Our Similarities Make the Difference: A UK View of the US Healthcare Supply Chain

Recently, I spoke with Clare Nash, RN, a clinical procurement nurse (think Value Analysis) working at two hospital trusts (similar to integrated delivery networks or IDNs) in the U.K. Clare and her colleague David Williams attended the 2025 AHRMM conference as part of a reciprocal arrangement with the Health Care Supplies Association (HCSA), the trade association for procurement professionals working for the National Health Service (NHS). In the U.K., procurement covers what we generally refer to as supply chain, including sourcing, contracting, inventory management, distribution, and logistics.

Even though we speak the same language, there are differences in the terms we use. But beyond how our two countries finance healthcare, Clare believes the challenges, opportunities, and motivations for supply chain professionals are remarkably similar.

Clare commented on the keen sense of pride in their profession shown by the AHRMM attendees. During the pandemic, she says recognition of the role of supply chain grew in the U.K., but perhaps not as much as in the U.S. In the U.K., procurement directors report to the chief financial officer. That’s still the case for about half of the supply chain leaders in the U.S., where we have also seen an increase in the number of chief supply chain or procurement officer titles. Even when finance leaders have overall responsibility for supply chain, Clare believes it is difficult to fully understand how the complexity of the supply chain can affect the ability to achieve overall organizational goals. She is frustrated by those who label supply chain as a “back office” function, when she sees it as a front-line enabler. Clare also said while physicians are often involved in product evaluations, they rarely have a formal role on supply chain teams. In the U.S., on the other hand, we have seen a rise in the number of doctors with supply chain medical director titles.

When Clare first assumed a procurement role, she thought it would be a short-term position. Eight years later, she is an enthusiastic advocate for clinical and supply chain collaboration, working tirelessly to make sure clinicians and patients have a say in the products used in patient care.

Like her counterparts in the U.S., Clare says financial constraints are a major consideration when sourcing and contracting for new products. She says anything that improves patient safety and/or lowers costs is an easy yes. Even if a product can reportedly improve patient outcomes, (e.g., lower infection rates) it can be a harder sell if the price tag is higher.

One difference in the U.K. is the existence of the National Institute for Clinical Excellence (NICE), which reviews clinical evidence and makes recommendations, at times including product choice. Trusts that veer from those recommendations need to explain why. Trusts can also buy from national contracts negotiated by NHS Supply Chain, which manages contracting and distribution on the national level and minimizes workload for local staff.

Trusts have freedom to purchase product outside the NHS Supply Chain contracts, but when entering large purchasing commitments, they are required to consider more than just the product itself. In stark contrast to the U.S., the NHS requires trusts to give at least 10% weighting to the social value of such contracts. That social value needs to include how a supplier will lower overall greenhouse gas emissions over the life of the contract, but it can also include things like improving employee and/or community well-being or reducing health inequalities.

At the end of our conversation, Clare and I agreed, we have more in common than is different, and in her words, if we were to focus more on our similarities, and work together to achieve our common purpose, think of the difference we can make for our patients and our profession.