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Describing the supply chain for medical consumables used in the UK National Health Service (NHS), this case covers a hospital trust and the distribution centres of a wholesaler and two major manufacturers. It focuses on a hospital that uses a modern ward stock management system, but an old paper-based system for its operating theatres. The supplies manager needs to reduce expenditure to match annual targets. NHS culture and priorities make this a unique operations management challenge, with a complex supply management task in a government-funded service organisation. Descriptive information portrays an overall picture of the business issues that exist at both strategic and tactical levels, enabling students to understand a range of issues within supply chain management, including: (1) mapping to review supply chain complexity, inventories and lead times; (2) improving the speed and value of communications; (3) management of risk and costs; and (4) the importance of customer/supplier relationships.