collaboration focuses on optimising energy efficiency and cutting chemical waste. In many of the partnerships, for example at Westchester Medical Center Health Network in New York state, Philips provides equipment too. Its sustainability policy dictates that Philips products should aim to consume reduced amounts of materials, energy, and contain recyclable substances.
Looking beyond equipment itself, much more can be done says Terry Tudor, senior lecturer in waste management at the University of Northampton. He notes that the UK’s National Health Service (NHS) is one of the largest organisations in the world, and so its choices around service delivery impact the environment significantly. The NHS, has in the past for example, been responsible for approximately 25% of all of England’s public sector greenhouse gas emissions.
Circular economy principles centre around keeping resources in use for as long as possible through their recovery and re-use. Lieke van Kerkhoven of FLOOW2 Healthcare, a sharing marketplace for healthcare organisations, says incorporating such values requires a new mindset.
“Once healthcare organisations implement an internal or regional sharing marketplace or start using FLOOW2 Healthcare, staff members start seeing opportunities to earn or save money in all kinds of areas we didn’t think of beforehand. For example, renting out parking spaces in the weekends to local events, or a larger hospital making its hygiene and infection prevention expertise available to smaller healthcare organisations in the region.”
Hospitals, which depend on reliable lighting, may be among the best poised to benefit from the burgeoning “lighting as a service” model. Lighting could be rented from a company at a flat rate, with the company retaining responsibility for the system’s performance. The company has a financial incentive to provide the most energy efficient service possible, while hospitals get cash back if they go over their expected usage.
NHS Scotland last year committed to a contract for the reuse of furniture and equipment, involving the 140,000 staff working in the 2,000 NHS facilities across the country, as well as linking with schools, local authorities, businesses and charities. And in London, Guy’s and St Thomas’ NHS Foundation Trust runs an in-house programme for furniture refurbishment and reuse.
Tudor also recommends more effective segregation of waste materials at source to reduce costs of treatment and to enable value to be recovered from recyclable materials.
He notes that fundamental challenges exist however. “For example, employee perceptions largely govern issues such as the effective segregation of waste materials and energy conservation within the workplace. So effecting behaviour change is a key challenge. Job patterns make the delivery of training difficult and also lead to high staff turnover, and an ageing physical infrastructure makes retrofitting and storage a challenge.”
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