Richard Shaw, sustainability lead at PD-M outlines the cost benefits medical device companies consider as part of their plans to go green.
Matthew Smith
First, how would you define sustainability in the medical device sector?
It’s becoming a hot topic. For a lot of organisations, it’s totally new, but unlike Brexit and COVID, it’s not transient, sustainability will be a driving force across the sector for decades to come. Currently, we’re at the bottom of the S-curve, we’re through the literacy building and well into the ‘take action’ phase. We’ve seen an increasing desire to adopt a circular economy with medical devices through programmes such as ReMed and Design for Life (DHSC). Things are also moving in a systemic way and the NHS net-zero roadmap has been the catalyst for this. When an organisation of that scale makes a net-zero commitment it puts the entire supply chain on the same journey. This domino effect has been felt over the last year and whilst it may feel like another burden to suppliers, sustainability represents a business opportunity. To see the opportunity requires a mindset shift, and that’s the hardest part to achieve. Once directors and senior leaders see sustainability as an opportunity rather than a burden then things can move quickly.
What should be considered when designing an environmentally friendly healthtech product?
PD-M
Richard Shaw
There’s a lot to consider, and it requires a shift in strategic thinking. It’s important to determine where the product sits in the care pathway. If the device can speed up diagnosis, reduce hospital visits, or theatre time, this can yield the greatest carbon savings, way beyond switching to a bioplastic for instance. It’s an important aspect, and one that’s gathering interest as it builds on the existing value-based healthcare approach.
The first thing to understand is what the product lifecycle looks like – the three main phases of production, use and end-of-life. This is important as sustainability gains can be made at almost every point in the process. During the creation, we can look at sustainable materials, low-energy production methods and reduced packaging. Then in use, does the product consume energy or other resources to function, and how can these be minimised? There is real momentum building around re-useable devices, but they aren’t a silver bullet, and we must look at the effects of reprocessing since washing and sterilisation has an impact too. Lastly, the end-of-life phase can vary depending on the nature of the device, as we know many are incinerated, some are designed to be re-usable, and others are a hybrid of the two. The NHS waste strategy features a target reduction of 50% in carbon emissions from waste by 2026. With high temperature incineration producing 15 times the emissions of recycling, it is clear which directions things are heading.
What are the main challenges in applying sustainable design to medical devices?
The biggest challenge is probably the mindset shift that’s required to see sustainability as an opportunity rather than a burden. This isn’t unique to medical devices, but largely being a B2B product there isn’t the consumer demand for sustainability since patients have virtually no influence into the devices they’re treated with. It’s only now the net-zero agenda is ramping up we’re seeing manufacturers start to look at this seriously. We knew we could reduce the carbon footprint of devices through design decisions, but this needs to be tied back to the cost benefit. We’ve been taking clients through the carbon accounting process for their carbon reduction plans (CRPs) and once the correlation between cost and carbon becomes apparent, we see senior stakeholders more engaged, and want to probe further into reducing carbon and cost together.
One big challenge is with the regulations. Manufacturers design devices to meet them and if sustainability isn’t written into them, it can be a barrier. Bringing a device to market is fraught with risks, costs, and challenges, so to add a ‘novel’ material on top needs to be very carefully considered, so being smart and selective in the approach is critical. Also, used devices are often treated as contaminated waste and have regulations which limit recycling options. Things are changing however and the DHSC is working towards a framework to bring circularity into medical devices. This will be a huge step forward, and there are already examples of devices supporting this model, but we’ve got a long way to go to see wider adoption.
80% of a product’s environmental impact is determined during the design phase. A) How is this the case? and B) What can be done to minimise any detrimental impact?
During the design stage you’ve got to consider what materials the device is going to be made from, how it will be manufactured, assembled, the technical performance, even where and how it will be transported. Once a product is designed and moves into a manufacture phase, its production run can go on for years, even decades. Making changes to a product already in the market for a sustainable improvement can be very hard to commercially justify, so it’s vital to build-in sustainability considerations right from the start.
Thanks to carbon footprinting tools you can assess the environmental impacts of a design in a comparative way, at the early stages. This allows you to refine the design and measure the impact of your decisions. It’s also at the design stage you begin to engage with manufacturers and material suppliers. Deciding who and where a product or component is going to be made can have a significant impact, particularly if there are components or materials are being sent by air freight. Typically devices are manufactured and sterilised in different locations leading to a lot of shipping back and forth. All this transportation creates emissions, so shrinking the supply chain or bringing sterilisation in-house brings carbon and cost savings. Again, we can use design to help reduce emissions, for instance optimising product size, weight, and packaging to minimise shipping volume and more efficient sterilisation.
Does reducing emissions also reduce costs? Or is it more nuanced?
It can be that simple, the two are directly linked. In doing Green House Gas carbon accounting, you see the parallel with every invoice carrying a carbon cost. The increase in energy costs prompted a lot of organisations to look at energy efficiency measures. These will help cut costs, but also the emissions associated for instance in heating a building. These operational reductions fall under scope 1 & 2. It’s a common place to start because it’s quick to implement as it’s within the control of the company and brings a quick ROI. Making changes relating to products is usually part of a long-term strategy, they can be harder to achieve but could bring far more significant savings. Simple steps can be taken such as ‘lightweighting’ by stripping out material we can reduce the weight, cost, and carbon all together with minimal regulatory implications. Historically ‘sustainability’ hasn’t been a factor for medical devices so there is great potential for improvements, both to existing devices and those in development.
Adopting new, more sustainable materials can carry a higher cost, so a holistic approach is needed. By balancing several changes, we can deliver an overall net saving in cost and carbon. This is critical, particularly with businesses facing increased operating costs, squeezing margins. With a strategic approach, sustainability can be a real opportunity to innovate and improve margin, whilst building resilience.
Anything else you’d like to add?
Sustainability needs to be viewed more as a journey, with incremental gains adding up over time, rather than a switch that’s flipped. It’s easy to be overwhelmed and not know where to start. Getting external advice can help kick-start the journey, collaborating with others in the value chain, and sharing the progress you’re making, are all important. There is a real fear about not being ‘perfect’ or of ‘green-washing’, but this leads to ‘green-hushing’. It’s important to share the initiatives being undertaken to inspire others. If we, as an industry, are going to reach net-zero and safeguard the future for the next generation we need to act now. Globally, the healthcare sector is responsible for 4-5% of emissions, it’s roughly the same figure for UK emissions and so the government can really drive change in the sector via the NHS. The net zero roadmap the NHS has released is world leading in terms of its scale. We know other countries are working on implementing their own versions, so avoiding the UK and exporting overseas won’t work for long. Essentially, it’s a subject that organisations can’t afford to ignore. We’ve seen through CRP’s that products being manufactured can easily represent 75% of emissions. It can be tempting to go for the quick-wins and leave the more complicated areas such as products until later, but it’s in the products where the greatest carbon and cost savings lie. Sustainability really needs to be engaged with and seen as an opportunity to innovate. The products designed today are those we’ll (carbon) account for tomorrow, so businesses need to be thinking and acting on this now.
