Sustainability in the NHS Healthcare Uniform: Looking Beyond the Garment
When people think about healthcare uniforms, they often think about comfort, durability and appearance. Increasingly, however, trusts are also asking important questions about where garments come from, how they're made, and what happens to them at the end of their life.
Throughout the NHS Healthcare Uniform Project, these considerations have helped shape decisions around sourcing, manufacturing, implementation and end-of-life management.
Sustainability Is Not One-Size-Fits-All
For trusts considering the NHS Healthcare Uniform, sustainability is rarely about a single solution. Every organisation starts from a different position, with existing contracts, local partnerships, operational challenges and strategic priorities to consider.
As this month's TeamTalk focus shines a light on the Sustainability and Social Value team, we asked Sustainable Procurement Specialist Jade Gaffney for her perspective on how sustainability considerations are being approached through the NHS Healthcare Uniform Project.
"Effective sustainability isn't about applying the same solution everywhere. It's about understanding each trust's existing arrangements, identifying opportunities to build on what's already working, and helping organisations make informed choices that take a broad view of sustainability, including environmental, social and economic considerations. What has been particularly encouraging is seeing the breadth of innovation already happening across the NHS and being able to share that learning more widely. Sustainability is not separate from the NHS Healthcare Uniform Project – it is considered throughout, from sourcing and manufacture through to implementation and end-of-life considerations."
This philosophy has helped shape a number of key decisions throughout the Project.
Ethical Manufacturing and Sustainable Sourcing
Ethical Manufacturing
Manufacturing for the NHS Healthcare Uniform is undertaken through manufacturers and mills located in Bangladesh and Pakistan. While these countries have long-established textile industries capable of supporting large-scale garment production, it is understandable that questions are often raised around ethical manufacturing, worker welfare and modern slavery risks.
Rather than relying solely on information provided through the tender process, representatives from the project team visited supplier manufacturing facilities as part of broader supplier engagement activities. These visits provided an opportunity to gain a better understanding of manufacturing operations, meet members of the workforce and discuss the approaches suppliers take to areas such as worker welfare, employment practices and responsible manufacturing.
While these visits did not constitute formal independent audits, they provided valuable insight into supplier operations and complemented the wider assessment of supplier credentials, accreditations and commitments undertaken as part of the procurement process.
As with all global textile supply chains, risks relating to labour standards and environmental impacts cannot be entirely eliminated. The NHS Healthcare Uniform project therefore focuses on continuous improvement, transparency and collaboration with suppliers and NHS organisations to strengthen outcomes over time.
During market engagement and procurement planning, considerable attention was given to the capacity required to support a Project of this scale. While UK textile manufacturing remains an important part of the wider sector, the anticipated demand for a national healthcare uniform Project required production capacity beyond what was readily available domestically. The focus therefore remained on securing a resilient, high-quality supply chain capable of meeting NHS requirements, while maintaining robust ethical and social value standards.
Sustainability Built Into the Specification
Sustainability was not treated as an optional extra during procurement; it was built directly into the garment specification.
Suppliers were required to source all cotton through the Better Cotton Project, helping to support more sustainable cotton production practices and improved outcomes for farming communities. Better Cotton is recognised as the world's largest cotton sustainability initiative and works with farmers and supply chains to improve environmental, social and economic outcomes.
In addition, all polyester used within the uniform range was mandated to be 100% recycled polyester, helping to reduce reliance on virgin fossil-fuel-derived materials while supporting the transition towards more circular textile supply chains.
Supporting Trusts Beyond Implementation
Another important consideration was how trusts manage existing uniform stock as they transition to the NHS Healthcare Uniform.
Following engagement with trusts, it was decided not to include a mandatory recycling or disposal solution within the uniform offer itself. Many organisations already have established waste management arrangements, charitable partnerships or local initiatives in place, and a standardised approach risked duplicating services and creating unnecessary costs.
However, this does not mean trusts have been left to navigate the challenge alone.
Through NOE CPC's Total Waste Management Framework Agreement, trusts can access specialist textile recycling providers and obtain support in identifying appropriate solutions for their organisation.
We have also seen excellent examples of social value-led approaches emerging across the NHS. Some trusts have implemented charitable initiatives, where suitable non-branded garments are collected, repurposed and distributed to communities and healthcare organisations in need. In some cases, this has included supporting countries affected by conflict, such as Ukraine, extending the useful life of garments while delivering meaningful social impact.
By capturing and sharing learning from trusts already undertaking this work, NHS Supply Chain and NOE CPC are helping organisations identify approaches that best align with their own operational requirements while benefiting from the experiences of others across the NHS.
The NHS Healthcare Uniform Project continues to evolve, supported by collaboration between trusts, suppliers, NHS Supply Chain and partners across the healthcare system. By embedding sustainability and social value considerations throughout the Project and sharing learning across the NHS, we can continue to strengthen the positive impact delivered through uniform provision.
Find Out More
To learn more about the organisations and initiatives supporting sustainable uniform provision:
- Better Cotton Initiative
- Alsico
- Alexandra (Mi Hub)
- NHS Supply Chain – NHS Healthcare Uniform
- The Scrubbery
- Total Waste Management Service
If your organisation would like to discuss NHS Healthcare Uniform implementation, sustainability considerations, or learn from the experiences of other trusts, please contact the NHS Supply Chain Implementation and Adoption Team on nationaluniforms@supplychain.nhs.uk.