Procurement category: Textile products and services

Environmental and social impacts targeted: Sustainable textiles, workers' rights. 

Relevant EU legislation/policy/guidance: EU GPP criteria on Textiles (2017) and the Technical background report, EU Strategy for Sustainable and Circular Textiles (2022). 

A leading hospital 

Ghent University Hospital (Universitair Ziekenhuis Gent or UZ Gent) is a leading academic medical institution at the frontline of healthcare, research, and innovation. Closely associated with Ghent University, both institutions are publicly funded and operate as autonomous entities of the Flemish Government. With a capacity of 1,049 beds, it is one of the largest hospitals in Belgium. Annually, it manages around 60,000 day-admissions, 36,000 multi-day patient stays, and approximately 35,000 emergencies. In 2023, the hospital counted over 1,400 doctors, over 6,900 employees and thousands of students on campus. UZ Gent aims to provide excellent and efficient clinical and hospital care tailored to patients’ needs, in line with the university's mission of education, research, and service provision.

Contributing to a more sustainable healthcare sector

UZ Gent is committed to making its organisational operations more ecologically, socially and economically sustainable, in line with the UN’s Sustainable Development Goals. The hospital is a signatory of the Flemish Government’s Green Deal for Sustainable Healthcare. Launched in March 2023, this voluntary agreement between the Flemish government and 150 partners promotes sustainable actions in the healthcare sector over three years. The hospital also has a sustainability policy which promotes the purchase of green energy, investments in solar panels and heat pumps, as well as cycling infrastructure and bicycle leasing for their employees. The catering services aim to limit food surpluses and offer vegetarian options, and employees’ break rooms are equipped with water taps to reduce the use of bottled water. UZ Gent is involved in several research projects on sustainability in the healthcare sector, including ones examining alternatives to single-use medical materials and devices and solutions to reduce the material footprint of hospitals. Ghent University Hospital has a sustainable procurement policy which takes into account responsible consumption, product design and the total cost of ownership of purchased goods and services. 

Procurement objectives: sustainable, socially responsible and comfortable workwear

In 2018, UZ Gent decided to replace the workwear of more than 4,000 hospital employees in line with its broader institutional commitment to sustainability and patient-centred care. Recognising the importance of staff’s visibility and comfort, the hospital’s new clothing policy also aimed to improve patient-staff interactions through clear visual distinctions among different staff roles, while fostering a welcoming environment. As conventional polyester-cotton blends used in hospital workwear have an environmental impact on water use and energy consumption, UZ Gent sought alternatives that would minimise its ecological footprint. Furthermore, given concerns about workers’ conditions in the global garment industry, the hospital aimed to ensure its supply chains respected international labour rights.

Pre-tender preparation: assessing staff needs and available solutions

Prior to launching the tender, UZ Gent undertook an internal needs assessment and preparation phase to ensure that the procurement aligned with both organisational goals and user requirements. It first reviewed its existing workwear situation and identified the limitations of the staff uniforms it had at the time. An internal consultation was conducted across hospital departments to gather input from medical and nursing staff, support services, the facility and logistics teams, procurement and sustainability officers. This consultation helped identify key functional and aesthetic needs, such as garment fit, thermal comfort, and the need for visual distinction between clinical and non-clinical roles among the staff. The hospital also conducted market research to assess available sustainable textile solutions. The findings from the internal and market assessments informed the development of technical and sustainability requirements for the tender documents. This ensured that the requirements were realistic, evidence-based, and aligned with both user needs as well as environmental and social priorities.

Procurement procedure 

In 2020, Ghent University Hospital initiated an open tender procedure for a structured, five-phase competitive negotiation procedure for a framework agreement for the design and provision of new workwear. The process was designed to identify the most environmentally and socially responsible supply options, as well as ensure staff comfort and functionality. 

Technical specifications

The UZ Gent employees are required to wear work clothing based on their job function. The clothing profile classification includes: 

• Care (nurses, technologists in medical imaging); 
• Doctors (including dentists and specialists in training); 
• Pediatrics; 
• Operating theatre (nurses, doctors, midwives, and perfusionists in the operating rooms); 
• Rehabilitation (Physiotherapists, occupational therapists, speech therapists, and podiatrists);  
• Laboratory (laboratory technicians and technologists); 
• Care support with risk (staff in roles with contamination risk, including cleaning, patient transport, logistics, CSA, pharmacy production, and technical services); 
• Care support (staff without contamination risk, such as dieticians, social workers, mediators, certain therapists, volunteers, and front office personnel). 

Based on these professional functions, the bidders had to design a coherent clothing line which enabled a distinction between the various staff profiles. 

Minimum requirements 

All garments had to be unisex and intended for year-round use by staff. While certain uniforms could be shared across different profiles, a clear distinction between healthcare and non-healthcare roles had to be visible. Based on the outcomes of the negotiations in phases 1 and 2, the design of these garments could be further refined. 

Selection criteria 

Prior to the five-stage negotiation process, the bidders had to complete a pre-qualification questionnaire to demonstrate their financial and economic standing, experience, and competence to undertake the project. The bidders had to submit a European Single Procurement Document (ESPD) confirming they are not subject to exclusion under Articles 67–69 of the Belgian Public Procurement Act of 17 June 2016. The bidders had to declare their average total annual turnover over the past three years. To demonstrate technical capability, the bidders had to provide a list of their main relevant deliveries from the past three years, including quantities, dates, and clients. And at least two references from hospitals, including one involving significant customisation without subcontracting. 

Four interested bidders submitted the questionnaire. However, one withdrew their application after being fully informed of the tendering process.

A five-stage competitive negotiation procedure 

The procurement was weighted towards sustainability and user experience, with price evaluated only at the final stage.

Phase 1 – Design Evaluation (40 points)

The three remaining bidders were evaluated across four key award criteria, each worth 10 points:

1. Environmental friendliness, CSR, and circularity (10 points): The bidders were required to complete a questionnaire regarding the traceability of their fabrics, the number of subcontractors, and the monitoring of labour conditions. The Bidders also had to present a concrete project or initiative demonstrating their contribution to sustainability or circularity within the textile industry.
    
2. Look and feel (10 points): The coherence and visual identity of the clothing line were assessed, including its ability to differentiate healthcare providers from support staff through colour schemes and modern designs.
    
3. Quality (10 points): The bidders had to send samples and prototypes of the workwear which met all the minimum requirements. The fabric samples and clothing prototypes were evaluated through laboratory washing tests for shrinkage, colour retention, and wear resistance. The garments had to withstand at least 120 industrial laundering wash cycles. The finishing quality of garments, such as seams, buttons, and reinforcements, were scrutinised post-washing.
    
4. Service provision (10 points): This criterion assessed delivery capabilities (e.g., timelines for initial and follow-up deliveries), and support mechanisms such as complaint handling, replacement of defective items, and a dedicated client contact point.

During this phase, the bidders were required to submit a first design for each required clothing item, a visual representation of the clothing line, sample fabrics, and prototypes of certain garments. Only the bidders who submitted the relevant documentation and samples could proceed to further evaluation. The bidders had to submit pricing as part of Phase 1, but this was not evaluated by UZ Gent until the final Phase. Only the two highest-scoring suppliers progressed to Phase 2, however, if either of these fell below the minimum required score for wear testing, the third highest-scoring bidder would be invited to complete Phase 2.

Phase 2 – Wear Testing (30 points)

The selected suppliers provided test garments for extensive user trials involving 700 hospital staff, who were not involved in the tendering process. Evaluation criteria included:

• Thermal comfort
• Freedom of movement
• Fit and suitability of unisex designs for functional roles

Each of the hospital staff involved in the testing scored the garments, and the average score contributed up to 30 points towards the final evaluation. The minimum required score was 22.5. While the evaluation of each staff member might be considered subjective, the results from the large representative sample of workers who tested the garments (around 10% of the total staff) provided the Contracting Authority with insights into the clothes’ performance. 

Phase 3 – Interim Offer

Following the feedback from wearer tests, both bidders were allowed to refine their technical and design offers in alignment with functional requirements developed during earlier phases.

Phase 4 – Best and Final Offer (BAFO)

The final designs were submitted along with calibration garments for approval. These garments served as quality benchmarks for future deliveries.

Phase 5 – Price Evaluation (30 points)

Price was assessed as the final criterion, worth 30 points. This included:

• The total estimated cost based on the estimated quantities of workwear.
• Optional variants, such as a 36-month rental model, were permitted.

Notably, sustainability and user experience were prioritised over cost until the end of the evaluation, reinforcing the hospital's commitment to responsible procurement.

Awarding the contract

The winning bidder, SARCO, a Belgian textile company, distinguished itself through its strong commitment to sustainability, product innovation, and supply chain transparency. In response to UZ Gent’s tender, SARCO proposed a workwear solution using Tecawork™ Ecogreen fabric, developed in collaboration with TenCate Protective Fabrics. This fabric blend composed of 65% mechanically recycled polyester and 35% lyocell met the hospital’s stringent environmental and functional requirements. SARCO also demonstrated good corporate social responsibility practices, providing detailed insight into its production processes and confirming compliance with International Labour Organisation (ILO) conventions through a signed declaration of honour. Furthermore, SARCO actively engaged in dialogue throughout the phased procurement procedure, refining its offer based on user feedback and laboratory testing. By supplying approximately 50,000 metres of sustainable fabric, SARCO enabled Ghent University Hospital to achieve a significant reduction in environmental impact, while delivering high-quality garments that met the expectations of over 4,000 hospital staff. The new hospital uniforms were introduced in October 2022. 

Results

The procurement of sustainable workwear at UZ Gent delivered notable environmental and social benefits, in line with the hospital's commitment to responsible purchasing.

Environmental Benefits

The selected fabric, Tecawork™ Ecogreen, is composed of 65% mechanically recycled polyester and 35% lyocell (LENZING™ branded) a blend with a lower environmental footprint compared to conventional polyester-cotton textiles. Cotton is a water-intensive crop, with an estimated water footprint of 994 litres per kg of fibre. In contrast, lyocell production requires just 46 litres per kg, resulting in an estimated 95% reduction in water use in the production phase. Through this procurement, the hospital avoided the use of an estimated 514,000 m³ of water.

The use of mechanically recycled polyester (derived from post-consumer PET bottles) instead of virgin polyester reduces energy consumption by 45%, water consumption by nearly 20%, and CO₂ emissions by over 30%. This tender prevented the emission of 22,185 kg of CO₂ and repurposed approximately 483,325 PET bottles, promoting circular practices in this textile production. Furthermore, lyocell fibres are produced in a closed-loop system. The chemicals used in the process to transform eucalyptus and other FSC- or PEFC-certified wood pulp into lyocell are non-toxic and environmentally benign. 

Unlike conventional cotton and virgin polyester, which often use hazardous chemicals and pesticides, both components of the Ecogreen fabric are certified to meet rigorous environmental and human safety standards (e.g. REPREVE® certification for recycled content, SCS certification, and Oeko-Tex Standard 100 pending).

Benefits for the staff

The blended fabric helped to improve staff comfort. For instance, the lyocell fibres absorb 50% more moisture than cotton and dissipate it quickly, offering a cooler and drier feel, an essential property in warm hospital environments. The fabric demonstrated high tensile and tear strength and withstood industrial laundering at 75°C with minimal shrinkage (of less than 2%), when set at the right laundering and tumble drying settings. This resistance ensures a longer lifespan for each garment. The unisex garments provided good fit, breathability, and visual differentiation among hospital roles, contributing to both staff comfort and patient clarity.

Social sustainability

The winning bidder was required to demonstrate supply chain transparency and compliance with the International Labour Organisation (ILO) conventions. SARCO, the winning supplier, submitted a declaration of honour affirming adherence to labour rights and demonstrated an understanding of conditions throughout their subcontracting chain. While it is difficult to trace workers’ conditions along global supply chains, the commitment of the Contracting authority and supplier to decent working conditions can help to send a signal to other industry stakeholders. 

Lessons learned

Through this procurement procedure, UZ Gent demonstrated that it is possible to find sustainable and socially responsible alternatives to conventional materials used in the healthcare sector.

• Staged evaluation enables learning: The five-phase approach allowed bidders to develop their solution, fabric testing, and stakeholder engagement, which led to more informed decision-making.

• Sustainability should precede price: Deferring price evaluation to the final phase ensured that quality,  environmental and social performance were prioritised without compromising value for money. The Contracting Authority was willing to pay the price for a more sustainable product. The offers from the two final bidders differed by a mere € 3,000 and both met the sustainability requirements. 

• Promoting innovation: Not specifying a fabric from the outset encouraged market innovation. The successful bid proposed an alternative blend previously untested in the Belgian healthcare sector.
• Cross-disciplinary collaboration: The inputs from clinicians, procurement officers, patients, and experts informed the process and helped mitigate risks (e.g. shrinkage concerns were resolved through expert laundering calibration).

More information

For related information, please see the EU GPP criteria on Textile (2017) and the Technical background report, and the EU Strategy for Sustainable and Circular Textiles (2022). 

Tender documents are available online on TED.