Analyzing Internal and External Factors Affecting NHS Procurement

This dissertation delves into the realm of sustainable procurement within the UK's National Health Service (NHS), examining the impact of both internal and external factors on its effectiveness. The research begins with an introduction outlining the background, aims, objectives, rationale, and significa...Read More

DISSERTATION

TABLE OF CONTENTS
CHAPTER 1: INTRODUCTION....................................................................................................3
Background.................................................................................................................................3
Aims and objectives....................................................................................................................3
Rationale.....................................................................................................................................4
Significance.................................................................................................................................5
Dissertation structure..................................................................................................................5
CHAPTER 2: LITERATURE REVIEW.........................................................................................8
REFERENCES..............................................................................................................................11

CHAPTER 1- INTRODUCTION
Background
The sustainable procurement is defined as a process through which the companies meet
for their need relating to goods and services needed to provide services to the consumers. It is an
act of adopting the social, economic and environmental factors at time of the management of raw
material within the company (Procurement, 2021). This sustainable procurement is of benefit to
the company as when the business complies with sustainable procurement then the mission of the
company is accomplished as the material is being procured by not harming the environment and
this makes the procurement more effective and efficient (Gelderman, Semeijn and Vluggen,
2017). The present research study is based over the health care setup NHS that is National Health
Service which is an umbrella term for the publicly funded healthcare system. Since, the time of
1948 the company is being funded by the general taxation only. There are total of three setups
which combine makes the NHS that includes NHS in England, Scotland and the Wales (The
NHS, 2021). In addition to this above fact NHS work upon three principles which includes the
fact that it meets the need of everyone, it is free at the point of delivery and that it is based on the
clinical need of the person and not the ability to pay of the person.
The present research will discuss about the different types of internal and external factors
which affect the sustainable procurement within the health care set up that is at NHS. Further the
discussion will also include the understanding relating to the concept of sustainable procurement
and what is its significance. In addition to this the critical evaluation of different types of internal
and external factors will take place. Further the research will also outline some of the challenges
which affects the sustainable procurement will be discussed with respect to the NHS. This is
particularly important for the researcher to undertake the NHS as this will provide a clearer and
wider area for the study to be completed in successful and effective manner (Ahsan and Rahman,
2017).
Problem statement
In the current business environment, the competition is very high and the resources are
very low. Hence there is always the problem of management of resources and material and the
procurement within the company. hence, when the procurement will be late then the production

will be delayed resulting in the loss for the companies. Hence, this is the major problem which
involves the fact that procurement must be sustainable that is it will be beneficial for the future
as well. thus, the present research will disucss the problem that how sustainable procurement can
be managed and what are the external and internal factors affecting the procurement.
Aims and objectives
Aim
“To analyse impact of internal and external factors this affects the sustainable procurement
within UK health care sector. A study on NHS.”
Objectives
 To develop understanding relating to the concept of sustainable procurement
management and its significance.
 To critically evaluate the different internal and external factors that affects the
procurement and over supply chain at NHS.
 To examine the challenges relating to the use of sustainable procurement management
that hampers performance of company.
 To recommend some of the measures with which procurement management can be
effectively used.
Research question
1. What is the concept of sustainable procurement management along with its importance?
2. What are the different internal and external factors which affects the sustainable
procurement and supply chain of company?
3. What are the different challenges which affect effective use sustainable procurement
management of the company?
4. What are some of the recommendation which will assist company in improving
performance of company with respect to sustainable procurement management?
Rationale
In the current competitive world, it is very essential for the companies to have an
effective procurement management. This is particularly because of the reason that if the material
will not be made available on time then this will affect the working efficiency and effectiveness
of the company. Hence, for the companies it is very essential for them to manage their

procurement system and process so that material is being made available timely and work can be
done in required manner. In the present research the impact of internal and external factors
affecting the sustainable procurement within the UK health care sector will be analysed and
evaluated. In the present highly competitive environment, the competition is at its peak and for
every company it is essential to have the effective procurement management which stays for the
betterment of the company (De Soete and et.al., 2017). Hence, every company works in order to
manage the procurement but there are some factors which restrict them in managing procurement
system. Hence, the present research is based on analysing these factors and taking some measure
in managing the supply chain and procurement process.
Hence, this is the major reason for researcher to complete the study on NHS as in the
health care setup it is very necessary that all the required resources are being available on time.
This is particularly essential because of the reason that when the resources will be made
available on time then in case of any emergency the work or treatment can be started on the spot
and the people do not have to wait as they are not having the material to operate. In addition to
this when there will not be sustainable procurement then the resources will not be made available
on time and in case of emergency there might be problem faced by the companies. This can be
undertaken only with the help of the sustainable procurement only that the resources are being
made available on time and can be used in case of emergencies. Hence, for this reason it is very
essential to NHS that all the equipment and materials are timely available. In addition to this
another reason for conducting the present research over factors affecting sustainable procurement
is the personal and academic interest of the researcher themselves. This is particularly because of
the reason that researcher himself want to increase their knowledge relating to the different
internal and external factors which affects the procurement to a great extent.
Significance
In the current competitive environment there are many companies doing similar kind of
work and providing similar services to the consumers. hence, it is obvious that the resources
required by these same companies will also be similar. Thus, already the resources are very
limited and scare and if there will be many companies dealing in the same field then they will all
be requiring the same resources. Hence, this research is of significance to NHS as the study is
being conducted over the company. Thus, with help of this research the company will come to
know about different internal and external factors affect the sustainable procurement at NHS.

Therefore, with help of this research the company can make effective strategies so that the issue
or the factors affecting the procurement can be managed by NHS and this will be only possible
with help of this research (Mousa and Othman, 2020).
Hence, this research is of significance to NHS as with help of this they will get
knowledge relating to the factors which can affect their sustainable procurement and they can
make strategies to handle those factors. In addition to this, the present research is also of
significance to competitors of NHS like Integrated Care, GSI Health and many others. These
competitors can also use this fact and figures and can handles those factors in the similar manner
as suggested to NHS.
Dissertation structure
Chapter Description
Chapter 1- Introduction The chapter one involves the overview of the
research topic that is sustainable procurement.
This chapter deal with outlining the
background of the topic and the aim and
objective is relating to the concept of
sustainable procurement. In addition to this,
the present chapter will also outline the
rationale that is the reason behind the
selection of the sustainable procurement as the
research topic.
Chapter 2- Literature review The literature review is defined as the analysis
of the different types of the views and
opinions of different authors. This chapter
will outline the analysis of the different
secondary sources like books, journals and
other published sources relating to the internal
and external factors affecting the sustainable
procurement within the health care setup.
Chapter 3- Research methodology The next chapter deals with the methodology
of the research that is what methods will be

used in order to complete the research. In the
present completion of the study on analysing
the internal and external factors affecting the
sustainable procurement use of qualitative
study will be undertaken. This will be selected
for the reason that qualitative study will
outline the in depth analysis of the research
topic.
Chapter 4- Finding and discussion This is a chapter which relates to presentation
and analysis of the collected data so that some
meaningful inferences can be drawn from that
collected data. The data relating to analysis of
the internal and external factors affecting the
procurement will be collected. Hence, with
help of the thematic analysis the current
collected data will be analysed and evaluated
in order to draw some conclusion and
meaning from the analysed data.
Chapter 5- Conclusion and recommendation This is a chapter which deals with the drawing
of the conclusion from the analysed data and
finding, this is very essential for the success
of the research as if any conclusion will not be
drawn from the study then it will be a waste of
time and energy as there is not any
conclusion. Hence, after the analysis of the
finding the conclusion will be drawn as
whether the research was successful in
attaining their aim and objectives or not.

CHAPTER 2: LITERATURE REVIEW
Literature review is being defined as the analysis of the different types of secondary
sources of data relating to the research topic. This LR is essential for the research to be
completed in successful manner. The reason pertaining to this fact is that with help of LR the in
depth knowledge relating to the concept of research topic is increased and this assist researcher
in developing knowledge relating to research topic. The present chapter will outline the views of
different authors and writers relating to the internal and external factors which affect the
sustainable procurement within the health care sector of UK. Hence, this chapter will outline and
increase the knowledge of the readers relating to the concept and different factors of sustainable
procurement and how it affects to the health care sector.
Theme 1- Concept of sustainable procurement management and its significance
By referring to the works of Kannan (2021) sustainable procurement management can be
defined as the integration and adoption of the CSR principles into procurement process and
decisions relating to the requirement of all stakeholders of the company. This is essential because
of the fact that when the company will focus on the sustainable procurement then this will
involve the environment and society as well into the working. On the other side Zaidi and et.al.,
(2019) argues that sustainable procurement is being defined as a process whereby organization
tend to meet their need of goods and services in such a way that leads to achieving value for
money along with a focus of not only benefiting to the company but the society and economy as
a whole. This is necessary as when the company takes resources from the society and the
environment and it is the moral duty of the company that they provide something better in return
to the society and environment as well.
Along with this Kaur and Singh (2018) argues that when the company does not focus on
sustainable procurement process then it affects the working of the company to a great extent.
This is particularly because of the reason that when the company does not take into consideration
the sustainable procurement process then this affects the working as consumer and other
stakeholder does not like the fact that company is not taking care of the environment. Hence, this
will have a great impact over the working of the company as consumer will like the fact that
company is taking care of the environment and society from which they have taken the resources
and raw material.

As per the views of Roman (2017) it is the moral and ethical duty of the company that
they take care of the environment from which they are taking the material to make their
operations run. This is particularly because of the reason that when the company will not take
care of the environment and society then this will create a negative image of the company among
the consumers. Hence, for the effective management of the brand image and goodwill of the
company it is essential that the company takes care of the sustainable procurement so that it also
involves the protection of the environment and the economy as a whole.
In addition to this Kaur and Singh (2019) articulates that use of sustainable procurement
is very important for the companies in this modern and highly competitive environment. The
most common importance or significance of sustainable procurement is that this leads to more
efficient and effective use of natural resources. This is particularly because of the reason that the
resources provided by nature are very limited and the competition towards use of these resources
is already very high. Hence, when the company makes use of the sustainable procurement then
the company comes to know the fact that how effectively they have to undertake the use of the
natural resources in such a manner that they are optimally and efficiently used.
On the other side The importance of sustainable procurement (2020) argued that the
major significance of using the sustainable procurement process is the reduction in the harmful
impact of pollution and waste. This is particularly because of the reason that when it comes to
sustainable procurement then it means that the company will rely over the procurement process
which will lead to working without any of the waste or pollution. Hence, this sustainable
procurement and operation process will lead to minimisation of the waste and pollution from the
operational and manufacturing process of the company.
In against of this Chiarini, Opoku and Vagnoni (2017) stated that the major importance or
significance of the sustainable procurement is that this will encourage more of the innovation.
This is particularly because of the reason that when the company will make effective use of the
sustainable procurement process then there will be minimum of wastage and resources will be
used in more effective manner. Hence, as a result of this employees will be more focused on
working in effective and efficient manner. Thus, as a result of this the employees will become
more of the innovative and creative in their working efficiency and this will improve their
productivity and efficiency to work in much better and effective manner.

Along with this Aragão and Jabbour (2017) supported the fact that when the company
goes for sustainable procurement process then this will lead the business to be more transparent
and express its commitment towards the eco- friendly development of the company. This is
majorly due to the reason that when the company will deal with sustainable procurement then it
means that all the business practices will be transparent to consumer and all the other
stakeholders of the company. Hence, the entire business stakeholder will be happy with the
company and its operations and activities. Thus, this will increase the goodwill of the company
as the practices of the company are more transparent and company is more committed towards
building of the eco- friendly development of the business.
Furthermore, as per the views of Ghadge and et.al., (2019) the major significance of the
use of sustainable procurement is that this will increase the sustainable reputation of the
company. This is pertaining to the fact that when the company will be complying with the
sustainable development and procurement process then this will lead to increase in goodwill of
the company which will stay for longer for the company. This is particularly because of the
reason that when company will be taking care of the environment and the society then this will
assist company in developing their good image among the society and the consumers. Hence, as
a result of this the company will be facing a good and sustainable reputation which will increase
the market share and market value of the company to a great extent.
In the end as per the views of Islam and et.al., (2017) it can be stated that for business to
be successful in this highly competitive era it is essential for the company to have a focus on the
effective sustainable procurement. This is majorly because of the reason that when the company
will have a focus on the sustainable procurement then this will result in effective operation and
management of the company. As a result of which the operations of company will be undertaken
in proper and effective manner and will result in attainment of the objectives of business to a
great extent. Whereas, through effective sustainability procurement, companies ensure that it
leads to manage the resources which creates positive impact upon the overall performance of a
business. That is why, due to change in the overall environment, there is a need to identify the
same and hen implement the same accordingly that helps to stay ahead within a competition.
Theme 2- Different internal and external factors affecting the procurement and their impact
on supply chain in health care sector

From the above analysis it is very much clear that it is very essential for the companies
within the health care setup in order to manage sustainable procurement. This is particularly
because of the reason that when the procurement will be sustainable then this will assist the
companies in managing the supply chain in proper and effective manner. In accordance with the
views of Roman (2017) there are many factors which affects the working of the company to a
great extent. There are many internal and external factors which affects the working and the
procurement system along with the supply chain of the companies. The major internal factor
which affect the working of the supply chain of health care sector companies is the management
strategy. This is particularly because of the reason that when the management strategy is not
good then this will affect the working to a great extent. This is particularly because of the reason
that for instance if the strategies relating to allocation of the resources is not good then this will
have a great impact over the supply chain of the company. Moreover, when the strategies are not
clear then employees do not know how they have to use the material in order to treat the people
coming to health care setting. Hence, as a result of this people will not be able to manage and use
the resources to the optimum. Kaur and Singh (2019) also shared their views in negative aspects
that due to not having enough knowledge about the management strategies within an
organization, then company are not able to meet the defined aim. Though in health care sector,
there are variety of talents people recruited who support management in order to manage the
things and that is why, lead towards proper strategy. That is why, there is a need to have enough
knowledge that strengthen up the supply chain, otherwise it leads to cause many negative impact
upon the business performance.
In against of this Zaidi and et.al., (2019) argues that cost of infrastructure also affects the
sustainable procurement to a great extent. This will affect the procurement process to in a great
way as when the company will not have proper infrastructure to store the resources and material
then they will have to order the material very frequently. This in turn will increase the cost of the
company for ordering the supply very frequently. Hence, for this it is advisable to the companies
that they must work on improving the infrastructure so that the materials can be stored in proper
and effective place. Skipworth, Delbufalo and Mena (2020) supported the same and stated that
there is a need to adapt the changes and upgrade the machines in order to implement the same
into a business. Further, there is a need to identify the machines which gets obsolete and that is

why, to adopt the concept of sustainable procurement, there is a need to identify the budget and
then make changes accordingly in order to reduce the changes.
Furthermore, Patrucco and et.al., (2019) articulated the fact that leadership within the
change management process also affects the procurement and impact over the supply chain
management. The major reason underlying this fact is that when the company will not have good
and effective leadership then they will not be able to implement the changes within the supply
chain. Hassan, Tretiakov and Whiddett (2017) also argued that leadership is a key driver of a
successful implementation of a supply chain. That is why, an effective leadership within a
change management also lead towards a success. Whereas, lack of coordination between team
within a supply chain of health and social care also arise the results of poor leadership. So, it
directly affects the overall performance of the company's employees and this in turn somehow
leads to causes negative impact upon business overall profitability. Also, leaders are the one who
always support the entire employees and provide effective direction, but due to change in the
external market, it affect the overall performance of an employees which needs to be managed.
For example, the policies and procedure of NHS might changes due to fluctuation within
the outer marketing change. At that time, leader must aware their employees to adjust with new
working environment and with proper consultation within management they can reduce their
extra expenses to remain stay ahead in the competitive era. Thus, it can be stated that with the
help of leadership within a change management, they improve the supply chain and if,
management do not focused upon such, then it might affect the overall business performance in
opposite manner.
Samuels (2021) emphasized that internal management structure also affect the overall
business and sustainable procurement within health & social care. Such that there are many
companies who do not developed strong internal management structure because most of the
senior authority do not support them and as a result, it affects the overall performance. Author
also support that support from a top management is recognized as a most influential driver in
order to promote supply chain. It is so because they also emphasized upon innovation and
advance technology such as pollution control and environment management systems etc. on the
contrary side, Toppinen and et.al., (2019) also critically evaluated that due to lack of
management structure (internal factor) companies might prevent themselves from undergo any
change which ensure to enhance the profit as well as sustainability. Thus, change management is

a considered as a critical strategy which enable companies to adjust their practices and programs
in order to improve their overall performance against changes in any market situation.
External factor is mainly deal with the macro factor that affect the overall performance as
well as causes direct impact upon the environment of a country. Therefore, there are list of
factors which affect the business or healthcare setup which includes Political factor. Zaidi and
et.al., (2019) explained in their studies that generally trade association and business organization
are completely involved within a sustainable procurement system. As every group and individual
have different interest which also affect the overall process of the company. This political factor
also affected the procurement process of a firm and that is why, it results into business activities
and cost cutting measures. On the other side, Kristensen, Mosgaard and Remmen (2021) also
argued that due to not complying with any legal framework and regulations which affect the
supply chain activities of a health and social care setup. But this can be eliminated by arguing
with politicians so that the supply chain might not affect in any manner.
Further, Skipworth, Delbufalo and Mena (2020) investigated in their studies that Social
environment is another external factor which also cause direct impact upon the sustainable
procurement and supply chain such that due to lack of external pressure from a government
which might drive towards a social sustainability. Moreover, most of the time media as well as
civil societies does not cause any problems to the public's attention, but it somehow creates
pressure upon firms due to become more environmentally and socially responsibility (How
external factor affect procurement, 2021). That is why, Meehan, Menzies and Michaelides
(2017) argued that due to not determining the actual demand of the customer might also affect
the overall performance in opposite manner. As, this factor always leads companies to become a
social responsible and focused upon sustainability. Although, there are many companies who do
not took pressure from outside and that is why, they do not focused upon the sustainability. This
also affect the overall performance of the company in adverse manner thus they have to consider
the same.
Economic factor also plays a vital role in the upon the procurement and this also have a
direct impact upon the overall supply chain of a business. According to Bakir and et.al., (2018)
economic environmental factors significantly related to GDP of the company and this in turn
somehow effect any fluctuation within economic conditions. Such that inflation and depreciation
in the exchange rate also affect the supply chain of the company and this might affect the

negative impact upon economic sustainability. However, it is examined that GDP growth and
increasing supply levels can promote the supply chain of the company in the economic point of
view Belvedere, Grando and Legenvre (2018) supported the same and stated that due to growth
in GDP, it leads to reduction in the purchasing cost even though there are plenty of raw material
available within market. So, it is reflected that there is a strong interrelationship between the
economic condition and supply chain. Also, if there is an economic stability within a market then
it also helps to increase the consumption rate along with increase in the purchasing power of
customers.
Overall, it is clearly identified that there are different factors which affect the
procurement of a business along with its supply chain. Nevertheless, it is also identified that
some of the health care organizations have strategies in order to overcome the same which
includes strong expertise and highly talents employees who always supported them in order to
meet the defined aim. Moreover, there is a need to manage the external and internal factors
because these are strongly associated with the supply chain and it might cause many barriers
which also hindered the development and implementation of sustainability procurement.
Theme 3- Various challenges relating to use of sustainable procurement management
hampering the performance of the companies within health care setup
According to the Ahsan and Rahman (2017) the sustainable procurement management is
very challenging for the businesses that are operating under the health care sector. One of the
most significant challenges are the financial constraints and the budgeting requirements that are
to met by the company in order to ensure the financial stability in the market. In order to meet
the corporate social responsibility the company has to design efficient business model that does
not harm the environment and leads to the social welfare of the people. While ensuring this
additional costs are incurred which ultimately fails the budget, causes deviations and also
reduces the profitability of the business. On the contrary the Chiarini, Opoku and Vagnoni
(2017) mentions that while ensuring the sustainable procurement management in the hospitals it
shall be easier to attract and develop the new potential target market. It shall be driving factor of
motivation for the various employees who are working for the organization since it is fulfilling
the corporate social responsibilities as well as is ensuring profitability and future growth
prospects for the business De Souza Dutra and et.al. (2017) evaluates that the practice of
conducting the operations through the sustainable procurement the business can cause

demotivation to the shareholders of the business. Since they shall be befitted by the higher
profitability of the business by getting the excess returns post saving it in the form of retained
earnings of the business. The company focusing on applying the techniques that shall be
resulting in the sustainable development of the society will be costlier as compared to the routine
business. For instance if NHS has developed a budget for the execution of the routine business
operations and then are to deliver these services such that the sustainability is ensured then it will
cost them over and above the charges of the routine business.
Delmonico and et.al. (2018) mentions that another major challenge is that for once if the
hospital incorporates the policies governing social welfare but how shall it ensure the same
within all the participants that are there in its supply chain. All the businesses that are vertically
or horizontally interacting with the health care business must be ensuring to have the shared
vision and objective of sustainable procurement management. This shall be ensuring smoothness
while conducting the beneficial activities that are related to the society. Ghadge and et.al. (2019)
contradicts that while bringing all the businesses on the socially accountable and responsible
status the company shall be loosing its own base for sustaining the competitive advantage in the
business. This shall be ultimately increasing the competition among the various businesses
regarding the sustainable procurement management. The higher the competition the lesser shall
be the rewards for the health care company within the industry. The benefit of the first mover
advantage through the capitalization of the market opportunity shall be driving growth and
success for the company. Kannan (2021) studies that if the company wants to be associated with
all the businesses which are performing the sustainable operations then they can redefine their
supply chain in a manner that the goals and objectives of the business are fulfilled in terms of
profitability and future growth prospects of the business. The supply chain management in itself
is a complex procedure whereby the company shall be ensuring that it is efficient to ensure that
the timely and efficient services are provided to the customers.
As per the views of the Lăzăroiu and et.al. (2020) in the health care services market
which shall be ensuring that the sustainable and the ethically sourced products are produced for
the customers without the harmful effects of the chemical in the market. This is the biggest
challenge for the company since these products that are served in the health care industry are
formed after severe market research and applying band testing of the products. Suddenly the
ethically developed products can't be incorporated by the business which are replacing the drug

based medicines. Apart from that the Masase (2018) disagrees and says that the market for the
sustainable and eco-friendly products shall be giving scope for the entry of the new competitors
in the industry. Within the time that the company shall be changing its existing business model
the newer companies shall be incorporated who will be capitalizing on the opportunities that are
there in the external environment and attaining the profitability. Not just that the major challenge
arises that how will the company market the new products and services that it is offering and win
the trust of its potential customers in the market. The customers perception in the health related
areas is very serious and they are not able to trust any kind of new medicine or the different
services that are provided by the business. For example NHS is the wide healthcare service
provider who is supposed to adopt the practices that ensure the sustainable development and
environmental protection while developing and growing the economy. The NHS uses the various
equipments which re using the energy and the fuel but in order to do the sustainable development
the company has to change these devices into the energy efficient ones. This shall pose the threat
to the company and also the technological advancement will imply huge requirements of the
capital resources in the business.
Montalbán-Domingo and et.al. (2019) interprets that the sustainable development in the
health care sector is a challenging task because this is a change that has to be incorporated in the
business operations of the hospital. But on the contrary it can be assessed that the employees in
the business remain resistant to change and are finding it difficult to adapt to the changed
business environment. The employees have to be directed as per how the company shall be
including sustainability in its operations and also the employees are to be trained regarding the
same. This shall be disturbing the routine operations and also shall be increasing the costs for the
company. It can also increase the labour turnover in the hospital. The employees that are there
shall be very professional and has expertise in their profession who are very difficult to be hired
again in the business by the organization. This shall be affecting the overall operational
efficiency of the business and also cause the loss to the profitability and the market position of
the company. On the contrary Morioka and et.al. (2017) believes that the sustainable
procurement management that is being undertaken in the business shall be contributing to
generating the satisfaction level of the employees as they are the part of the society and shall be
motivated by the development of the society. The employees shall be supportive in the decision
of the business and shall be contributing to the increased efficiency of the business. Most of the

stakeholders shall be in the favour of implementing the decision as ultimately they also form the
part of the society where they have to support the environment and its protection policies. It can
also be ascertained that if the environment is not harmed and shall be protected in that case the
government intervention can also be reduced to an extent and the brand loyalty and reputation of
the business shall be increased. This will be bringing success and growth competency for the
business.
Conclusion
By summing up above section it has been concluded that sustainable procurement is the
process that helps to meet the needs for goods and services in order to attain the values that helps
to address the equality principles for a sustainable development. Moreover, the study also
examined different factors that affect the overall procurement and its supply chain process which
includes external as well as internal factors. Further, the report also concluded that external
factors include political, social and environmental factor that affect the overall business
performance and it also causes negative impact upon the business. On the other side, internal
factor includes leadership, change in management strategy and cost of infrastructure that also
affect the overall business and its procurement supply chain. Therefore, there is a need to
manage the change and implement the strategy accordingly. Further, through the secondary
research it has been concluded that there are many challenges that affect the procurement which
includes financial constraints, resist between the employees that cause direct impact upon the
overall supply chain.
It has been also identified from the above section that there are many changes identified
if the sustainable procurement has been implemented, but health and social care must implement
the strategy to overcome such

REFERENCES
Books and Journals
Ahsan, K. and Rahman, S., 2017. Green public procurement implementation challenges in
Australian public healthcare sector. Journal of Cleaner Production, 152, pp.181-197.
Aragão, C.G. and Jabbour, C.J.C., 2017. Green training for sustainable procurement? Insights
from the Brazilian public sector. Industrial and Commercial Training.
Chiarini, A., Opoku, A. and Vagnoni, E., 2017. Public healthcare practices and criteria for a
sustainable procurement: A comparative study between UK and Italy. Journal of
Cleaner Production, 162, pp.391-399.
De Soete, W., and et.al., 2017. Challenges and recommendations for environmental sustainability
assessments of pharmaceutical products in the healthcare sector. Green Chemistry,
19(15), pp.3493-3509.
Gelderman, C.J., Semeijn, J. and Vluggen, R., 2017. Development of sustainability in public
sector procurement. Public Money & Management, 37(6), pp.435-442.
Ghadge, A., and et.al., 2019. Sustainable procurement performance of large enterprises across
supply chain tiers and geographic regions. International Journal of Production Research,
57(3), pp.764-778.
Islam, M., and et.al., 2017. Do sustainable procurement practices improve organizational
performance?. Sustainability, 9(12), p.2281.
Kannan, D., 2021. Sustainable procurement drivers for extended multi-tier context: A multi-
theoretical perspective in the Danish supply chain. Transportation Research Part E:
Logistics and Transportation Review, 146, p.102092.
Kaur, H. and Singh, S.P., 2018. Heuristic modeling for sustainable procurement and logistics in a
supply chain using big data. Computers & Operations Research, 98, pp.301-321.
Kaur, H. and Singh, S.P., 2019. Sustainable procurement and logistics for disaster resilient
supply chain. Annals of Operations Research, 283(1), pp.309-354.
Mousa, S.K. and Othman, M., 2020. The impact of green human resource management practices
on sustainable performance in healthcare organisations: A conceptual framework.
Journal of Cleaner Production, 243, p.118595.
Roman, A.V., 2017. Institutionalizing sustainability: A structural equation model of sustainable
procurement in US public agencies. Journal of cleaner production, 143, pp.1048-1059.
Zaidi, S.A.H., and et.al., 2019. Addressing the sustainable development through sustainable
procurement: What factors resist the implementation of sustainable procurement in
Pakistan?. Socio-Economic Planning Sciences, 68, p.100671.
Patrucco, A. S. and et.al., 2019. Which shape fits best? Designing the organizational form of
local government procurement. Journal of Purchasing and Supply Management. 25(3).
p.100504.
Hassan, H., Tretiakov, A. and Whiddett, D., 2017. Factors affecting the breadth and depth of e-
procurement use in small and medium enterprises. Journal of Organizational
Computing and Electronic Commerce. 27(4). pp.304-324.
Samuels, D., 2021. Government procurement and changes in firm transparency. The Accounting
Review. 96(1). pp.401-430.
Toppinen, A. and et.al., 2019. Internal and external factors of competitiveness shaping the future
of wooden multistory construction in Finland and Sweden. Construction Management
and Economics. 37(4). pp.201-216.

Zaidi, S. A. H. and et.al., 2019. Addressing the sustainable development through sustainable
procurement: What factors resist the implementation of sustainable procurement in
Pakistan?. Socio-Economic Planning Sciences. 68. p.100671.
Kristensen, H. S., Mosgaard, M. A. and Remmen, A., 2021. Circular public procurement
practices in Danish municipalities. Journal of Cleaner Production. 281. p.124962.
Skipworth, H., Delbufalo, E. and Mena, C., 2020. Logistics and procurement outsourcing in the
healthcare sector: a comparative analysis. European Management Journal. 38(3).
pp.518-532.
Meehan, J., Menzies, L. and Michaelides, R., 2017. The long shadow of public policy; Barriers
to a value-based approach in healthcare procurement. Journal of Purchasing and Supply
Management. 23(4). pp.229-241.
Belvedere, V., Grando, A. and Legenvre, H., 2018. Testing the EFQM model as a framework to
measure a company’s procurement performance. Total Quality Management & Business
Excellence. 29(5-6). pp.633-651.
Bakir, S. and et.al., 2018. Exploring the critical determinants of environmentally oriented public
procurement using the DEMATEL method. Journal of environmental management. 225.
pp.325-335.
Ahsan, K. and Rahman, S., 2017. Green public procurement implementation challenges in
Australian public healthcare sector. Journal of Cleaner Production.152. pp.181-197.
Chiarini, A., Opoku, A. and Vagnoni, E., 2017. Public healthcare practices and criteria for a
sustainable procurement: A comparative study between UK and Italy. Journal of
Cleaner Production. 162. pp.391-399.
de Souza Dutra, C. T., and et.al., 2017. Barriers and challenges to the sustainability requirements
implementation in public procurement of engineering works and services. Open Journal
of Civil Engineering. 7(1). pp.1-13.
Delmonico, D., and et.al., 2018. Unveiling barriers to sustainable public procurement in
emerging economies: Evidence from a leading sustainable supply chain initiative in
Latin America. Resources, Conservation and Recycling. 134. pp.70-79.
Ghadge, A., and et.al., 2019. Sustainable procurement performance of large enterprises across
supply chain tiers and geographic regions. International Journal of Production
Research. 57(3). pp.764-778.
Kannan, D., 2021. Sustainable procurement drivers for extended multi-tier context: A multi-
theoretical perspective in the Danish supply chain. Transportation Research Part E:
Logistics and Transportation Review. 146. p.102092.
Lăzăroiu, G., and et.al., 2020. Environmentally responsible behavior and sustainability policy
adoption in green public procurement. Sustainability. 12(5). p.2110.

Masase, W., 2018. Sustainable procurement challenges in the beverage industry in Zimbabwe
during the period 2014–2017. A case study of Delta Corporation, Lagers
division (Doctoral dissertation, BUSE).
Montalbán-Domingo, L., and et.al., 2019. Social sustainability in delivery and procurement of
public construction contracts. Journal of management in engineering. 35(2).
p.04018065.
Morioka, S. N., and et.al., 2017. Transforming sustainability challenges into competitive
advantage: Multiple case studies kaleidoscope converging into sustainable business
models. Journal of Cleaner Production. 167. pp.723-738.
Roman, A. V., 2017. Institutionalizing sustainability: A structural equation model of sustainable
procurement in US public agencies. Journal of cleaner production. 143. pp.1048-1059.
Online
The importance of sustainable procurement. 2020. [Online]. Available through:
<https://www.supplychaindigital.com/procurement/importance-sustainable-
procurement>.
How external factor affect procurement. 2021. [Online]. Available through:
<https://www.achilles.com/industry-insights/how-external-factors-can-affect-
procurement/>.