From Commodity to Commons: Creating local eco-systems for the design of sustainable NHS garments in Scotland

This paper investigates the transformation of NHS Scotland garment systems through a design-led, commons-based localist framework that challenges prevailing globalised procurement models. Drawing on co-design methodologies and sustainable material innovation, this project repositions garments - specifically surgical caps and scrubs - as relational artefacts embedded within systems of care, identity, and ecological responsibility. Collaborations with healthcare professionals, designers, and regional manufacturers have yielded prototypes utilising regenerative fibres such as lyocell and linen, made locally within Scotland. These interventions demonstrate the potential of commons-design to foster civic engagement, decentralised production, and circular economies. By embedding garment systems within local ecologies and economies, the research advances a situated design paradigm that foregrounds care, stewardship, and institutional transformation. The paper argues for a conceptual shift from commodity-design to co-design and ultimately to ‘commons-design’, offering a replicable model for sustainable innovation in healthcare infrastructure that is both socially responsive and environmentally attuned.