Episode Transcript
[00:00:00] This Podcast is brought to you by the GOSH Learning Academy.
[00:00:00] Hello and welcome to this, our fourth series of GOSH Pods Goes Green. In this series, we're exploring Plastics in healthcare. I'm Jason Dawson, and I'm the Chief Infrastructure and Redevelopment Officer at Great Ormond Street Hospital. In this episode, we'll be setting the tone for the series and talking to Tsanko Dimov.
Tsanko welcome to our GOSH Pods Goes Green. Can you tell us about yourself, about your role and about the goals within the greener NHS?
Of course. And yeah, just before I launch in, thank you so much Jason and team for having me today. I'm really excited. So my role, I'm a senior manager in NHS England, where I lead on circular economy for the greener NHS program.
My role includes the implementation of the NHS net zero supply roadmap, but more relevant to this conversation reducing emissions and waste associated with the use of medical devices and equipment, of which obviously a huge part is plastic in terms of goals. We've identified that reducing [00:01:00] unnecessary use of medical devices and equipment or transitioning to reusables where we can and where it's appropriate, could save the NHS tens of millions of pounds each year, improve patient and staff experience and reduce emissions.
My goal is to identify which product changes offer the biggest measurable benefit to trusts and support those organisations with the resources they need to achieve them.
Tsanko thank you. And again, thank you so much for being available and agreeing to, to join us today, and it sounds like you've got a huge portfolio there and a huge set of ambitions that I'm really quite keen to, to explore today. Before we talk about some of those, you know, kind of NHS related things.
I, you know, I think we've all got personal triggers on a journey of sustainability and the environment. I'm really keen to understand from your personal point of view. What was it in your career or home life for that matter that triggered your drive and desire in this space?
Ooh, yeah.
[00:02:00] So you said trigger point and I think speaking with a lot of my colleagues that's the term or that's something that. People do have those decisive moments where they really feel they need to act and feel really compelled to do and I guess reflecting on that question, it's really hard for me to think of a specific trigger point.
One moment where I felt I need to change what I'm doing to focus on this agenda, or this is a priority and. I think for me it's actually a little bit of a different feeling. It's almost like nagging feeling that's just that you feel a bit more physically. The feeling that something isn't quite right or some something's off balance or something just doesn't add up and, you know, you could compare it to the feeling of, you know, you're getting dressed to go to work and you put on an outfit that you just think, oh, that should, that doesn't make sense that those colours don't work together.
Or you are watching a film and there's yeah. Some background music, which is putting you on edge. For me, it feels a bit more like that. And because you asked about growing up. Yeah. You know, I think for [00:03:00] me, that came from. A, as a kid, moved around a lot, so I was born in Bulgaria. I moved to New Zealand when I was three years old and lived there until I was 12 and we moved to the UK and I dunno, Jason, if you've ever been to New Zealand, but it's a very beautiful place.
Lots of nature, lots of wildlife people are very chilled out and spend a lot of time outdoors. And I think moving between those three countries especially, as a child. It gave me this exposure to the different ways that we live around the world and the places where people feel relaxed and feel better.
Or the place where, you know, the natural environment you see around you looks its best. And I think I, I guess as a curious person or just as a kid, I was always intrigued why is this that way? Or why do those people do the, these things? And asking those questions really,
yeah.
drove me to finding answers, which I felt it probably did, made that feeling of things just [00:04:00] don't feel right.
It doesn't feel like that's the way we should be doing it. And so for me, it's less a trigger point or an urgency to act. But maybe it's more of an act of service to the things that I believe in or really appreciate.
Yeah. Thank you. Tsanko, and I guess when I reflect upon my journey, I guess it's very similar.
There's not been one trigger point, but more of a growing unease with the way things are working in the world. I don't have the luxury of visiting New Zealand and living there unfortunately. But I remember back in the eighties, because I'm actually very much older than you and Nicola that.
You know, we studied acid rain, and I remember actually collecting samples in the garden and measuring the PAs levels. It was around the time of Chernobyl, so I think we were trying to check, but even then it felt kind of quite academic in nature. And I've seen lots of changes across the world and I guess it's a growing reality for me an understanding.
But arriving at GOSH and hearing from young people directly. For me, it felt like a real catalyst and that cemented all the learning on my life experience and make giving [00:05:00] me the drive and urgency to maybe make a difference. So yeah, similar to you really don't have a one specific trigger point, but maybe the reality, the growing reality of lots of things coming together.
Yeah. So thank you for that.
It all just adds up, doesn't it? And I, you know, some, something you said that was just really thought provoking for me. It just reminded me I, I have memory from when we were kids, and this is obviously a very fortunate, privileged thing to be able to do, but we, in, when we were in New Zealand, we went on a trip with mom and dad for the weekend and we went to go see one of the glassier there.
And when we were there, it wasn't a big deal. You could just drive to the parking lot, you walk up. And, you see it and you walk back and it's a great fun day. When my sister went back to visit 15 years or so, whatever it was later you couldn't walk up anymore. You had to take a helicopter.
And, you know, there's these changes like that actually kind of happened quite quickly and yeah, it's a very lasting impact on what one generation might get to experience versus another. And yeah, it's kinda scary.
I guess, I [00:06:00] think, I guess we are probably the one of the first generations that can see the change within that generation, if that makes sense.
From when you were at school to maybe now. And even the things that we were studying and the, you know, the, as you say, glassier and the changes, I, you can see the real time change within our lifetime. And that's probably the first generation that's been able to see that. And I guess, you know, talking at personal level.
The challenge seems so huge and overwhelming at times. But I guess for me now arriving at, gosh, and maybe similar for you, Tsanko Dimov. With the NHS, you feel almost in a position of ability to do something greater than an individual level. Yeah, it's that it. Joining reality that yes, things are changing, but we're also empowered to, to make a change and contribution.
Totally.
Thank you. Really insightful intro in terms of how you got into this space. But coming back to the NHS, again, a huge. You know, world of change. And I know that the, you know, the healthcare system across the world is a significant contributor to carbon footprints, et cetera.
So the opportunity to make a difference is significant. [00:07:00] But also the, you know, plastic and use in plastic, in, in healthcare as being around for, you know, decades now, probably going back to the fifties, and you can see lots of benefits back in at that time. You know, it's convenience. It's saved money.
But again, what you can now see is the, you know, the scale of plastic waste across the NHS. And it's I guess we grapple with how do we, you know, at a time when the NHS is challenged financially, how do we consider alternatives? And are those priorities not still the same?
It's probably really important to start with before we talk about moving away from single use plastics.
And that's just a reminder that plastics are amazing. They're incredibly versatile material. We are so able to adapt their properties. If it's weight, flexibility, the texture, the surface colour, transparency by our compatibility, all these features, we can make them exactly as we need them to be.
And, you know, not many other materials can offer. Such versatility and at such a low cost per product, really. And [00:08:00] I think single use plastics will continue to bring huge benefits to patients around the world. And just because, they do. That doesn't mean that we have to then use them everywhere.
And I think that's the distinction. It's single-use. Plastics are really helpful. There are so many procedures which we won't be able to do without them, but it doesn't mean that they're always the right solution. And when you talk about priorities and. You know, have they changed? Do we not value, convenience or cost in the same way we did then?
And I think it's a really it's a really good point because obviously we do convenience is obviously critical and cost is I think we're all aware of the pressures the NHS is under, but with those nuances to them as well. So if I take a single use plastic product and I compare it to a reusable.
It might be that single use product is much cheaper than the reusable one. However, if the reusable one allows me to use it 70 times, then the cost over the course of the year or the cost for the provider of providing that surface not surface service, [00:09:00] sorry is a lot cheaper in the long run.
And I think it's priorities like that, that we've, they're still the same, but we're just looking at them slightly differently. Yeah. Yeah. And it I wanted to also just kind of break the question down perhaps into two slightly different chunks, because I think there's. You know, you spoke about what the perception would've been towards this material or towards the, these opportunities in the 1950s, and I think the first thing that I just wanna flag is the world is obviously very different now and since COVID and since various different.
Conflict events we've seen around the world. It's really disrupted our supply chains and I think as a country, it's changed the attitudes that we have around how much we can depend on things like that going forward and where. Reusables exist and offer us an opportunity to have more control of our supply chains, to have those managed locally and creating, we get the benefits of [00:10:00] local jobs or skills development or supporting local businesses.
I think it starts to make sense as a country to, to make those transitions where it's clinically beneficial or appropriate to do and yeah, I guess I think you are probably much more aware of this, but there's definitely a personal element as well. It's not all just as a country. I think a lot
of
NHS staff we're hearing just really fed up of having to throw away so much stuff all the time.
I.
Yes, I'm contacted almost daily with people raising some of those concerns. And I think you really, you raised some really interesting points there and we talk about single use plastic, but again, plastic doesn't have to be single use either, and maybe there's ways and I guess I'd never thought about it that way.
Plastic can be reused in different forms in lots of different ways, but that in itself will create some sort of carbon footprint to do that. And I guess doing some of those things will create the microplastics that become the problem. And I'm no expert in some of these things, but I know that I'm reliably told that we ingest a credit card sized.
Amount of [00:11:00] microplastics on a regular basis. I'm not sure it's a weekly or monthly basis, but that is quite, you know, stark, isn't it, really? And quite you know, it makes you realize just how you know, we, we don't see sometimes some of the things that are generated, but I think plastic does play a part.
I think you're right to point out the benefits, but also there's a significant downside with waste and the micro plastics. Yeah. Do you know, kind of on an annual basis what sort of amount of plastic is used across the NHS? I'm not sure I would even measure something about like that Tsanko, but it'd be interesting to know what sort of scale that is.
Yeah it's a little bit of a tricky one to answer because while we have a national figure for the amount of clinical waste, we produce exactly what. Proportion of that is plastics. And how you would measure that it is a little bit difficult to answer. But actually healthcare without Harm did an amazing report on measuring and reducing plastics in the healthcare sector a few years ago.
And that's got a few interesting statistics that I think have enabled us to get to have a bit of an estimate. And we [00:12:00] as a healthcare system produce 156,000 tons of clinical waste each year. And looking at estimates that were published in this Healthcare Without Harm report, we can think, we can estimate that it might be around 25% in the UK.
If we use the figure that they take as the average for Europe, it's more like 36%. And so 25% would give us about 39,000 tons. But if it's 36%, that's 56,000 tons of plastic.
Yeah.
And so if you. Took that weight and you translated that into London red buses. Yeah, that'd be over four and a half thousand London red buses.
Wow. And I, for me, even just imagining that many buses is difficult, but if you park them one after another and you have to walk that distance, it would, you'd be walking from more than 50 kilometers. So yeah. I hope that just gives you a bit of a sense of that's
incredible
kind of sizes we might be working with.
Really [00:13:00] interesting, you know, the metrics that you use to measure plastic across NHS and I think, you know, red buses is really compelling and most people can recognize that. I guess I was thinking as well from a domestic point view at home, I'm constantly encouraging my family to recycle, to separate the waste.
Plastics being a big component of that. And do you think that staff bring that kind of perspective from home to work. You know, so they've still got the same commitment. And you know, the feedback I get regularly is why are we using plastic water bottles when we can just as easily use, you know, glasses and things like that.
So do you think that transfer of responsibility from home to work is real,
Absolutely. We see that day in, day out and hear that just the same way you do NHS staff. Reiterating in their behaviours and in the constant communications that we get on this agenda, that they care about it and they're passionate and willing to make a change.
I, I think part of it is absolutely feeling a responsibility to reducing waste. Every member of NHS staff will hear daily reminders that as an organization, we need to [00:14:00] be more efficient, we need to be more productive. We need to reduce waste. And if then at the same time, you are using products.
Sometimes you're not even using them, you're just preparing them for use, and then you have to bin them just because they've been opened. I think that kind of waste just doesn't sit right with NHS staff and it's not just. That element of it. I think NHS staff care so much about the patient about the patient experience and the care that they give.
And sometimes these single use plastic products 'cause they've been manufactured deliberately to be cheap, just aren't ergonomic or they're not comfortable or they can lead to injuries because. The way they're set up isn't quite right. And I think with a lot of this it's not just staff feeling a responsibility and bringing that from home, but it's also just the care that they have for their patients and they just want the best.
Yeah. I think we are blessed at, GOSH, with the patient demographic that we've got. They share, if not more so the same ambition. They challenge me regularly about, you know, I've turned up to the Young People's Forum before [00:15:00] now and at lunchtime, and. My team have brought water bottles out and I cringe because I'm then held accountable by and quite rightly and I think that also overlaps with clinical teams as well. They see plastic day in, day out, and they ask those very obvious questions that sometimes we're so busy that we kind of don't stop and ask. They do. And I think we've got to use that energy, haven't we? To continue to drive change.
Can I ask another question about plastic? We've talked about plastic waste and single use plastic, but how does plastic, you know, contribute to the carbon footprint of the NHS? Because that's the metric that lots of people use, but how does plastic work alongside carbon footprints, et cetera?
Yeah, so maybe this is a little bit similar to the response in terms of the plastic contribution to waste. It's really difficult to be able to say, this is the number that plastic contributes. And our data and analytics team are incredible and at the minute just starting and working to [00:16:00] get a more detailed understanding that will hopefully be able to help us answer questions like this in the future.
But. The best response that I can provide at the minute is, when we look at the products that we use in the NHS and we look at their lifecycle emissions, we can see that the majority of emissions come from the manufacturing environment or when it's extracted from the ground that first phase of production.
And so when we look at the NHS footprint, we would associate that with the amount of emissions that come from our supply chain. And so it's a crude, it's a crude translation, but in the greener NHS progress report published in September we can see that clinical consumables and equipment make up 18%.
Of the NHS footprint. So it is a huge proportion. Plastics aren't gonna be all of that. No, but we know plastics make it make up a big proportion of the products that we use. And so it's fair to assume that plastics are making a substantial impact on the emissions [00:17:00] that associated with the care we provide.
Yeah. And building on that Tsanko, you look at the, you know, the amounts of plastic. I look around me here now. I can see plastic everywhere. I've had experience recently. My father was in hospital and I, again, you look at the amount of plastic or plastic based products, they are everywhere you look.
So we've got this reliance, on, you know, the material itself. And I can see some of the barriers being that's just how we've done things for such a long time now. You know, what is the alternative? Are those barriers really? Are those the kind of barriers that you come across around change and reducing that use that it's just everywhere and it becomes so convenient and how do we pull back from that?
Yeah, totally. I when I first started working on this. Project nationally the scale of some of the barriers that you encounter are quite daunting and I think. We have these moments of, I guess it's both validating. You go around and talk to people all around the system and they come up with the same barriers, so at least we know what they are.
But then when you think [00:18:00] actually, God, everyone across every NHS organization is experiencing this, it gives you. Yeah, kind of. It's a bit scary to try to think approaching it, but the wider program that we are a part of is actually a collaboration between NHS England and a Department of Health program, which is called the Design for Life program.
And that program was launched in October, 2024, and the vision for it was a commitment that the UK will transition away from all avoidable single use med tech products. Towards a functioning circular system by 2045. And the report or the roadmap that they published is really interesting in that it breaks down some of the barriers that you've just asked about and gives action points around what we can do to address those.
And so if I just tried to summarize what the key barriers are. That report describes is first around leadership and behavioural change.
So I think this is what you were, you're talking about the behaviours that are instilled and we don't even question why we do it, it's just what we do.
And then [00:19:00] leadership is around. If that's leadership on the front line or at a team level, or if that's an organizational level, just making sure everyone's aligned on the issue in the same way and sees the opportunity in the same way. So that's kind of the first barrier spaces.
It's conflicting priorities and challenges and pressures that people are under, which mean that we don't necessarily get to see the opportunities in front of us. The second barrier is around commercial incentivization and innovation. So in lots of spaces, we do actually have really viable options that we can move to in others.
We, we, the products haven't quite yet been developed yet, or they're not optimized really for us to adopt as a, at scale, as a system. And this barrier around the commercial elements of it is, making sure that when the NHS works with its suppliers, it's showing them in the way that it's procuring goods that.
This is our priority now. We are moving away from single use products where they're unnecessary. We're moving towards reusables and [00:20:00] just making sure that our policy and buying practices line up in that way. And the final is around regulation standards and infrastructure. Talking with our suppliers, many of them might be keen to, to move into reusables or to offer those kind of products
but sometimes the regulations or the standards that we have don't encourage them or make it more costly for them to do and so there's work that can happen there to make that easier for innovative supplies. And the final one is just around infrastructure. If we're gonna start reusing
more products. We need to have more central sterilization capacity. Yeah. We need to have local decontamination units. We need to have more laundry. And it's just understanding what we have and is it enough and where should we be investing.
Yeah. Thank you. And, you know, the healthcare Without Harm work that there's been undertaken for me has demonstrated some really challenging areas of work, but actually some really good opportunities. You know, reusable probes, for example, is an area that I know that the team have been driving forward. But that did present challenges, as you say about the contamination [00:21:00] sterilization, you know, the infection control issues. What I am finding though, is that people, there is ways to get around them.
It's just spending the time to map that journey you know, reusable curtains or hats, and the like. There's definitely fun ways to change some of those things as well. I think you're right. At every level there's a contribution that can be made. But if one of those levels doesn't work, you tend to find things get stopped.
Absolutely. And then yeah that's the bit that really it really affects me and I get it just, it's so challenging to see when you have a really passionate clinical team.
Yeah.
Making all the changes they need to, excited about it. And then they hit a barrier, which is just outside of their scope of control or, and then all of that energy enthusiasm is lost because there was a bit of policy that didn't facilitate that change or made it confusing or the infrastructure wasn't there. And yeah, it's, it is just, it is a shame when you have so much passion and energy and you're not able to reward that with the change it deserves. I can,
I can hear the passion in your voice as well Tsanko.
So I do and we've come across some of those examples where we've been able to unlock [00:22:00] things, but I think as you say, it's that collective approach to, to change that's needed. People become quite disheartened when what on face, it seemed relatively simple things block things from happening.
So I think we've all got a shared responsibility to try and drive those changes forward. So thank you. One example I wanted to talk about is the gloves off. Campaign. Obviously we've launched this in 2018. At GOSH. I think we were one of the first hospitals to launch the campaign.
And actually the, you know, the benefit has been significant. I think we measure the reduction in plastics in tyrannosaurus rexs you know, i've seen the diagram of it. Yeah we've got some of those metrics 'cause it makes it real, makes for children as well. But what we found was not only the direct reduction in plastic, but also the springboard for a lot of other things across the organization.
And that one campaign itself has been, you know, the thing that's opened people's minds to thinking differently. Are there any other. Innovations that hospitals elsewhere were looking at or case studies that, you know, we can share that will help, you [00:23:00] know, drive that further thinking and transformation.
Absolutely. And as a national team, now we're in the process of trying to compile all of these different examples of just amazing practice that we're seeing from across the system. Honestly, there are so many just so one, one that there's a lot of conversation around is torniquets at the moment.
A lot of organizations are transitioning from single use torniquets or from the old fabric ones that people would use to reusables and seeing all sorts of, plastic waste savings and financial savings. Mid Yorkshire Teaching Trust have a great case study where they demonstrate they save 20,000 pounds by transitioning to reasonable torn case and that, that kind of sentiment is just echoed across the country with these and, you know, the amount of presentations where you just see a picture of a mountain of single used torn case showing what they've saved is yeah, really helps you visualize the benefit.
There's some really great examples of reducing unnecessary cannulation. So Northampton General [00:24:00] and Chaing Cross have got some great examples of this. I think I think it was Chaing Cross actually who managed to save something like 95,000 pounds in, in 12 months by reducing unnecessary cannulation and obviously the cost savings great.
But the benefits to patient comfort I think really would just speak to themselves. We've got. Examples of re reusing hollowware, reusable sharps containers. People all over the country are doing those. And that, that's another one with a patient, with staff benefit. Actually we tend to see huge reductions in needle stick injuries when you go from single use sharps containers to reusables.
And yeah, for example as well Black Country Pathology Services it's another space. It's, you know, it's obviously a different part of the healthcare system, but they've been using tube racking systems instead of plastic bags for the, for their blood samples. And I think in the example that they've shared, it's over 44 tons of plastic waste was saved annually.
So there, there are examples everywhere.
Yeah. So there's a lot going on, isn't there? And [00:25:00] I think a lot of initiatives, and I guess the question I guess today, not just for yourself, but also of healthcare organizations, is how do we take these areas of expertise and learning and make them more national initiatives?
You know, what is it we can do together? Because if it works somewhere else, it should work everywhere. And I guess you must come across many barriers to rolling out some of these things on a more national basis.
Yeah. If. And I suppose the things we're prioritizing in the way we've structured it as a national program is listed in that design for Life roadmap.
You can see the actions they prioritize there. They published a one year on document recently actually, so you can see exactly the progress that we've made so far. But just to give you a bit of an indication, so the first step has been compiling all of these. Great practice examples that we've heard from across the country and looking at our supply chain data to, to start to prioritize which are the biggest opportunities and where we should really focus [00:26:00] our efforts for reduce or reuse initiatives.
Then to, to support that and what, and to enrich it, I guess with a more, experiential inputs and to make sure we're focusing on the right things. We've held focus groups with colleagues from all over the system and representatives from all different professions and specialties and from different regions.
And that what they've helped us understand is what exact support they need or what those barriers that they're all hitting are and where we should focus as a national system to help.
Yeah.
To help remove those barriers in, in a single way so that everyone doesn't have to reinvent the wheel.
Yeah. I think that's really interesting because people do feel at times where everyone has to start from scratch and actually what you're demonstrating there. Yeah. The case study's already been proven. So I think as a healthcare organization that they can lean into those things and take their responsibility.
Do you think that then comes down to individual healthcare professionals really in terms of their [00:27:00] confidence or understanding of the change? Do you find that as a barrier sometimes where it's a change to the way people work, but also it's how do you evidence that the, you know, the alternative way is at least as good, if not better?
Yeah it's a great question because. Yeah the barriers or the challenges for me, at least in my mind, they're quite distinct groups, so that there is those sort of impersonal, larger organizational level barriers, which we are definitely focusing on, but I really get the sense that the biggest opportunity lies in that interpersonal element or in the elements of the way people just practice how they provide care and to understand those behaviours better. We've kicked off a behavioural change work stream or team across DofH and NHSE with behavioural change specialists to find out what are the little nudges and what are the little changes that we can make that or that people can make that just makes it the easiest thing to do.
Yeah. That's the way you get success, right? It's not something you have to do. [00:28:00] It's when the good, the thing you wanna happen just happens as a default. 'cause it was the easiest thing anyway. And that's what we're trying to set up. We've had all sorts of great examples from, from clinical nurses and supply teams around saying the biggest impact or the easiest thing we did was just move the reusable so they were easier to get to than the single we use and put them higher up on the shelf.
And so people just got the first one. And it's little things like that I think can create a lot of opportunities and yeah, understanding. That is key but more than that, taking people on the journey is, as you said is so important. Yeah. Telling someone they have to do something just never gets the best reaction.
But actually, you know, working with them to understand why they do something the way that they're doing it in the first place, and then showing, actually, you know, You can reduce needle stick injuries if you swap to this product. Or actually, this is an unnecessary cannulation. Here's an alternative way you could do this.
And I think those are the kind of things that help people want to switch.
I, I love that the phrase you used there, little nudges, and I think that's all it takes sometimes. [00:29:00] I think it's fascinating that, you know, nursing teams would move the, you know, the plastic products to the furthest, and that in itself makes such a difference.
So I, I find that fascinating. You know, from a psychological point of view. I guess the other question, I guess would be. Why give people a choice as well. And that's, you know, we get into the realms of confidence and change. Aren't we better? Yeah. Giving people a choice. I think people will choose the right thing.
If it's, as you say, with a little nudge, it's so that pressure time though when people don't have time to think, they may or ally revert to. So maybe eliminating some of those choices, but that can be seen as a mandate then that also doesn't particularly well received. So I can see that as being a really delicate balance between nudging, encouraging, but also preventing things from happening in the first place
Totally, and I think something that I'm incredibly aware of, and I think as a team we're aware of, is that individual organizations are under a lot of pressure. NHS staff are under a lot of pressure, mandating a change amongst all of [00:30:00] the other changes and adjustments they have to make to their workplace and with their colleagues. It doesn't feel right, right now to mandate things like that. I think organizations should have the opportunity to make those changes in the way that they see fit and the times that they see fit.
Personally speaking from a national to local perspective, but what we're doing in the background is really building a really compelling story and evidence as to why people would want to if changes are mandated in the future, it would be under circumstances which that's really demonstrated.
It's within all patient and staff and organizational level benefits because it is quite a drastic thing to, to mandate a change like that. And the other thing that we're really mindful of is, We have supply networks which are really finely tuned to operating the way that they are at the moment.
And any dramatic change in the way that we buy products will impact. Can impact other [00:31:00] healthcare organizations or how care is provided in different places. And so the more we plan for a change like that, the better.
Yeah, absolutely. And can I just ask a question? We've talked about staff, we've talked about organizations but what feedback have you had from a patient?
Perspective, you know, or family perspective. I know, GOSH, I hear that all the time from our young people, and they are very vocal in this space, but do you have any feedback from other organizations around the patient voice or the, you know, the public voice around NHS plastic use?
Yeah, so I think it's important to distinguish between the types of products that we're talking about and how they are used. So if it's a surgical instrument, the patient might not know, might not even want to know actually that instrument has been used on them let alone whether it was single use or reusable. But other patients we, patients in community [00:32:00] settings, they have to deal with the same problems NHS staff do of the volume of single use products that they have to buy, process, dispose of. So I think in some instances we have a lot of support because the, our priorities are perfectly aligned with our patients. In other instances, patients maybe don't care. They just, they just want the best care that is available to them. And I think that's the part of the journey one at the moment is, yeah, engaging with patients, understanding better, where are the spaces in the products where they really have a strong opinion, we need to consult and give them the option. Where are the places where we need to ensure through all the quality control processes that we have in the NHS already, that they're getting the best care and whether it's one product or another, doesn't concern them in the same way as if you use one brand versus another.
And so understanding how to make that judgment call and who is best to make that judgment call? Is it the clinician, is it the patient, is it the organization? Is part of the journey we're on. [00:33:00]
Yeah. Just a final question before we wrap up, Tsanko… we've talked about plastic and the actual physical use in, in, you know, in hospitals.
But I guess when you look at supply chain as well and even, you know, packaging and the like, are you seeing any changes? You know, if I order from Amazon, for example, they give me the opportunity to either, not have it wrapped in, you know, the usual paper envelope, you can have it delivered with the native wrapping, but also you can have by having multiple deliveries, you can have a, you can wait a few days to have it all delivered in one, which all has a positive you know, environmental impact.
Are you seeing supply chain responses that are similar to that to try and mitigate the use of, you know, plastic?
Absolutely. There, there's a whole host of suppliers who are really leading the way in this and in fact, probably all of the best examples of a change that has happened in the NHS has happened with the support of the suppliers.
It's happened because the [00:34:00] supplier has engaged with the trust to understand what the challenges that they're having or the attributed costs with using that product. They're spending time training staff to, to use a different. A different style product or how to process the reusable. And we are creating stronger alliances between our healthcare providers and our suppliers and that link is what's enabling change at scale because it's only through partnership that we can really move forward in that way, And the closer we design the products to the needs of the patients, the staff and the healthcare system is the more effective they're gonna be. So yeah, absolutely, We're seeing a lot of support from.
Tsanko, thank you so much. It's been a real pleasure to have you here today. Are there any final words or thoughts you want to leave us with just to encourage us that little bit more?
I think it's just a massive thank you to, to you guys, the leadership you've provided with the gloves off [00:35:00] campaign and all the other product interventions that you're doing, and to any other clinical staff or NHS staff who are implementing changes like this above and beyond the duties that they have in their role.
I think just a massive thank you, to you, and yeah, please do contact us as a national team if there are places where we can provide further support.
Tsanko, thank you so much. On behalf of GOSH pods goes Green. Thank you. It's been incredibly interesting, incredibly motivating as well actually.
So thank you for that. You can clearly see the passion that you hold for this and having passion for a role that you do daily must be really motivating. So on behalf of GOSH pods goes Green, thank you. I do look forward to speaking to you again in the future. So thank you.
Thanks so much Jason.
