Embedding Planetary Health in BC's Health Care Procurement

Case study submitted as part of Lancet Commission call for case studies.

Team members / location: Marianne Dawson, Canada, British Columbia

Issue: To scale sustainable change and not add to the already high workload of clinical and procurement staff, the procurement process needs to be transformed so planetary health considerations become a natural part of the work, supported with tools and resources so everyone involved feels they have what they need to be confident in participating.

Intervention: The solution we are working toward is formalizing a sustainable procurement program that is well-resourced and embedded in the provincial procurement team. We will embed planetary health goals throughout our procurement process and track progress.

Outcomes: 

• Clinical
  This work represents a system change rather than a discrete project, making it challenging to measure patient outcomes at that level. However, specific innovations like St. Paul’s Hospital’s trial of reusable surgical gowns during the COVID-19 pandemic demonstrate the benefits. This innovation allowed the hospital to maintain near full surgical capacity despite unstable disposable gown supplies. (https://bcgreencare.ca/threads-of-change/)
• Environmental
  The environmental impact of the change isn't yet known. We plan to calculate our Scope 3 emissions for the first time in 2024 and then we can build out plans to address the highest supply chain categories first. Once we know our contribution we will set reduction targets and monitor progress.
• Social
  By adopting a holistic approach to sustainable procurement, including environmental, social, ethical, and Indigenous aspects. The Director of Indigenous Relations and Procurement at PHSA is strengthening ties with Indigenous communities and businesses, viewing Indigenous procurement as sustainable. A new Supplier Code of Conduct will set expectations for ethical labor, eliminating modern slavery, Indigenous reconciliation, and environmental sustainability. We will baseline suppliers’ progress and develop plans for improvement.
• Financial
  We don't have any concrete financial data to share, but we know that even if some change costs more money, there will be savings in other areas including making our delivery of care more efficient and timely in order to free up more intensive care units.

Key learning point: Everyone in PHSA, and especially in the Procurement team, sees that planetary health and sustainability needs to be part of how we do business going forward. It's important to have a full and clear understanding of how procurement happens in your organization, and I recommend starting by talking to a lot of people about their work. Map out current process and get involved.