In May 2009, the All Wales Nurses’ and Midwives’ Uniforms Procurement Project Board was put together to provide leadership for a new contract tender for an estimated 150,000 uniforms. The management and coordination of the procurement contract was carried out by Welsh Health Supplies on behalf of NHS Wales. Welsh Health Supplies recognises the important role it plays in supporting the Welsh Assembly and UK Government sustainability agendas. It has developed a CSR policy which outlines its responsibility in twelve areas, including ethical procurement. As a part of Welsh Health Supplies’ approach to sustainable procurement, all contracts valued over £25k are required to include a sustainability risk assessment. As a result, a number of key issues were highlighted, including the labour issues associated with the supply chains. As a further step, Welsh Health Supplies mapped the supply chain for uniforms from fabric  manufacture through the dyeing process and garment production. This mapping demonstrated that poor labour standards were a risk beyond the first tier, right down the supply chain.

The outcome of a competitive dialogue process was to include a requirement in the contract for the whole supply chain to be compliant with the Ethical Trading Initiative (ETI) Base Code. The contract also required a labour standards audit to have been conducted within the last 6 months at each supplier’s site throughout the supply chain, including the textile manufacturer, the dye house, and the garment manufacturer, as well as any warehousing. In addition, details of the most recent corrective action report were required. If an audit was not available, the supplier was required to pay for an audit to be undertaken by WHS’ approved partner. Welsh Health Supplies worked with High Street Textiles Testing Services (HSTTS), a qualified audit body, to review the documentation provided by potential suppliers. HSTTS provided advice on non-compliances and closeout of issues identified in the audits.

The intention of this approach was to incorporate the requirement for ETI Base Code compliance in the conditions of contract. This allowed WHS to agree with the supplier reasonable timescales to achieve compliance and ensured that action would be taken throughout the supply chain.

In December 2009, a contractor was selected for the manufacture of the uniforms. WHS requested social audits from all sites, including Greige fabric manufacturing, production and dyeing. Sites without an audit were asked to commission one immediately. Whilst no major issues were raised, HSTTS is continuing to provide ongoing support on corrective actions and closing out issues identified by these audits. Welsh Health Supplies believes that the inclusion of compliance with the ETI Base Code as a contractual obligation added minimal cost to the procurement process, as these costs were borne by the successful contractor. Whilst the entire procurement process was time consuming, with two people working full time for six months, the inclusion of the assessment of the bidders against the ETI Base Code added very little extra time to the process.

Welsh Health Supplies is keen to take a similar approach with other contracts, e.g. surgical dressings. They are eager to share their learning with others in the NHS through the BMA Medical Fair and Ethical Trade Group and other forums.


Further case studies

Nottingham University Hospitals

Calderside Medical Practice