Imagining a circular healthcare system
Co-creating a board game with healthcare professionals and citizens to imagine a more circular, climate-resilient future for NHS Scotland.
CLIENT
V&A Dundee
YEAR
2025
DELIVERABLE
Speculative board game
Co-creating a board game with healthcare professionals and citizens to imagine a more circular, climate-resilient future for NHS Scotland.
CLIENT
V&A Dundee
YEAR
2025
DELIVERABLE
Speculative board game
How might NHS Scotland adapt to the climate emergency while protecting quality of care?Healthcare is materials-intensive and systemically complex. From scrubs and surgical scissors to logistics and laundry, today’s mostly linear flows lock in waste, risk and cost. As NHS Scotland approaches its centenary in 2048, we asked: what would it take to shift toward circular, resilient ways of making, using, maintaining and recovering resources?
The V&A Dundee are Scotland's design museum. They are on a mission to inspire and empower through design, and advocate for the power of design shaping our daily lives. V&A Dundee brings design from all over the world to Scotland and gives a new platform to Scottish designers.
We worked with V&A Dundee as part of Design HOPES — an AHRC-funded Green Transition Ecosystem exploring sustainable design in health and care. Together, we set out to create a participatory tool that could help NHS staff and the public think systemically about how climate and circularity intersect in healthcare.
The result was Circulate: a speculative board game that turns complex systems into a space for play, collaboration, and imagination. Co-created with NHS staff, healthcare practitioners, and citizens, the game draws on design fiction to explore how healthcare systems might evolve under climate duress. Through a series of cards, boards, and prompts, players collectively navigate plausible future scenarios and reimagine how everyday materials — from surgical instruments to medical textiles — could move through circular lifecycles of Make, Use, Maintain, and Recover.
The design process was iterative and hands-on. We prototyped the game in multiple workshops at V&A Dundee, bringing together clinicians, estates and procurement staff, sustainability leads, and members of the public. Each session tested different mechanics and storylines, helping us balance accessibility with depth. We also designed the game in both analogue and digital formats, with an accompanying facilitation toolkit to support use in education, training, and exhibitions. Sustainability was embedded throughout: materials were locally produced, recyclable, and designed for open-source distribution.
An open-source game for anyone to play
The final version of Circulate is available as a free, open-source toolkit — adaptable for NHS workshops, classrooms, or public engagement. Designed to be simple, tactile, and collaborative, the game provides an accessible entry point into the complexities of circular healthcare systems.
New innovations shaping NHS thinking
The ideas generated through gameplay are already influencing NHS practitioners and policy teams. By visualising interdependencies and constraints, participants have begun rethinking how equipment, textiles, and services could be designed for reuse, repair, and regeneration. These insights are informing new discussions around procurement, operations, and climate adaptation.
Public engagement and exhibition
Circulate is now part of V&A Dundee’s Design HOPES programme, presented as a playable mini-game within the museum’s public exhibitions. This extends Design HOPES’ broader mission to engage citizens in Scotland’s green transition — inviting visitors to imagine what a sustainable, circular NHS could look like by its 100th year.
Early workshops focused on rapid paper prototyping, inviting participants to literally hack the game. Using pens, sticky notes, and scissors, players drew directly onto boards and cards — adjusting rules, clarifying stories, and adding depth to content. This hands-on method helped surface unspoken assumptions, test what resonated, and shape the final mechanics. The result was a co-created game that feels lived-in, intuitive, and grounded in real NHS experience.
.jpg)
