Abstract
Reverse exchange (RE) in dealing with the return, recycle and reuse of products is receiving a growing focus. When properly handled, RE in healthcare can deliver an economic benefit of cost minimisation and has extensive positive impacts on both human health and the environment (Li and Olorunniwo, 2008) but to date, RE research is mostly limited to pharmaceutical return. This paper investigates the potential for RE benefits in the UK National Health Service (NHS) supply chain for medical devices. Hearing aids supplied to adults with hearing loss are used as an illustrative example. This research applied a consensus approach through the use of dispersed nominal groups in order to obtain qualitative data on information, barriers, solutions and priorities to support findings. Findings illustrate that the end user behaviour of returning the device, and the requirement by NHS Procurement for manufacturers to meet RE targets are secondary to the importance of audiology departments who have the autonomy to design RE processes and successfully implement initiatives. A schematic highlighting the information and materials flow of the supply chain and the barriers and facilitators to RE is presented for hearing aid devices with potential for transferability to other small medical device supply chains.