The NHS is under pressure to look beyond the purchase price of medical products and weigh patient outcomes and the wider cost of care, after value-based procurement won cross-party support in the House of Lords.
The backing came during debate on the Health Bill, where peers considered an amendment tabled by Labour's Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. The amendment would require ministers to report annually to Parliament on progress in adopting value-based procurement across the NHS and social care in England.
What the approach changes
Value-based procurement takes account of patient outcomes, clinical benefit and the downstream costs of care rather than the initial purchase price alone. According to the report, the approach is already being introduced across the health service following national guidance published in June.
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement exists to secure value for money but can do much more, describing the aim as moving away from always choosing the lowest price towards quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, run with health and hygiene company Essity, in which continence products matched to individual patient needs led to a 48% reduction in leaks and an 8% fall in product use.
Peers warn of false economies
Baroness Finlay, a professor of palliative medicine, praised the work of the Department of Health and Social Care's Medical Technology and Innovation Directorate and called for wider adoption across the NHS and social care. She argued that cheaper equipment can prove a false economy when it leads to complications or further treatment, with the resulting costs often falling on different NHS budgets.
She pointed to specialist cardiac pacemakers as an example of more expensive devices that can help prevent serious infections in vulnerable patients, potentially avoiding costly intensive care. Clinicians, she said, know that the cheapest option is not necessarily the best and understand the outcomes associated with particular devices, so that knowledge should be embedded in the tendering process.
Conservative peer and former health secretary Lord Lansley also supported the proposals, warning that rigid pricing thresholds could prevent more expensive products from being properly assessed for their wider benefits. Liberal Democrat health spokesperson Lord Scriven described the national guidance as a genuine step forward but cautioned that financial pressures could still encourage NHS buyers to favour immediate savings over better long-term outcomes.
Government response and monitoring
Health minister Baroness Merron reaffirmed the government's commitment to value-based procurement and confirmed that NHS Supply Chain had adopted a 'comply or explain' approach for future purchasing frameworks. She said the intention was for value-based procurement to become routine practice when NHS teams purchase medical devices, consumables and services. The government has also commissioned independent monitoring of the national guidance, with annual reports over the next three years to assess its impact.
Core List concerns
The debate also exposed questions over whether existing purchasing practice is consistent with the policy. Lord Hunt questioned NHS Supply Chain's recent decision to identify 79 additional product categories for potential inclusion in its Core List of standardised supplies, including urinary catheters and colostomy bags. He warned that these were highly personal products rather than standard commodities, and criticised the lack of prior consultation with relevant trade associations.
Baroness Merron acknowledged the importance of products being tailored to individual patients but did not directly address the proposed expansion of the Core List, leaving open how the NHS will balance greater standardisation with its commitment to clinically led, patient-centred procurement.
Chris Whitehouse, a health policy lobbyist whose agency Whitehouse Communications worked on the amendment with Essity, said there was now clear support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.