The Going Circular Pilot

EnableNSW provides assistive technology and related services to people in NSW with specific, short term or ongoing health needs to assist them to live safely at home.¹

Many respiratory devices returned to EnableNSW when no longer needed remain in good condition and still in warranty. The Going Circular Pilot addressed barriers to routinely re-issuing respiratory equipment including quality concerns from clinicians and patients, and a lack of visibility of quality standards and processes for third party suppliers to assess, clean and re-issue equipment.

Developing a circular economy model

EnableNSW’s Going Circular Pilot developed a circular economy model for home respiratory equipment in NSW to reduce waste and carbon emissions. The project team partnered with the Clinical Excellence Commission, clinical experts from Sydney Local Health District (SLHD), South Western Sydney Local Health District (SWSLHD) and a third-party supplier to develop and implement best-practice procedures and quality standards to clean and refurbish returned respiratory devices.

Returned devices meeting quality and safety standards were added back to stock and re-issued to new patients in the community. A survey for patients and clinicians captured feedback regarding perception of quality and acceptance of re-issued equipment. This pilot will inform EnableNSW’s statewide model for equipment provision, with the potential to significantly reduce emissions and waste generated through the supply chain in NSW, keeping valuable products and materials in circulation for longer. This project aligns with the NSW Waste and Sustainable Materials strategy 2041.²

New processes to streamline equipment cleaning and refurbishment

A collaborative approach included a multi-stakeholder workshop to identify barriers and solutions. The workshop included expert clinicians, procurement teams, end-users (patient representatives) and the third-party equipment supplier to support solution design. The project team developed best practice cleaning procedures and quality standards for re-issued equipment in collaboration with expert respiratory clinicians from SLHD and SWSLHD, Clinical Excellence Commission and a third-party supplier.

Between March 2023 and July 2023, the project team partnered with the supplier to trial and embed best practice cleaning procedures, quality standards and refurbishment processes for returned EnableNSW equipment. They developed and implemented new EnableNSW processes to streamline approvals for equipment cleaning and refurbishment, stock management and re-issue of returned equipment. Between August 2023 and August 2024, a randomised-controlled study protocol was used to re-issue respiratory devices to eligible patients (n=40) in SLHD and SWSLHD.

All issued equipment was checked by clinicians before being issued to patients. A digital survey tool captured feedback about patient and clinician perception of quality and their experience receiving and using the equipment. The pilot was successful in translating best practice circular economy principles into practice. In line with the findings of the McGuiness pilot project, the Going Circular pilot demonstrated that respiratory devices returned in good condition can be safely cleaned and re-issued to patients in the community.

Patients and clinicians want to participate in sustainable healthcare

A survey of the 40 participating patients and their clinicians demonstrated good acceptance of equipment, with an average rating of eight and half out of ten for perceived quality. The surveys also gathered valuable feedback to refine the processes and improve patient experience.

The survey feedback also demonstrated that patients and clinicians want to participate in a health system that cares for the environment and that models of re-use and refurbishment also improve the patient and clinician experience. This successful pilot has demonstrated a safe and acceptable model for maximising the use of valuable equipment with significant cost, carbon, and waste savings. The model also improves supply chain resilience and supports timely access for LHD clinicians to a pool of devices.

The pilot outcomes will inform EnableNSW’s statewide model for equipment provision, keeping valuable products and materials in circulation for longer. The quality standards and processes developed also have the potential to be translated for the re-issue of other types of equipment. Rolled out to a state-wide scale for respiratory equipment, the Going Circular model could save approximately 1.5- 3 tonnes of CO₂e per year and prevent approximately 250-500 kg of high-value materials going to landfill every year, including metals and rare earth minerals.

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