The power of repurposing: How smaller manufacturers helped the UK withstand COVID-19’s first wave

As COVID-19 battered Britain’s economy and threatened to overwhelm the NHS, many small- and medium-sized manufacturing firms regrouped, repurposed and provided the vital materials the country needed. How did they do it, and when a new crisis arises, could they do it again?

‘In a few short months, companies adapted and repurposed their manufacturing operations in support of the NHS and the national need.’ Image: Amy Reinecke/Institute for Manufacturing

By Charles Boulton, Tim Minshall and Jason Naselli

By the middle of March, the scale of the COVID-19 pandemic, and its potential impact on the UK economy and healthcare system, was becoming abundantly clear. Graphic news stories coming in from Italy emphasised how serious the situation could become if action was not taken.

As predictions and models showed that COVID-19 demand could quickly overwhelm the NHS supply of ventilators, the government issued the Ventilator Challenge to spur domestic production. Soon, the country was in lockdown, with the prime minister’s announcement that people must stay at home.

For many small manufacturing businesses, there was a palpable sense of crisis and frustration. Despite the introduction of the furlough scheme, many were facing hard decisions about how best to survive; yet many wanted to offer support to the strained healthcare system.

Meanwhile, a parallel sense of urgency was being felt around the NHS. While the Ventilator Challenge was successfully increasing capacity for this critical equipment, news was spreading about shortages of personal protective equipment (PPE). Social media was alight with requests from hospitals, care homes, GPs and hospices.

Centralised systems were being established to catalogue available production capabilities and offers of help. But, despite these efforts, in March, the UK did not have the domestic production capability necessary to meet these emerging needs, particularly for PPE.

Yet, in a few short months, there was a remarkable response. Companies adapted and repurposed their operations in support of the NHS and the national need. Supplies held up, and fears of the health service being overwhelmed were allayed. Though estimates vary widely, the government has claimed that, under its PPE strategy, the majority of PPE demand will now be met by domestic manufacturing, compared to less than one per cent before March.

How did such a response come together so quickly? What does the experience during the initial wave of coronavirus say about the capacity of UK manufacturing to repurpose? And how could this inform decisions and choices in the next crisis?

We analysed a database of over 70 COVID-related manufacturing repurposing projects, reviewed the many examples signposted by others, and selected particular examples of PPE manufacturing for deeper research. For each of the selected projects, we interviewed central figures and drew upon evidence captured from secondary sources.

Our report provides an insight into the role that such rapid manufacturing repurposing has played in helping to address supply chain crises during COVID-19, but also highlights the difficulties that needed to be overcome along the way. It recounts what was in many respects an extraordinary achievement on the part of smaller UK manufacturing firms, while offering lessons to government and industry on how such resilience can be cultivated as we head into an uncertain 2021.

We’d like to help — but how?

Prior to March, most PPE used in the NHS was produced abroad. But as global demand overwhelmed supply chains, and as the need for PPE grew, it became clear that the UK was going to have to develop its own supply — almost from scratch.

In these fraught early days, there was a clear willingness to help from many corners. Everywhere, however, the question was the same — we’d like to help, but how? The UK government had set up websites for companies to register their capabilities to supply certain products, but the task of rapidly reviewing all the offers of help quickly became overwhelming.

Many companies mobilised to donate any PPE they already had in-house. Companies like Midton Acrylics, in Lochgilphead in the west of Scotland, gathered all the PPE they could find. ‘As we furloughed our staff and closed our sites, the obvious thing to do was donate what we could to where it was most needed,’ explains Craig Cameron, managing director.

For some companies, the call to action was personal. Jon Tolley, then-managing director of Prime Group, a firm that works in plastics and printing, received a call from his wife, on the front line of intensive care. She told him they were running out of PPE, and asked if there was there anything he could do.

Surely, thought Tolley, they could make something like the protective visors that were now so scarce? He asked if there was a sample from which they could work. Without spares, they were informed they would have to work off of a disinfected used visor, but by early afternoon, they had their sample. Working overnight to set up the machines, by 6 am the next day the team had a production prototype and by early evening they were delivering the first batch to the hospital.

Other companies faced a battle for survival. ‘Customers were not only cancelling future orders; they were asking us not to ship completed goods,’ says Leon Edwards of Display Mode. ‘We make point-of-sale display fittings for retailers and brands, and with lockdown in place, everything stopped.’ And nobody knew how long lockdown would last. ‘We needed to find a way to help and a way to survive.’

Midton Acrylics were also facing an uncertain future. Their core business is making sculptures for events such as the Royal Television Society awards. As the coronavirus pandemic spread across the UK and amidst a pervasive sense of gloom, with few events and little to celebrate, they knew that they were about to see a massive downturn in that business.

Craig Cameron and his colleagues contacted their suppliers about securing parts for a switch to visor production. In parallel, they set up a crowd-funding appeal and publicised their efforts on social media. But the donations began as their small local community pulled together.

‘It was fantastic,’ recalls Cameron. ‘We put a blue bin out the front and so many people from nearby donated raw materials; thousands of sheets of acetate and also the things we just couldn’t source from elsewhere — elastic, foam and so on.’ Using a quarantine system for safety, the donations were then assembled by staff volunteering to help, and the visors were donated to the nearby hospitals. In three-and-a-half weeks, they made some 10,000 disposable visors.

‘I don’t think most people in the town [previously] knew what we did on some anonymous industrial estate,’ says Cameron. ‘But suddenly we found the whole community donating raw materials. And, as a community, we felt we were pulling together to do something vital — and helping our local hospitals made it even more special.’

Lead learners chart the course

Just as important as the will and ability to deliver were the underlying capacity for innovation and knowledge of certification. Some organisations were able to access relevant knowledge of the medical product certification process to become ‘lead learners’, quickly finding a way forward and providing a pathway that others could follow more easily and more quickly.

Local alliances brought together teams from hospitals and local professionals with experience in the medical device industry. In Cambridge, the Makespace community, a volunteer-run organisation that shares space and manufacturing facilities for hobbyists and small-scale commercial prototyping, linked up with the clinical engineering team in the nearby Addenbrooke’s Hospital.

Ward Hills, a director of Makespace, says, ‘From running start-ups in Cambridge, some in medical device manufacture, many of us knew that before we started anything, we first needed to know what was wanted and how it would be accepted [by the health service] — otherwise we were wasting everybody’s time.’

Close links with Abi Bush, a clinical innovation engineer at Addenbrooke’s, who is also part of the Makespace community, provided the answer. Bush worked with her clinical and procurement colleagues and identified visors as an early priority for the hospital. Then she worked with the hospital’s clinicians and procurement team to decide how to set up a hospital acceptance process, because CE marking, the normal standard for acceptance of health and safety products, was out of the question in the timeframe.

Meanwhile, Hills was enrolling the wide network of the Makespace community, especially those with experience of developing and commercialising medical products.

Most medical equipment is carefully certified against defined specifications. In this way, hospitals can buy with confidence, needing only to check the certification. Meanwhile, companies can develop their designs to meet the specification, achieve certification and, importantly, show how they will manufacture the products, repeatedly and consistently, to the specification.

But what do you do when new and ad hoc organisations are starting to make new products, when lots of people want to help, and when it is clear that the specifications and certification system is too slow?

As the Addenbrooke’s and Makespace teams did, you dig into the specifications to understand which parts were the most important and essential to certification. This work, bringing together clinicians and engineers, was pivotal in understanding how to manage the risks, especially as more companies began to offer their manufacturing services.

The Makespace team also realised that, if they were to go into visor manufacturing based on donated supplies and using volunteers for assembly, then they needed to develop manufacturing processes, layout, guidance and task instructions so that they could achieve repeatable consistency as their volunteers came and went.

This turned out to be really useful. Building on an open-source visor design from the US, they assembled a ‘technical file’ that could accompany their products, and this documentation meant that the hospital could check and satisfy themselves that the products were being safely and consistently made. This template joined the visor design as part of the open-source package.

In addition, this template for a ‘technical file’ would enable other companies to quickly help the hospital, not just with any visors, but with visors from repeatable and traceable processes that could be quickly accepted and safely put into service.

Locally, other companies such as packaging designers and manufacturers Charpak and Firstan began to use the designs and templates to help.

Elsewhere, other companies were drawing on open-source designs and adapting them. Craig Cameron from Midton Acrylics says, ‘We picked up a design from 4C Engineering in Inverness, who were about a week ahead of us up the learning curve. [It] saved us having to develop our own.’ This design was then approved by the local hospital and supply began.

Prime Group, after their initial sprint to supply masks, explored how to scale up. They collaborated with Nottingham Trent University, developing open-source designs and learning about the technical documentation needs to get British Standards Institution (BSI) certification. All this information was then passed on to other companies struggling with the same issues.

Twenty-eight other companies picked up the visor design, locally and internationally, further customising it to their local needs and capabilities. And so the network of supply grew.

While most design modifications were made to suit new entrants’ manufacturing capabilities, in some cases, the new designs of PPE offered improvements for all.

David Nieper, a designer and manufacturer of fashion garments, turned their attention to scrubs and surgical gowns. They looked at the current designs and made a few quick changes, enlarging the pockets in the scrubs, changing fastenings, and making them easier to put on. They even came up with a design, the ‘parachute style’, that makes it easier for doctors and nurses to remove the gowns while minimising the chance of contamination as they disrobe.

Meanwhile, companies known for their innovation were being asked for help.

MarchantCain, an engineering design consultancy, were approached by the Coventry and Warwickshire Local Enterprise Partnership in the early days of the Ventilator Challenge. MarchantCain knew enough about the science and engineering of medical devices and the regulatory regime for safety-critical equipment to recognise that there were others much better able to lead in the development of ventilators.

But, as Pam Cain puts it, ‘We’re known for our innovation, so we thought surely there was something we could do to help. And for us, social media provided the links to a problem where we could help a lot.’

Via contacts made through social media, MarchantCain worked closely with the NHS in Northern Ireland on the issue of how to help the deaf and hard of hearing, for whom masks prevent lip-reading. Their research had also flagged up the issues of mask fit and discomfort, especially for NHS staff wearing masks for long shifts every day. So MarchantCain developed new designs and prototypes for FFP3 masks. In their particular case, raw material supply issues prevented manufacture — but the designs remain.

Lessons

· ‘Lead learners’ are invaluable. In the PPE response, they were the source not only of designs, but also of manufacturing processes and quality systems that became a template for others. Instead of everybody finding their way in the dark, identify the key organisations able to build a torch — and then disseminate instructions for torches.

· There is a lot of tacit knowledge hidden within the process of specification and certification that underpins the efficiency of everyday life. When a crisis means that things need to be made fast and unconventionally, it becomes vital to understand what, exactly, are the key and prioritised requirements that those products must fulfil for them to be useful and adequately safe. Establishing those baseline requirements and sharing them between new manufacturers and the people who will use the products really speeds up the creation and adoption of interim measures.

Lead learners chart the course. Image: Amy Reinecke/Institute for Manufacturing

Crisis and opportunity

Not everyone approached their coronavirus response as a short-term fix. As some companies were seeing their demand plummet, they realised a complete shift would be a way to save and even grow the business. These companies also realised that volunteers would not be able to scale their efforts and many temporary suppliers would return to their core offering once the crisis eased. Only the determined would still be there for the next wave.

Display Mode, which supplies retail display fittings, were seeing customers cancel orders, and as lockdown effects rippled across the country, it was clear that this was going to have a profound impact. But they were not in despair. ‘If you can think it, our team can make it,’ says managing director Leon Edwards confidently. Rather than shut the business and hope to survive, they explored a complete change of direction, moving into visor manufacturing.

They recognised that this move would require speed and adaptability, but they also quickly realised that, if the business was going to be sustainable, quality and cost-effectiveness would soon become vital. They set about using their internal design and prototyping capability, repurposing machinery, and building new supply chains to create a product that would meet spec, consistently and reliably, at a competitive cost. Product and process design went hand in hand, and as they explored the available open-source designs, assessing and adapting processes, they always had these ends in sight.

Realising that material supply chains would be the bottleneck — and were quickly becoming more precarious — the team sought raw material supplies from all over the world. Some of these new relationships would turn out to be a robust basis for the new business, while others didn’t work so well. Finding the mix of responsiveness and quality in those early days was not easy. Not everybody who claimed to be able to supply was able to deliver.

Outsourcing some of the manufacturing process was considered by Display Mode, but it proved difficult to find the required commitment and agility from third parties, and was deemed too risky. This was particularly true as it became clear that so many companies were on steep learning curves, but not all were managing it. Many potential suppliers and partners did not understand this new world.

Fortuitously for Display Mode, some years earlier, the operations manager had bought an old roller press, primarily as a fallback resource — but this ancient machine now provided a foundation for the new processes. They have now bought nine more of these machines from Poland, both old and new, and from this foundation the company has built a new line of business.

Another company making a major change in direction was LJA Miers, specialists in the conversion and lamination of rubber, foam, plastic and fabrics. Though they worked primarily in the automotive and industrial sectors, via a contact from one of their machine suppliers they found themselves in touch with Addenbrooke’s Hospital and an order for 100,000 visors.

‘At the time, we thought that was colossal,’ says Tony Barber, their sales director. But as they developed their designs in collaboration with Addenbrooke’s and gained CE approval they realised the magnitude of the need was far greater. They scaled up their manufacturing but, like others, found it hard to get confirmed orders to match their available capacity, as a fragmented procurement system struggled to match rapidly growing local needs with new suppliers.

Here, serendipity played a role, as a chain of informal connections eventually led to the procurement director of a hospital trust in Wales, who placed a major order. Further links of contacts enabled other orders, and thus expansion.

LJA Miers have now built on this to explore manufacturing other devices for the medical sector. The agility they developed in serving the demanding and deadline-driven automotive industry has been vital, together with the capacity to innovate in new products. ‘We demonstrated we could shift across to a new market, develop the products and even help people who have been in these markets for years,’ says Barber.

Berry-BPI was in a slightly different position. Their business, revolving around polythene sheeting, was already linked to the health service, and they supplied most of the clinical waste sacks used in UK hospitals. As orders from other industries dried up and staff were furloughed, they reflected on how to respond.

A front-line consultant told her husband, who worked at Berry-BPI, that they desperately needed aprons as supplies ran short. And so Berry-BPI shifted wholeheartedly into making single-use long-sleeved aprons.

Knowing the material so well, the team focused in on a short-term solution very quickly. But extra help was needed. So networks of contacts kicked in. Based in the Midlands and knowing the automotive sector, they contacted automotive suppliers for help with cutting the material while Berry-BPI completed the manufacture and distribution. Within a fortnight, their systems were up and running.

But more was needed. Automation is the only way to manage the volumes — and new machines take 4–5 months to arrive.

Such high-volume, low-cost production of aprons as Berry-BPI was attempting has long since moved to China; indeed, several years earlier Berry-BPI had moved their own production to China, eventually selling the business to focus on products where they could add more value. But this history meant that their sales director could turn to old contacts to find unused automated machines and ship them in.

Setting them up in an empty factory in Scotland and using in-house resources to recommission the equipment, soon Berry-BPI was able to offer high volumes of locally sourced aprons. A short-term fix was transformed into a long-term solution as a result of a combination of networks of knowledge, local engineering capability, and the resources and willingness to invest in scaling up production.

Another company that reacted decisively was David Nieper. As well as its immediate response in shifting from fashion garments to the manufacture of gowns, Christopher Nieper, the managing director, identified another approach to the bottlenecks that were constraining supply. Rather than focus on increasing the ‘flow’ of gowns, they decided to try to increase the ‘pool’ of gowns by shifting from a mindset of single use to one of reusability. As he phrased it, ‘We have a limited capacity, so let’s not waste it by making disposables.’

From past contacts, Nieper was able to source the specialist textiles that meet the moisture penetration resistance needs of surgical gowns, not from thousands of miles away but from a Japanese-owned local manufacturer in the Midlands, Toray, whose site was originally established to serve European markets. Critically, this material can be washed and reused many times.

Coordination was vital. The University Hospitals of Derby brought their procurement team, current suppliers and laundries together with the team from David Nieper. Quickly, new options were created and designs developed, and the David Nieper designers provided ways to track how many times a gown had been washed.

The manufacturing team at David Nieper tuned their cutters and sewing machines to deal with the new materials and began production. Gradually they brought back furloughed staff as production ramped up, beginning with the most adaptable and multi-skilled people. And within only a few months they were supplying 25 hospitals, locally and further afield. As you’d expect of a fashion business, they were even able to customise the gowns, offering a variety of colour options to their customers. Local for local production flourished.

Lessons

· Recognise that most organisations and volunteer groups will not be able to sustain ‘crisis-mode’ for long, especially as restrictions are lifted and life returns to normal. But a few key businesses will make greater commitments and become valuable resources for the future. They are characterised by acting quickly, targeting ‘first mover advantages’ of credibility and cost effectiveness by designing quality products, by investing in equipment and by establishing robust supply chains to keep product flowing.

· The ability to repurpose manufacturing and the investment in new machinery is also underpinned by the ability to maintain and adapt it. Different companies have taken different approaches, but all are characterised by a focus on resilience — being able to develop, adapt, maintain and improve.

Supply chains are critical; so, eventually, is price

What these firms found was that the ability to adapt and repurpose was not the biggest issue facing UK manufacturers. Many companies were able to adjust their machinery, tuning it for new materials, and to set up new assembly sequences. Some firms, such as LJA Miers, a tier-two automotive supplier turned medical device manufacturer, scaled their new product lines simply by increasing their production capacity. Others scaled by adding automation.

Raw material supply came to dominate the attention of companies trying to produce masks and visors. As global supply chains stopped, and as national governments began to demand that supplies stay within their borders, so supplies became stretched.

When companies ramped up to supply at larger volumes, they found that their developed relationships became critical. For example, at Midton Acrylics, their excellent relationship with a long-standing Glasgow supplier helped keep materials flowing, even while major suppliers were forecasting eight-week lead times. ‘We found out how old friends could produce miracles, even when others were saying it was impossible,’ says Craig Cameron. Trying to source materials from abroad turned out to be tricky and expensive, without the guaranteed quality levels needed.

Others were having similar experiences. Trusted suppliers were able to help. But new suppliers, often from abroad, did not work out so well.

According to Leon Edwards of Display Mode, some of the material supply quality problems arose not from malice, but lack of knowledge. ‘Some suppliers simply didn’t know whether their materials would be fit for the new purposes we planned,’ he says. ‘But it was cash up front [to buy their materials] and somebody had to find out.’

Companies were taking risks, buying materials on long lead times so they could get started as soon as possible. In some cases, companies were buying ahead of the contracts so they could confidently accept jobs knowing that delivery was possible. Understandably, suppliers were demanding payment with the order (there was no time for complex credit checks) and without the ability to quickly value specialist assets, banks would not lend against raw materials.

So many small businesses chose to take financial risks in order to respond to the needs of the NHS and to keep hospitals and care homes operating.

Some of the companies that were moving fast and finding raw materials were running into other problems. They couldn’t get the significant orders for PPE that would enable them to use the volumes of visors they’d made and the supplies they had. Frustration was intense. So was media attention.

As Display Mode had thought, after quality and safety was established, price quickly became a critical factor again. ‘We knew that price would become important and [so] we tried to find ways we could scale,’ says Leon Edwards. And scale they did. From early orders of tens of thousands of masks, they ultimately made millions.

But the orders were hard won. Investing in machinery and in raw materials meant that companies were taking financial risks and they needed orders that reflected their new capacity. Small quantities of PPE supplied to local hospitals were ideal for the volunteer manufacturers, but now that the companies were up and running, they needed larger orders and visibility of future need.

For small companies that could not get effective access to the centralised procurement system, the only solution was manufacturing for those hospitals that were running their own procurement.

Lessons

· The network of material supply chains and logistics matter just as much as raw manufacturing capability. Find and address bottlenecks.

· Identify where the financial risks rest. Because of the challenges of global supply chains, much of the risk in the first wave was borne by the same small businesses that were critical to the response. Cash and visible continuity were two of the greatest concerns of the most deeply committed companies. As business owners invested to repurpose, they faced a need for cash to pay immediately for raw materials. And only with visibility of future need can a small business judge its ability to continue a product line.

· As time passes and enthusiasm wanes, and as the crisis ebbs and companies return to their ‘day job’, only the most focused will be able to continue to pursue a business in the supply of PPE.

It’s who you know

Robust information about PPE priorities, specifications, acceptance criteria, material supply chains and manufacturing capability was very hard to come by. There was plenty of information but much of it was conflicting and even contradictory, as many discovered. ‘I learned to cross-check everything I was hearing,’ says Edwards. The more newsworthy a story became, and the more people that were involved, the harder it became to discern the facts from opinions.

Part of the problem was simply the uncertainty, and the difficulty of communicating that uncertainty. Some figures were estimates; many were forecasts of an uncertain future. Seldom was it malicious, but often people just did not know. ‘The simple numbers were often misleading,’ says Alex Campbell of the Scottish Manufacturing Advisory Service (SMAS). ‘It was important to understand whether the figures we were hearing were from worst-case scenarios, point estimates from a model or an expert’s guess.’

Another factor was time. There were delays in the communication of information, so it was unclear whether much of it was up to date. Were these requests for PPE current or from last week? Or were they a combination of requests from several sources? And because the virus has an incubation period, did the information apply to now, or in two weeks’ time when things were expected to get worse?

As Lorcan Mekitarian, sales director of Berry-BPI, puts it, ‘As companies locked down and switchboards closed, knowing somebody’s mobile number became critical.’ The best networked people were able to find new partners to help with manufacturing, new sources of raw materials, and, importantly, were able to access the best sources of information.

Several organisations helped by signposting manufacturing capability and, because of their insights, were able to bring people together. For example, Make UK, the industry association for UK manufacturers, had a good network across the automotive sector, now at a standstill, and were able to link together companies with complementary skills. Make UK were also able to signpost the relevant standards and accelerate the manufacturing sector’s ability to help.

Other networks such as Medilink were very active in these early days, applying their in-depth knowledge and networks across the healthcare sector.

Knowing the companies mattered. ‘You need to know more than just what products they make; instead, it’s what capabilities they have and what they could make,’ says Charlotte Horobin of Make UK. ‘And that’s not usually on websites that are just focused on selling a product.’ Make UK is now encouraging companies to showcase capability as well as products.

Knowledge of the sector and its structure also proved to be vital. The team at SMAS knew that, for manufacturing gowns in the UK, assembly capacity wasn’t the issue. It was all about the convertors — the companies that make the material. The key to success here was to access the right point in the established supply chain and find out quickly from them where the bottlenecks would be — and how to overcome them.

‘It’s triage down the supply chain to understand what really matters,’ says Alastair Semple of SMAS. And, in cases such as the production of sterile gowns, the entire chain matters.

As well as learning what was needed, the UK needed to find what capabilities were available. And this was not just a central government problem. Companies also needed to find who could support them, and quickly. Here too there were learning curves.

Raw manufacturing capability was not enough. How fast people would move, how adaptable they would be, whether they would act first and resolve commercial issues later — all became critical to success. Speed, adaptability and helpfulness are not attributes stored in databases. But they were exactly the discussions being had as people sought help from their networks.

Lessons

· Personal networks matter — many success stories depended upon personal knowledge and insights built over many years of professional networking and relationship development.

· In-depth knowledge of capability (and not just of products) is critical. Even more important is knowing which individual organisations and people will actually rise to the challenge. Tacit knowledge trumps a database every time.

‘UK manufacturing can survive only by providing products and services that demand high quality and certification against agreed standards, and where price is not the only determinant.’ Image: Amy Reinecke/Institute for Manufacturing

As the urgency ebbs, what of the future?

In August, the initial crisis was ebbing, lockdown was over, in many sectors the economy was recovering, and people began to talk about ‘the new normal’.

The manufacturing companies who had made the greatest commitments looked at matters of viability and sustainability. The crisis had tested both supply chains and absolute capacity. Furthermore, new capabilities had been developed. Companies had adapted and built a new confidence in their ability to change direction, to adopt and develop new designs, and to reshape their manufacturing. ‘We built a new sector and its manufacturing capability, from scratch, and in only a few months,’ beams Jon Tolley of Prime Group.

Along the way, new networks were established together with new supply chains. Companies invested in machinery and automation and built their capability to develop and maintain their facilities. Importantly, company owners took commercial risks to respond to the crisis, creating capability ahead of demand, knowing that by doing so they could help the UK when most urgently needed and also build a future for their employees and businesses in an uncertain environment.

But when raw materials are on long lead times, when companies want to be sure they can deliver their orders, and when they need to invest, then they need confidence in the likelihood of new orders. One can’t simply turn orders on and off without destroying the new capabilities developed at such cost.

And looking to the future, a return to the presumption of global supply chains and a focus on initial minimum cost would lead, inevitably, to manufacture of PPE returning abroad and the decay of the new capabilities and the investments that underpin them.

David Nieper had thought about global supply chains and sustainability, including the carbon footprint of bringing single use gowns into the UK. This, together with recognising the extra resilience of short supply lines to UK manufacturers and the potential for multiple UK suppliers of surgical gowns, underpinned their argument for the adoption of reusable gowns.

But although they supplied some 25 hospitals at the peak of the crisis, there was never the centralised order continuity that would enable committed investment from the private sector to make the reusable option a long-term reality.

UK manufacturing can survive only by providing products and services that demand high quality and certification against agreed standards, and where price is not the only determinant.

A procurement system that focuses on price only inevitably works against a robust and resilient source of supply that can respond in emergencies. As the source of supply disappears, so do the capabilities that will allow adaptation to the new and unforeseen needs posed by the next crisis, whatever it may be.

The more nuanced the catalogue of requirements, quality, adaptability and responsiveness, environmental sustainability, and robustness of supply, the better able is UK manufacturing to respond to those requirements.

And the deeper and richer the established capability, the channels of supply and the networks of knowledge about where this capability lies and what it can achieve, the greater will be the UK’s capacity to respond to the next crisis.

Case studies

As part of the research for this article, the authors interviewed executives from small manufacturers and others involved across the UK to get their accounts of how they repurposed their manufacturing during the first wave of COVID-19.

Acknowledgements

The Institute for Manufacturing gratefully acknowledges the Gatsby Charitable Foundation for their support of this project.

The authors would like to thank the following people for their help:
Abi Bush, Cambridge University Hospitals NHS Foundation Trust; Alastair Semple, Scottish Enterprise; Alex Campbell, Scottish Enterprise; Carl Von Behr, University of Cambridge; Charlotte Horobin, Make UK; Chris Carter, Cambridge Makespace; Christopher Nieper, David Nieper Ltd; Craig Cameron, Midton Acrylics Ltd; Jon Tolley, Precision Proco Group; Kate Willsher, IfM Education and Consultancy Services; Leon Edwards, Display Mode Ltd; Lorcan Mekitarian, Berry-BPI Group; Georgia Semple, University of Cambridge; Pam Cain, MarchantCain Group Ltd; Tony Barber, LJA Miers & Co. Ltd; Ward Hills, Cambridge Makespace

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