How SME innovation directly improves outcomes for patients, staff and NHS systems

Small and medium‑sized enterprises (SMEs) play a vital role in supporting the NHS. They bring agility, innovation and strong value for money – qualities that are essential as the health service works to meet the ambitions of the 10‑Year Health Plan and respond to rising demand across elective recovery, digital transformation and community‑based care.

Around 85% of NHS suppliers fall into this category. SMEs can adapt quickly, innovate and problem‑solve creatively. This makes them uniquely placed to support better outcomes for patients, staff and local communities. SMEs cover a broad range of companies, from one-person set-ups to companies with 250 employees.

This blog explores why SMEs matter now more than ever – and how NHS SBS framework agreements make it easier for NHS organisations to access the outcomes they deliver.

Why SMEs matter to the NHS

SMEs offer strengths that directly support operational pressures and service improvements across the NHS:

• Innovation: SMEs often bring the bold ideas, digital tools and creative solutions that larger suppliers can struggle to deliver at pace.

• Flexibility and speed: With fewer layers of decision‑making, SMEs can tailor solutions quickly – a crucial strength for an NHS that needs to adapt rapidly to changing demands.

• Value for money: SMEs regularly offer cost‑effective, scalable options that help organisations deliver more with tight budgets.

These strengths align with key national priorities, including the new guidance ‘Doing business with the health sector: a guide for buyers and small and medium-sized enterprises (SMEs)’ the Procurement Act 2023, and the wider transformation agenda.

How NHS SBS framework agreements support SME access

Our framework agreements aren’t just about compliance and speed – they also create more opportunities for SMEs to succeed and enable the NHS to access their products and services compliantly.

• Pre‑approved supplier lists: We run all the due diligence upfront, so NHS buyers can choose from trusted SME suppliers without the hassle of long, complex processes.

• Faster, more efficient procurement: Clear documentation, call‑off routes and ready‑made terms reduce admin and give SMEs a fair chance to compete.

• Better visibility of innovation: Categories and listings make it easier for buyers to discover SME solutions they may not otherwise come across.

• Built‑in compliance: Every framework agreement aligns with public procurement regulations and NHS policy, meaning organisations can meet SME and social value commitments with confidence.

SME breakdown on NHS SBS framework agreements

• Business Services – 250 suppliers, 153 are SMEs, accounting for 61% of all suppliers
• Construction & Estates – 768 suppliers, 496 are SMEs, accounting for 65% of all suppliers
• Digital & IT – 242 suppliers, 143 are SMEs, accounting for 59% of all suppliers
• Health – 344 suppliers, 222 are SMEs, accounting for 65% of all suppliers

This strong SME presence gives the NHS a diverse, competitive marketplace that drives value, innovation and resilience.

Building a more diverse, resilient supply base

A thriving supplier landscape is essential to ensure continuity of services and reduce reliance on a small number of large vendors. SMEs bring healthy competition, local economic benefits and solutions tailored to community-based care – supporting ICS priorities around prevention, population health and local growth.

This is especially important as the NHS shifts toward more local, community‑focused care.

Final thoughts

SMEs are a crucial part of the NHS supply chain, offering innovation, flexibility and value. Through our framework agreements, we help these suppliers thrive, enabling NHS organisations to utilise their products and services to improve patient outcomes, support staff, strengthen local economies and accelerate transformation.

By making the most of SME innovation, the NHS can build a more resilient, efficient and future‑ready service.