Sustainable Healthcare - Q2 2022

Q2 2022 | A promotional supplement distributed on behalf of Mediaplanet, which takes sole responsibility for its content

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Sustainable Healthcare

“The value of innovation in achieving sustainability goals.”

“Medicines manufacturing innovation underpins resilient and sustainable healthcare.”

Helen Dent, Chief Operating Officer, BIVDA

Mark Talford, Deputy Challenge Director - Medicines Manufacturing, UKRI, Innovate UK

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Caring for chronic diseases in lower-resource settings

Integrating sustainability into the health system for present and future patients

In the wake of COVID-19, lower-resource settings need sustainable healthcare more than ever to build back better. Promising solutions are at hand.

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ach year, 41 million people die from heart disease, cancer, diabetes and chronic respiratory diseases.1 This group of chronic diseases, called non-communicable diseases (NCDs), burden health systems and put people at increased risk of other illnesses such as COVID-19.

Sadly, NCDs disproportionately affect people in parts of the world with limited access to health services.2 Tried and tested solutions should be leveraged to strengthen health systems to prevent, diagnose and treat them in a timely way.3 Tailored health packages Cost-effective packages of health interventions4 could help support low- and middle-income countries reduce premature mortality from NCDs by one third by 2030, one of the global goals to which countries have committed.

For example, the upfront costs of diabetes management - such as glycaemic control, footcare, and screening and treatment of kidney disease - are high. However, these are associated with considerable health and socioeconomic benefits when combined with cardiovascular disease prevention throughout the life-course.5 Streamlining patient care by supporting a ‘one stop shop’ for daily disease management is another approach. Launched in 2020, the PATH-led CarePak initiative, which bundles diabetes treatment, consumables and educational material, has positively impacted health outcomes in Kenya, Mali, Mozambique and Tanzania.

By delivering wholesale sustainability initiatives, we can help the NHS become the world’s first net zero health system.

WRITTEN BY Chris Holmes Director of Supply Chain, NHS Supply Chain

Integrated care Integrated care at primary healthcare level, such as screening and treatment of multiple diseases at the same point of care, is a powerful model for leveraging scarce healthcare resources. One initiative looking to optimise limited resources is Sanofi’s Diabetes and Hypertension clinics,6 which detect, treat and manage the two conditions.

So far, this initiative has trained over 1,200 healthcare professionals and treated more than 50,000 patients in Cameroon, Côte d’Ivoire and Senegal. More integrated care models tailored to local needs should be developed.

Ann-Lise Mikolajczak Manager, Global Health and Access, IFPMA

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footprint comes from scope three emissions from our suppliers and products, which come from all over the world. One of our key priorities for this year is mapping our scope three emissions to better understand what opportunities there are to work with our highest carbon emitting suppliers to reduce their impact.

Considering environmental impacts We deliver clinically assured, value for money products that meet the needs of our NHS colleagues and patients.

We deliver a critical service every day to the NHS and have a responsibility to deliver this sustainably and with the utmost consideration to the impact on the environment. In line with the wider NHS mission to be carbon neutral by 2040, we are working with our suppliers, service providers and NHS trusts to optimise our impact both today and for the future.

Environmentally friendly vehicles We are transforming our vehicles and with our logistics service provider Unipart Logistics we have recently rolled out a new fleet of environmentally friendly vehicles that offer the lowest level of carbon emissions to date, supporting a 200 strong final mile fleet delivering to NHS trusts.

This allows a CO2 reduction of 2.1 tonnes per vehicle per year. The engines are HVO ready, meaning they can run on hydrotreated vegetable oil in the future which could reduce our fleet emissions by as much as 80-90% and reduce local air pollution.

We have also introduced new technologies in our warehousing to reduce our gas consumption and install LED lighting.

This work has helped us removed more than 6,500 tonnes of CO2 equivalent over the last year, but we recognise there is much more to do.

Integrating sustainability into the DNA of everything we do is crucial, not just for the patients of today, but for future generations.

We have committed to doing this through: • Reducing our direct CO2 emissions, eliminating single use plastics where possible and reducing all packaging used in our operations.

• Championing the supply of environmentally sustainable products and services to the NHS, including these requirements in all our future tenders.

References 1. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases 2. Ibid 3. https://digitallibrary.un.org/record/710899/?ln=en 4. NCD Countdown 2030: efficient pathways and strategic investments to accelerate progress towards the Sustainable Development Goal target 3.4 in low-income and middle-income countries. Dr David Watkins et al. Lancet 2022; 399: 1266–78. DOI: https://doi.org/10.1016/S0140-6736(21)023475. Ibid 6. https://globalhealthprogress.org/collaboration/diabetes-and-hypertension-clinicsin-sub-saharan-africa/

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ollowing the commitments we made at COP26, NHS Supply Chain are working with NHS partners to raise awareness of the relationship between health and the climate crisis, the NHS net zero ambition and its alignment with corepurpose activity – the improvement of health now and for future generations.

Managing scope three emissions The biggest contribution to our carbon

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Digital technology can empower communities that otherwise lack adequate access to healthcare systems.

Making the transition to sustainable healthcare Collaboration is key to reducing carbon emissions, meeting net zero goals and delivering sustainable healthcare.

H INTERVIEW WITH Will Saddington Sustainable Procurement and Supply Chain Health Lead, Deloitte

INTERVIEW WITH Sara Siegel UK and North South Europe Health and Social Care Sector Leader, Deloittee WRITTEN BY Mark Nicholls

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ealth services deliver enormous positive contributions to society in improving the health of the nation but, in doing so, are major contributors to greenhouse gas emissions.

The NHS contributes 4-5% of the UK’s total emissions, leading it to set ambitious targets and introduce initiatives to dramatically reduce its environmental footprint and reach net zero by 2045.

However, while recognising the considerable progress that has been made to date, there are a number of key components required to reach these goals by the set deadline.

Towards a sustainable healthcare vision Will Saddington, who specialises in helping healthcare providers address environmental challenges, says the sector is becoming clearer on its sustainable healthcare vision with ambitions for decarbonisation, social justice, supplier diversity and health equity.

“Sustainable healthcare is about delivering quality care without harming the environment while having a positive social impact,” he says. “You can’t have healthy people without a healthy planet.”

Three core principles of intervention, he adds, are: mitigating the impact healthcare has on climate; making healthcare systems more resilient to climate change through adaptation; and increasing access and health equity.

To achieve net zero Saddington says the NHS acknowledges it should include all personnel in the process, from front-office to back-office, as well as suppliers and other industry influencers.

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High impact changes There are a number of cross-cutting themes for the NHS to prioritise including digitalisation, green skills, circularity, radical collaboration and major programme thinking.

However, one significant functional driver is procurement, with the NHS Supply Chain having a crucial role in developing a greener NHS that is both sustainable and resilient.

The Evergreen sustainable supplier assessment framework formulates how suppliers should engage with the NHS to meet the requirements of the NHS net zero supplier roadmap. The roadmap contains bold and ambitious statements for changing the whole ecosystem; with the Greener NHS initiative requiring procurement teams to drive this change.

Saddington, who leads sustainable procurement and supply chain health at Deloitte, says the NHS has significant traction with suppliers as a major spender across a range of areas from IT and office equipment to clinical consumables and major construction projects.

The NHS is enormously well-placed to have meaningful engagement and establish action-based collaborations with suppliers and trade bodies about mitigating environmental impact, with the emphasis shifting from cost and quality alone to include productspecific environmental and social factors.

Co-benefits of going virtual Digital technology can empower communities that otherwise lack adequate access to healthcare systems.

Sara Siegel, Health and Social Care Sector Leader at Deloitte, explains that the company works with healthcare teams to mitigate negative

environmental and social impacts through positive transformation.

Siegel, who emphasises that Deloitte is committed to net zero in its own practices, says the value of virtual GP appointments became apparent during the pandemic, with patients and clinicians saving travel time and cutting emissions.

“There are millions of outpatient appointments a year that could be made virtual, and it is digitisation that allows us to do that because all images and records are shared electronically,” she says.

Diversity of thought and actions Although the climate crisis is generally perceived as an issue of environment, the impacts of the changing climate are having an increasingly acute impact on both human health and the business operations of the NHS. The fact that 3.5% of UK road travel is attributable to the NHS, and one in eight deaths in Europe relate to pollution, “shows the enormity of the challenge,” says Saddington.

Tackling these sustainability challenges will require a concerted effort with stakeholders committing to adopting sustainability as a guiding principle. Through partnerships and collaboration, industry can work towards actionable goals to ensure outcomes and impacts are deliverable.

Bringing together a diversity of ideas, experience, and skills will help deliver practical, tested solutions that will ultimately help clinicians, patients and the planet.

Find out more at deloitte.co.uk/ futurehealth

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Boosting greener healthcare Healthcare services are facing a critical challenge to reduce carbon emissions and make patient care more environmentally friendly.

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ealth services are high Even more than with other emitters of greenhouse gases industries, health and the due to energy required to environment are inextricably linked. run hospitals and surgeries For example, long-term exposure to and the travel associated with patient poor air quality is known to cause care. As a result, the healthcare sector cardiovascular and respiratory disease. is under increasing pressure to deliver This compounds the need for health services in more environmentally services to become more sustainable. sustainable ways.

The NHS is responsible for 4% of Digital health England’s total carbon emissions The NHS is an acknowledged world through transport, heating, lighting leader in developing a strategic and procurement of medicines and approach towards sustainability, with other goods; transport the establishment of within the health an NHS Sustainable sector is estimated Development Unit to emit 3.4 million and the NHS Carbon tonnes of CO2 each Reduction Strategy.

Even more than with year (18% of all As the UK’s biggest other industries, healthcare emissions); employer, the NHS and NHS-related has many diverse health and the traffic accounts for 5% ways to adopt environment are of all road traffic in greener approaches England. to delivery of care. inextricably linked.

Switching from Sustainable healthcare disposable to reusable A range of initiatives are already under items is a key step, as is reducing use way, such as the Greener NHS project, of plastic in medical supplies and setting the NHS the challenge of switching to paperless systems. becoming the world’s first completely Digital health solutions provide net carbon zero health service by 2045. additional opportunities to boost The NHS faces diverse challenges greener healthcare. For example, here, 59% of NHS carbon emissions virtual consultations can reduce are linked to procured medication the number of cars on the road and and goods, 24% to direct energy use in advanced software solutions can buildings and 17% to patient and staff reduce the number of miles travelled travel. Pharmaceutical production

by NHS staff. alone accounts for 22% of NHS emissions.

Hi-tech healthcare journeys New digital solutions are changing the way the NHS plans patient visits, cutting down the number of miles travelled and reducing fuel usage.

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echnology is changing the way people access healthcare. This has been accelerated during the pandemic. However, no amount of technical advancement will ever remove the need for face-to-face appointments and visits. This results in millions of healthcare-related journeys every year.

A significant number of these journeys are made by community nurses visiting older and more vulnerable patients. Around three million people receive care at home every year. Changing dressings and administering medication are just two examples of the vital in-person role that community nurses play.

These visits are critical to health and wellbeing.

Advanced technology Scheduling these visits is a complex, difficult job. It can result in unnecessary trips and long travel time for nurses on the road. Journeys need to be planned as efficiently as possible, to maximise the time nurses can spend caring for their patients.

This is where advanced technology can help. TPP’s award winning Autoplanner software uses intelligent algorithms to unlock the most efficient routes for nursing teams. The software automatically schedules visits across entire regions every day, matching the right clinician with the right patient, based on geography, type of care needed and clinical preference. It significantly reduces travel time and cuts cost, whilst ensuring patients get the care they need.

Sustainability This not only improves patient care, but also aligns with the NHS Carbon Reduction Strategy. Every mile each nurse drives contributes to national emissions, air pollution and fuel use.

Figures already show a positive environmental impact and increased efficiencies. Data has shown a 34% time saving on visit allocation, a 22% reduction in mileage and a 23% increase in visits made by community nurses. Kelly Rocher, Clinical Lead at Sussex Community NHS Foundation Trust, an early adopter of Autoplanner, says, “It’s so much quicker. It’s going to make a great difference to the way we allocate our visits and save a lot of time.”

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Patient apps – improving care and the environment The continuing rise of patient apps is improving care and delivering on sustainability.

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large percentage of NHS emissions are created by patient visits to their GP and to hospital. For example, there are over 300 million patient consultations in General Practice every year, and over 125 million outpatient appointments in hospitals.

Traditionally, the majority of these appointments have been carried out face-to-face. Often patients are travelling several miles and each appointment means a car journey or a trip on public transport. This is often accompanied by an additional journey to a pharmacy, to collect prescribed medication, before returning home.

Giving back time The system is customisable to reflect local priorities and resource. When implemented by Leicestershire Partnership NHS Trust, the functionality saved significant amounts of time, freeing-up the equivalent of 1.5 days of nursing time every day. At the same time, face-to-face patient contact time increased from 31% to 71%.

TPP’s Emma Brownless, who leads on sustainability, says, “Autoplanner’s advanced technology is a real game changer. It’s brilliant that we’re able to give back time to frontline staff and improve patient care, whilst enabling the NHS to minimise its impact on the environment. This is one of the many green initiatives that TPP is proudly supporting.”

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Find out more at tpp-uk.com

The app is also providing digital options for follow-up care, reducing the need for additional appointments. Patients can communicate directly with healthcare staff via secure, in-app messaging. Doctors can provide tailored questionnaires to patients to follow-up on their progress, after treatment.

Environmental impact This new digital functionality is serving to significantly reduce the number of journeys people need to make to access health services.

People can often get the care they need without needing to travel.

The increasing trend of patient apps and online Digital front-door consultations is also The NHS has long having a positive aspired to give environmental patients alternative impact beyond this.

The rise of patient apps digital options. This For example, it is became increasingly helping the NHS and the options for important during remote consultations look move to completely the pandemic and paperless services here to stay. Indeed, NHS services moved and removing the rapidly to provide need for printed England guidance now this choice. For prescriptions. states that GP practices example, data Ultimately reducing should ‘offer and promote’ the number of from the Royal College of General face-to-face remote consultations.

Practitioners appointments will showed that over also mean fewer 70% of GP appointments switched NHS buildings to heat and light. to be online, over video, or on the phone.

The new normal It is technology that has made this The rise of patient apps and the possible - for example, connecting options for remote consultations patients to their care team using look here to stay. Indeed, NHS TPP’s Airmid app. Airmid provides a England guidance now states that digital bridge between patients and GP practices should ‘offer and the NHS. It allows people to manage promote’ remote consultations. appointments online, have remote Surveys have shown that many video consultations, and access test people prefer online or video results and hospital letters. consultations, finding them easier Airmid also excels with medication to fit around their busy lives. management. It enables new Researchers from the University medication to be prescribed to of Surrey have also revealed patients and a digital barcode sent that patients miss fewer remote straight to their smartphone, so consultations than those taking they can collect it directly from the place in person. pharmacy.

Spread paid for by TPP THIS CONTENT WAS PROVIDED BY TPP AND WRITTEN BY Mark Nicholls

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The value of innovation in achieving sustainability goals

Delivering care more sustainably: how technology can be utilised Health tech is a major contributor to sustaining and saving lives, providing products from medical consumables to orthopaedic implants, surgical robots and digitally enhanced technologies.

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he health tech industry has unique barriers in reaching its sustainability targets, with patient safety a priority that can never be compromised. For example, contaminated needles used in hospitals cannot be recycled in the same way as a plastic bottle can. Given the complex design of many products, there are distinctive challenges when addressing this critical agenda.

Utilising technology in sustainability That said, health tech can be a great vehicle for delivering care more sustainably, as exemplified throughout the pandemic, where apps monitored cases and remote triage became the norm to manage attendance to a healthcare facility.

Using technology to change the patient pathway can therefore save a wealth of resources, including the fuel patients use to travel to hospital, as well as the devices and energy involved in managing hospital admissions. Indeed, the most sustainable hospital stay is the one that does not happen.

This is not about replacing doctors with digital tools, but rather, avoiding unnecessary visits to a hospital through technology utilisation, and in turn supporting our healthcare workforce to free-up their time to focus more on each patient interaction and complex cases. This way, we can achieve sustainability goals and improve healthcare outcomes.

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Improving early diagnosis Early diagnosis is also key. The sooner a patient is diagnosed, the sooner they can be treated and the better the outcome. A cancer patient diagnosed at stage one, rather than stage four, for example, would not only experience a greater chance of survival, but the amount of electricity, fuel, medical devices and medicine will be greatly reduced, all aiding more sustainable care.

Minimally invasive procedures, such as laparoscopy, can also be utilised to deliver surgery in a targeted way, lowering costs to the healthcare system as patients have a reduced hospital stay, recover quicker and have an overall better experience.

Creating circular product lifecycles Health tech suppliers are making impressive advances. From the materials used in their technologies, to how they can be recycled and reused safely, suppliers are designing product life cycles with circularity in mind. At ABHI, we have also produced a Sustainability Framework for Action for our members to aid their own sustainability journey.

The levels of innovation within the sector are already inspiring, but there are still many advancements to be made. Health tech can be used to make healthcare better for both the patient and the planet.

WRITTEN BY Addie MacGregor Sustainability Executive, ABHI

Innovation is paramount and is an opportunity to further strengthen UK based and global manufacturers who are established in the UK with a competitive advantage by working more sustainably.

WRITTEN BY Helen Dent Chief Operating Officer, BIVDA

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oving towards a more sustainable healthcare system in the UK will reduce carbon emissions and help to mitigate the impact of the climate crisis. It will also improve the health of the entire population. The environmental and societal aspects of the world have a direct impact on our health and affect long-term conditions.

Strengthening UK innovation The diagnostics industry in the UK is innovative and is leading in the identification and diagnosis of some of the world’s deadliest diseases and health conditions.

Key to manufacturing working more sustainably is ensuring the sector understands what net zero and social value is and how it is being evaluated. They will then know how to maximise activity to maximise scoring to be successful in tenders by signposting members to support mechanisms to deliver within the organisations.

Committing to social value and net zero goals In a price driven market, by committing to and delivering on UK and global goals for social value and net zero, UK suppliers can level the playing field and secure a competitive edge by leading the way on their sustainability contribution, now this is carrying a significant score in tenders.

Supply chain resilience is now a procurement driver, so UK based suppliers have significant advantages to offer the health sector. The carbon footprint in terms of miles travelled is significantly reduced with UK manufactured products.

The future of UK diagnostics is reliant on aligning with the UK goals. Therefore, providing resources and tools to suppliers is a value offering, so they can meet these expectations.

It is not enough now to just post a corporate social responsibility policy, social value must be measurable and evidenced.

Measuring and evidencing goals There are multiple social value evaluation models, so understanding these and mapping out an organisations ethos, core values and mission statement across the various models, including the United Nations Sustainable Development Goals, ensures that suppliers can be versatile when responding to tender bids.

It is not enough now to just post a corporate social responsibility policy, social value must be measurable and evidenced.

The same can be said for net zero. Suppliers need to calculate their carbon footprint, but this needs to be so much more than just a number. Organisations need to get to the root of their processes and identify, set targets and deliver actions to reduce their carbon emissions.

At BIVDA, we are providing members with a sustainability resource hub. All the requirements they need to deliver against, to be successful in bidding for UK tenders, are clearly mapped out with solutions, suggestions and resources on how to achieve them.

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Adopting a sustainable approach to healthcare decision making Changing the ethos within a pharmaceutical company can help deliver more sustainable healthcare, if actions follow ethical commitments.

W INTERVIEW WITH Ugo Di Francesco CEO, Chiesi Group WRITTEN BY Mark Nicholls

ith innovative product designs, reducing carbon emissions and reaching out into the communities they serve, healthcare companies can improve the environment and make the world a better and healthier place.

Biopharmaceutical company CEO Ugo Di Francesco is passionate about the responsibility his industry should bear. He believes the healthcare sector has a collective responsibility to tackle the climate crisis and its health impacts by addressing the root causes of diseases and not adding to the health burden of patients.

Going beyond treating patients Di Francesco heads global biopharmaceutical company Chiesi. Formed in 1935 and still owned by the Chiesi family, it has recently added rare diseases to its respiratory and special care products portfolio, with a focus on metabolic disorder and enzyme replacement therapies.

He says: “Companies must take on the concept of sustainable healthcare and shared value. That means going beyond treating patients and their symptoms, being actively involved within communities, and promoting the concept of caring about people.”

“On top of that, we need to acknowledge our place in the environment; we have to design our new products in a more sustainable way with recycled plastic and create inhalers that can be re-used.

For our services and solutions for the future, we must not only keep in mind the impact on the environment, but we must also do something about it,” he adds. He sees this as a period when the time for talk is over and the need to act must become the number one concern for CEOs. As an example, he points to Chiesi’s EUR 350 million investment to develop an inhaler which reduces carbon footprint by more than 90% while preserving all treatment options for people living with asthma and COPD.

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The net zero race The company has set goals that will see it reduce direct Scope I and Scope II greenhouse gas emissions by 2030 and become a completely carbon neutral company by 2035 by cutting indirect emissions. “We are working on a Net Zero Trajectory with our plan to reduce our scope III emissions by 90% by 2035,” Di Francesco confirms.

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Companies must take on the concept of sustainable healthcare and shared value. That means going beyond treating patients and their symptoms, being actively involved within communities, and promoting the concept of caring about people.

It has aligned with the Paris agreement on reducing global warming and changed its legal status to become a Benefit Corporation - to not only serve shareholders but the community, the environment and workforce. That means full transparency in its progress toward carbon neutrality.

A valued B Corp certification, awarded in 2019 and where companies are recognised for their social and environmental performance, is in the process of being renewed.

“This is a long-term commitment for us. We’ve created a culture change, an operating change and an attitude change in our way of doing business,” he says. “We have also developed a ‘code of interdependence’ for our suppliers. That means they must adhere to certain principles and work sustainably in their activities if they want to supply to the company.” Chiesi sees this as a movement, an un-stoppable force for change that everyone needs to embrace if they want a licence to operate in future.

Climate action Aligned to the Science Based Target Initiative (SBTi), the reference framework that drives climate action in the private sector, the company’s commitment to deliver on reducing the carbon footprint of operations, people and products, while preserving patient care, is underlined in its annual sustainability report.

“What I am particularly proud of – and is captured in the report -” continues Di Francesco, “is the determination our people are putting into their working lives every day in contributing to making the world feel better and create a healthier and more sustainable future.”

Find out more at chiesi.com

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The role of industry and innovation in healthcare sustainability When healthcare innovation is done right, it is proven to improve patient outcomes, enhance patient experience, create efficiencies in care, and save the NHS money.

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ealthcare innovation can also have a significant impact on the environment – whether that is indirectly, for example, through reducing unnecessary patient travel. Or more directly, by introducing new environmentally friendly products or technologies, made of more sustainable materials and reducing waste by making products reusable or repairable.

WRITTEN BY Paul Durrands Chief Operating Officer, Oxford AHSN and Co-Sustainability Lead for the national AHSN Network

Collaborating to make big improvements If healthcare providers want to significantly reduce their impact on the environment, innovation and a more sustainable healthcare industry’s supply chain will be essential – by collaborating we can bring about bigger, better and more rapid improvements.

Here are just a few examples of healthcare innovations that are making an impact on the environment: • The SENTINEL programme that aims to optimise the use of anti-inflammatory ‘preventer’ inhalers. They treat the underlying inflammation of asthma, while reducing the reliance on and prescribing of blue ‘reliever’ inhalers (SABA inhalers) and the greenhouse gas emissions they produce.

Early data showed that changes in prescribing reduced the number of blue inhalers used by over 16,300 units, equating to an offset of over 457 metric tonnes in CO2 emissions.

• Single use devices are constructed using earthly resources, sent to a hospital where they are used once and then

binned. Remanufacturing these devices instead of sending them to waste adds circularity and shifts the process to reuse instead of disposal. We’ve worked with Vanguard Medical Devices limited who specialise in remanufacturing these devices to reduce waste, CO2 and demand on raw materials. As well as a positive impact on the environment this can lead to savings through payment for collected devices; reduced costs of remanufactured devices; and a reduction in waste.

• Placental growth factor (PlGF) tests for pre-eclampsia, which reduce diagnosis time and speeds up treatment for women who are at risk of developing severe complications.

This in turn prevents serious illness and reduces the numbers of hospital admissions. We estimate that rolling out PlGF in 2020/21 saved approximately 1,149 tonnes CO2e, equivalent to 3,043,660 miles driven.

Implementing best practice This is just a snapshot of the way innovation is being used to bring about a greener NHS. The AHSNs work across the country to harness innovation and spread this type of best practice. We are building environmental sustainability into our support to innovators and to the NHS.

England’s 15 Academic Health Science Networks (AHSNs) are commissioned by the NHS to spread healthcare innovation. To find out more about the AHSNs, visit: ahsnnetwork.com

Medicines manufacturing innovation underpins resilient and sustainable healthcare The pandemic and the climate emergency together provide a real opportunity for manufacturing innovation to deliver a resilient, sustainable medicines supply.

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edicines supply chains are complex beasts. From raw material to finished dosage, a given medicine could have travelled across two or more continents and through multiple manufacturing sites. This is true both for patented medicines and generics, which make up 90% of medicines in routine NHS use.

When COVID-19 hit, the logistics within these supply chains were quickly impacted. But while the UK did not run out of critical medicines, the question was asked as to what could be done to increase healthcare resilience?

Drivers for sustainable medicines supply Alongside other sectors, the pharmaceutical industry is exploring how it becomes net zero. Despite sustainable chemistry initiatives, economy of scale manufacturing

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investments and the resulting ‘make to stock’ supply chain model contain inherent resource and energy inefficiencies.

Healthcare systems, led by the NHS, are providing drivers for change.

The ‘Delivering a Net Zero National Health Service’ report sets ambitious targets for a net zero medicines supply chain by the end of the decade.

Manufacturing innovation will be central to industry’s response.

Translating new technology to established manufacturing Oligonucleotide medicines have the potential to treat a wide range of diseases. But they cannot currently be manufactured efficiently at large scale. Investment from the UKRI Medicines Manufacturing Challenge is supporting the development of new technology enabling lower cost

production at scale with reduced carbon footprint.

This technology is flexible (making different oligonucleotides for different diseases), agile (quickly manufacturing where and when needed) and scalable (manufacturing for routine demand or public health emergency as required), enabling more patients to access new therapies more quickly.

Similar investment for manufacturing established medicines will deliver similar sustainability and health resilience benefits.

Digitalisation also plays a role, artificial intelligence and machine learning are revolutionising the identification of new medicines.

Further digitalisation will accelerate these medicines reaching clinical trials and the pharmacy.

Alongside innovative manufacturing technologies these will maximise the resource and energy efficiency of medicines manufacturing. Innovative supply chain models will more closely match medicines supply to patient need.

WRITTEN BY Mark Talford Deputy Challenge Director - Medicines Manufacturing, UKRI Innovate UK

Now is the time to innovate The coincidence of the pandemic and the climate emergency provide a real opportunity for investment in medicines manufacturing innovation to address both sustainability and health resilience. The UK can take the lead. We have the innovation infrastructure and the ecosystem to make it happen.

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