Recycling healthcare: implementing circular economy in norwegian hospital procurement

• Environmental protection, resource conservation, cost savings are significant drivers • Lack of regulations, financial resources, entrenched habits, waste infrastructure key barriers • Lack of knowledge and awareness about procurement rules and CE practices also barriers • Hospitals resist changes due to perceived quality differences and established linear behavior • Enabling standardized tenders, stakeholder collaboration, reverse logistics key to transition The shift towards a Circular Economy is crucial for sustainable development in resource-intensive sectors such as healthcare. The healthcare sector's environmental impact is profound, with hospitals standing out due to their significant energy consumption and waste generation. This study examines how Circular Public Procurement (CPP) is understood, enacted, and experienced by key stakeholders in Norwegian hospitals. Through a review of CPP literature and qualitative interviews with hospital procurement actors and field-level managers, we identify critical drivers (e.g., environmental protection, resource conservation, and cost savings), as well as barriers (e.g., regulatory constraints, limited financial resources, linear economy routines, and infrastructure gaps). A key strength of the study lies in its comprehensive stakeholder analysis and its inclusion of a managerial perspective informed by frontline operational experience - an underexplored yet vital lens for understanding the practical challenges and opportunities in implementing CPP. This perspective reveals how procurement policies are co-shaped on the ground and how practitioners actively adapt and negotiate CE principles. Building on these insights, we propose a Circular Readiness Framework (CRF), offering both a conceptual tool for understanding systems transition and a diagnostic instrument for assessing hospitals' readiness for circular procurement.