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Petrochemicals, Procurement and Patient Safety: Building a Resilient NHS
By Maia Shouksmith, Foundation year 1 resident doctor and Alhaji Bangura, PhD scholar, University of Wolverhampton
When NHS England leaders warn that the health service is on “high alert” because of a conflict thousands of miles away, it’s hard to imagine the reason. But the recent Iran conflict – and the instability it triggered in the Strait of Hormuz – has had a direct, tangible effect on the NHS.
Not because the UK imports medicines from Iran. Not because the NHS is involved in the conflict. But because modern healthcare depends on resource-intensive procurement models built on petrochemicals.
And petrochemicals flow through one of the most geopolitically fragile shipping lanes in the world.
Many healthcare products rely heavily on single-use plastics, imported manufacturing, and petrochemical by-products; from synthesis of active pharmaceutical ingredients, excipients and solvents to IV bags, catheters, PPE and cold-chain materials. A number of the routine investigations clinicians rely on, including blood tests, diagnostic kits and MRIs, are dependent on petrochemical procurement systems. Blood collection tubes contain a petrochemical derived plastic, polyethylene terephthalate (PET), the price of which has risen by 60% between February and April 2026 (The Guardian, 2026). Many MRI machines require helium, a finite resource sourced from gas fields in Qatar and the US (Murphy, 2026); concerns over its supply have long been recognised and will only grow. The clinical consequences are significant. Delays in diagnostics and equipment shortages will put further pressures on frontline care services, ultimately impacting patient safety.
Disruptions to energy-intensive supply chains have further demonstrated this vulnerability. Where temperature-controlled pharmaceuticals and radioactive isotopes with short shelf lives are particularly at risk, components central to biologics and oncology care (Murphy, 2026). And, while sustainability initiatives within the NHS are often framed primarily around carbon reduction, it is clear sustainable healthcare is equally a question of operational resilience, and this resilience must involve reducing avoidable dependence on vulnerable procurement systems.
The head of NHS England is right to be “really worried”. UK Government bodies including HM Treasury and Department of Health & Social Care have been unusually frank about the risks. Prevention, the most significant driver of sustainable change, has been highlighted in the recent Fit for the Future: 10 Year Health Plan. With further calls for the climate crisis to be declared a global public health emergency (Pan-European Commission on Climate and Health, 2026) it is clear that climate-related disruption directly threatens our health systems, supply chains and patient outcomes worldwide. This is a subject of patient safety and illustrates exactly how climate resilience and healthcare resilience are intertwined. Responding to shortages alone is unlikely to be sufficient; we must address our structural dependence in the first instance.
So where are the solutions? In fact, they already exist. Here in the NHS. In quality improvement initiatives that reduce carbon emissions, that address prevention and procurement pathways to reduce pressure on physical infrastructure while enabling more efficient use of resources. Initiatives led by frontline clinicians who identify inefficiencies within everyday practice and redesign systems around patient value rather than resource consumption. Initiatives that also build resilience.
Across the NHS, teams are working towards a model of ‘triple bottom line’ quality improvement demonstrating social, financial and environmental benefits. Sustainable Quality Improvement (SusQI) projects produce clinical evidence for resilient, high-quality care with lower environmental harm. For example, virtual fracture clinics, remote monitoring systems, and digital outpatient pathways have reduced unnecessary face-to-face appointments, lowered patient travel emissions while decreasing reliance on consumables and administrative resources (NHS England, 2023).
Encouraging education and appropriate PPE use have proven financial and environmental savings across multiple health boards, most recently highlighted in the 2025 Hampshire Hospitals Green Team Competition. The work is already happening. Now it needs to scale.
Ultimately, SusQI projects illustrate that sustainability should not be viewed as an additional organisational objective, but as a mechanism for strengthening healthcare resilience. In an increasingly uncertain geopolitical and environmental landscape, reducing unnecessary procurement may become one of the NHS’s most important resilience strategies.
The lesson is simple: a resilient NHS is a sustainable NHS.
References:
Murphy, F., (2026). Trump’s war with Iran is threatening medical supply chains, experts warn. BMJ Online, 10 April, Volume 393, p. s690.
NHS England, (2023). Virtual Wards and Digital Transformation Guidance. London: NHS England.
Pan-European Commission on Climate and Health, (2026). Pan-European Commission on Climate and Health: Call to Action – Progress measures dashboard. 17 May. (Accessed: 20 May 2026)
The Guardian, 26 April. NHS on high alert over healthcare shortages linked to Iran war petrochemicals. (Accessed: 15 May 2026).
