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Improving health
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Social responsibility and an ethical supply chain

The following case study looks at the action taken by NHS Lanarkshire and NSS National Procurement to embed a cohesive, quality and ethically responsible approach to the procurement of condoms. They wanted to deliver on the NHS ethos of community benefit whilst respecting and protecting the rights of people’s sexual health.

Reason action was taken

As noted in our take the right actions page, one of the key ways to reduce health inequalities is through procurement and commissioning processes.

NHS Lanarkshire and NSS National Procurement wanted to ensure NHSScotland boards were getting value for money on the products purchased. They also wanted to ensure inequalities were addressed by requesting that companies appointed to the purchasing framework were aware of the social responsibility of providing quality sexual health products.

The UK company who were awarded a first ranked status on the framework were bought by an overseas-based company. It was found that the conditions and rights of workers within parent companies were not of an acceptable standard and inequalities, whilst being addressed in Scotland, were heightened for workers in the parent company. This is what prompted action to be taken.

Action taken

NSS National Procurement and representatives from NHSScotland worked with the UK based company, the parent company overseas, and an independent ethical trading company to take action.


  • investigated within the workplace and accommodation settings of the parent company the extent of inequalities (an independent ethical trading company visited the sites)
  • created a corrective action plan with completion dates (based on the findings by the independent ethical trading company)
  • agreed affirmative action to ensure the quality of working and living conditions were improved
  • continued to liaise with all involved to ensure there was transparency and cooperation.

People who helped

NSS National Procurement worked with the subject matter experts from across the health boards to set out a framework of responsibilities and requirements for delivering on the contract for condom provision. Within this, the ethos and social responsibility of companies were made clear. This was important when applying to the issues that arose with the parent company and provided a framework to build on around ethically sound business practices.

Impact and lessons learned

Collectively, there has been a change in the living and working conditions for the workers overseas. This has also been a reminder for the UK based company that they must also ensure the rights of workers are adhered to.

A lesson learned was that the conditions of the overseas workers were unseen and unreported for some time. The appropriate business auditing processes had been undertaken and showed compliance with the standards in terms of how the manufacturing sites were operated. However, it was clear that either these audits did not ask the right questions to highlight issues, or they weren’t reviewing the rights of the workers and instead assessed only the processes.

Another finding was that there was a lack of engagement with the on-site workers in regards to these audits, which if improved may have highlighted the issues earlier. This has been raised with the appropriate organisations and will be reviewed.

It was also found that established and independent companies must be sourced to review services. This will ensure that corporate and social responsibilities are being delivered.

Further information

You can find out more about ways to reduce health inequalities within our reducing health inequalities section.

This case study is based on information provided by Jacqueline Martin of NHS Lanarkshire, and David Bryce and Paul Homby of NSS National Procurement. If you would like to discuss further, you can contact our Health Promoting Health Service (HPHS) team by email at