The must-read stories and debate in health policy and leadership.

Competition rules aren’t the only things changing in the busy world of NHS procurement.

The sustainability agenda is also influencing the sector, with the NHS set to introduce a mandatory 10 per cent weighting for social value in all procurements from April next year.

Sustainability chiefs hope this will help the NHS’ massive challenge in reducing carbon emissions from its gargantuan supply chain, which is thought to comprise about 100,000 suppliers.

Central government already abides by this requirement, and NHS commissioners procuring health services were also set to include a social value weighting in future procurements.

The move is one of several schemes by which the NHS hopes to force its suppliers to take sustainability seriously.

The health service is also planning to ban the use of any supplier who does not meet certain green standards by 2030, with companies set to be measured against an “evergreen” framework.

This framework will see suppliers self-assess (with the NHS applying random spot-checks) themselves and receive a ranking. The ranking creatively comprises “seed”, “sapling” and “evergreen” (the highest accolade), as well as the minimum requirement (“meeting expectation”).

In other words, suppliers will need to get their sustainability plans in order to do business with the NHS in future. This is only the beginning.

Rishi’s reality bites

NHS providers are girding themselves for the return of tough efficiency asks from the centre. They were warned back in June that hard times would return and have since been working on the assumption that they will need to meet a 1.5 per cent efficiency requirement in the second half of the year.

Trusts have been on block contracts, with top-up funding to meet their costs since March 2020, with little-to-no savings requirements.

Clearly this was essential to ensure the health service could function unencumbered during the pandemic. But it could not last forever, the Treasury was always going to ask for something in return for its largesse.

It is not clear yet precisely what efficiency requirement will be baked into the funding settlement for the second half of the year. NHSE and Treasury negotiations are ongoing. But trusts have been told to plan for a 1.5 per cent efficiency ask in H2.

This would come after a year without any efficiency ask (2020-21) and a 0.28 per cent efficiency requirement in the first half of 2021-22.

It is still just an assumption, for planning purposes, not a requirement. But, with negotiations between HMT and NHSE expected to run into September, it was necessary so trusts could make a budget to cover October to March.

After years of sizeable efficiency asks, it is unsurprising experts are suggesting it would be unrealistic and unreasonable.