Patrick Vernon

When people talk about health inequalities, they often focus on clinical services or public health interventions. But rarely do we talk about one of the most underused tools in our system: public procurement.

Every year, the NHS and local government spend billions on goods, services, and infrastructure. And yet, for decades, procurement has been treated as a back-office function – a technical, transactional activity rather than a strategic driver of change.

That mindset is shifting. And in Birmingham and Solihull, as part of the Children and Young People’s Health Equity Collaborative (CHEC) – a partnership between children’s charity Barnardo’s, integrated care systems, including Birmingham and Solihull, and the University College London Institute of Health Equity – they’re pioneering a growing movement that sees public spending not just as a necessity, but as a responsibility.

Originally tabled as an agenda item at the integrated care board, the idea of using procurement to release social value for child health equity sparked a conversation between senior responsible officer for CHEC in Birmingham and Solihull, Doug Simkiss, and the ICS’s procurement lead Simon Clarke, and inspired them to use the approach as a methodology for sustainable, whole system change.

Birmingham and Solihull ICS’s aim as part of CHEC is to maximise and embed social value and corporate social responsibility within procurement to support projects aimed at reducing health inequalities and improving the health and wellbeing of children and young people, including through action on the social determinants of health.

The idea is simple: if you’re spending public money, it must generate public value. That means embedding social impact into contracts, aligning procurement with the ICS’s 10-year health inequalities strategy, and ensuring that every pound spent helps build healthier, fairer communities.

It started with recognising the scale of the challenge. In Birmingham alone, 40 per cent of residents live in the most deprived parts of the UK, and more than one in three children live in poverty. These aren’t just statistics – they are indicators of deeply entrenched systemic disadvantage. And they demand bold, systemic responses.

This is where Simon and his team have stepped up. Through an innovative partnership with Match My Project, they’ve created a platform that connects suppliers with third-sector organisations delivering vital support in local communities. This isn’t about handouts. It’s about strategic alignment – ensuring suppliers are active partners in delivering on population health goals.

For too long, social value in procurement was vague, unmeasured, and optional. That’s no longer acceptable. Now, Birmingham and Solihull ICS’s suppliers are being invited – expected – to support projects that tackle poverty, improve access to food and housing, and reduce the social determinants of poor health, which are key if we are to create the healthiest generation of children the government has promised. They’re not just signing contracts; they’re signing up to a mission.

At Birmingham and Solihull, leadership is a priority within the ICB because the team understands that reducing health inequalities isn’t a job for one team or one programme.

The impact is already showing. Local charities and grassroots organisations – some working to reduce bed poverty, others supporting families in crisis – are benefiting from new resources, expertise, and networks. Suppliers are no longer passive participants in the health system; they are active collaborators in shaping a fairer future.

Birmingham Somali Action’s girls’ and boys’ football and basketball teams were having to travel outside of the city to find affordable training space, but they now have use of a supplier’s onsite gym and five-a-side pitch, while another has sponsored their kit and equipment.

This way of working has enabled a digital library to be set up, with suppliers donating their reconditioned tech for children and young people to borrow, including computers and tablets for homework, but also gaming stations and consoles.

Teaming up with one of the ICS’s hospital bed and mattress suppliers, Barnardo’s and Birmingham Voluntary Services Council have been able to double the number of beds, mattresses and bedding available to families living in bed poverty across the city.

An important part of this is to shift the perception of corporate social responsibility away from the classic volunteering day spent painting a fence or weeding a community garden.

Through Match My Project, skills and resources are being paired with need so the benefit can be maximised.

The financial team based in the UK of an international medtech supplier delivered financial education to children in schools in some of the most deprived areas of Birmingham, including about the consequences of taking out payday loans and of credit card debt. That team is now looking to deliver similar sessions in schools in Manchester, Glasgow, and Sheffield.

The next phase of this work focuses on supplier collaboration – bringing multiple organisations together to co-design and co-deliver community initiatives at scale. This shift from one-to-one relationships to collective action could be transformative.

The ambition is to see £2-£5m a year flowing from supplier partnerships directly into the third sector, generating measurable impact on the ground. But this isn’t just about numbers, it’s about values. It’s about redefining how we think about spending, accountability, and shared purpose.

Crucially, none of this works without leadership. At Birmingham and Solihull, it is a priority within the ICB because the team understands that reducing health inequalities isn’t a job for one team or one programme. It’s a system-wide responsibility, and procurement is one of the most powerful levers we have.

The NHS Constitution is clear: we exist to improve lives and reduce inequality. If we take that seriously, then procurement can no longer be neutral. It must be purposeful, strategic, and just.