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Ethical Threads: Rethinking NHS Workwear through the Values of Care

Author
Lewis Urquhart, Niki Taylor, Paul A. Rodgers, Lucy Welsh, Euan Winton and Sophia Murden
Book Title
Shaping the Future of Fashion
Publisher
Taylor and Francis Ltd
DOI
10.4324/9781003606987-26
Published
Jul 21, 2026

Hospital scrubs, worn daily by approximately 190, 000 NHS Scotland staff, are more than functional garments – they are material expressions of institutional values. Yet, their design and procurement have remained stagnant for decades, reflecting systemic neglect of sustainability, dignity, and ethical responsibility in public sector care. Current practices mirror fast fashion logics: rapid production, low-cost synthetics, and disposability, which externalise environmental harm and perpetuate exploitative labour conditions. This chapter reframes scrubs as ethical artefacts within care infrastructures, arguing that garment design mediates safety, comfort, and professional identity. Through a design-led, co-creative methodology, we interrogate how procurement models and material choices embody (or undermine) values such as attentiveness, justice, and ecological responsibility. By developing plant-based prototypes through participatory engagement with NHS staff, the study demonstrates how co-design can redistribute design authority, embed care ethics, and challenge extractive supply chains. These findings position scrub reform not as a technical upgrade but as a moral imperative: aligning healthcare workwear with principles of sustainability, workplace dignity, and global justice. In doing so, the project offers a pathway for institutional procurement to move beyond cost-driven metrics towards value-led frameworks that honour both people and planet.

Design HOPES is a collaborative design-led research initiative, comprising five Scottish Universities (University of Strathclyde, University of Dundee, Heriot Watt University, Abertay University, and the University of Edinburgh), NHS Scotland, the third sector, and design organisations.

This project is funded by the Arts and Humanities Research Council (AHRC) as part of the Future Observatory GTE Hub Programme at the Design Museum [grant number AH/Y00373X/1].

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