Last Updated on 04/12/2025 by Sarah Sarsby
One year after the launch of the Design for Life (DfL) Roadmap, NHS England (NHSE) and the Department of Health and Social Care (DHSC) have published a joint update highlighting substantial progress towards building a circular economy for medtech by 2045.
With around two-thirds of the programme’s 30 actions now underway and the DfL collaborative more than doubling in size, the past year has marked a significant shift in national focus on sustainability, innovation, and procurement transformation across the health system.
To help BHTA members understand how this work is evolving, this article summarises key developments across the six DfL problem statements that structure the programme.
For background on the initiative and the opportunities it presents for medtech suppliers, you can also read our earlier article: ‘How the Design for Life programme is opening new opportunities for medtech suppliers’.
Leadership and Alignment
DfL has prioritised developing clear direction for the transition to circular solutions. Over the past year:
- A Priority Adoption Working Group, including clinicians, procurement specialists, NHSE and NHS Supply Chain, has assessed more than 50 product areas to identify those most suitable for early transition to reusable alternatives.
- NHSE has launched a workstream to tackle the overuse of single-use products where evidence shows they are not required.
- Early staff focus groups have been created to understand the barriers and enablers frontline teams face when adopting circular practices.
- NHSE has collated best‑practice resources from across the system into a new central online repository.
- Seven pilots across England and Wales found both cost and carbon savings, with most also maintaining or improving staff satisfaction.
- The NIHR Innovation Observatory has identified 22 KPI classes to help measure circularity progress.
- At COP30, NHSE and partners published the report ‘Decarbonizing the healthcare supply chain – strategic actions for health systems’, setting out practical actions to reduce emissions linked to procurement.
Behavioural Change
Shifting mindset and culture remains a core focus. This year:
- A joint DHSC–NHSE behavioural change team has been established and will launch a stakeholder working group early next year.
- Three key enablers of reusable adoption have been identified: system‑level governance, standardised guidance, and accessible evidence.
- A full literature review has been completed to assess equalities considerations, ensuring circular options are accessible for all patients.
Commercial Incentivisation
Work to embed circularity into procurement and commercial frameworks has accelerated:
- New value‑based procurement guidance, including circularity questions, is being piloted with nine procurement teams and will support upcoming NHS Supply Chain frameworks.
- Circularity criteria have been added to the new assessment framework for community prescribing (Part IX drug tariff).
- Research into servitisation models, including digital twin applications, is underway.
- A series of market engagement sprints is assessing commercial barriers and supplier readiness.
Regulations and Standards
DfL has focused on identifying regulatory barriers that may hinder circular solutions:
- A national survey of suppliers has gathered evidence on remanufacturing of Class I devices to understand where regulations may need to evolve.
- Work has begun on developing national Infection Prevention and Control (IPC) guidance for reuse, supporting safe implementation of reusable products.
Physical and Digital Infrastructure
Building the infrastructure required for a circular medtech system is now a key priority:
- A call for providers to deliver a national review of decontamination capacity has closed and is being assessed.
- Research into current and future decontamination service models—including automation and UV—is underway.
- A joint project with the University of Exeter is analysing material recovery opportunities across high‑value product categories.
- The EPSRC‑funded Digitally Enabled Circular Healthcare Innovation (DECHI) programme has launched to explore how data and digital tools can support circularity.
- The REHEAL programme is underway across several European countries to develop data systems that support circular supply chains.
Transformative Innovation
DfL continues to build the research and innovation pipeline that will underpin future circular solutions:
- SUSTAIN, a sensor‑integrated simulated operating suite at Leeds General Infirmary, is being developed with DHSC funding.
- Seven new research projects worth more than £18 million have commenced.
- A major research convening event brought together 25 circular medtech projects to explore collaboration opportunities.
Looking ahead
Over the next three years, DfL will move from research and insight towards delivering tangible tools, standards, and frameworks to support system‑wide adoption of circularity. Five new working groups, covering behavioural change, commercial strategies, regulation and standards, physical infrastructure, and research coordination, will help guide this next phase.
The DfL website will continue to provide updates, and BHTA will share further information with members as new resources, guidance, and opportunities become available.
