The NHS is facing renewed pressure to look beyond the initial price of medical products and consider whether higher upfront spending can improve patient care and reduce costs over time, after value-based procurement won cross-party support in the House of Lords.
The issue arose 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 towards adopting value-based procurement across the NHS and social care in England.
Value-based procurement takes account of patient outcomes, clinical benefits and the wider costs of care rather than simply the purchase price. The approach is already being introduced across the health service following national guidance published in June.
Pilot cited as evidence
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement should secure value for money but could achieve more. He argued that purchasing should move away from always choosing the lowest price and towards quality that improves patient outcomes.
He pointed to a pilot at South Tyneside and Sunderland NHS Foundation Trust, conducted with health and hygiene company Essity, in which continence products were matched to patients’ individual needs. The pilot led to a 48% reduction in leaks and an 8% fall in product use, he said.
Baroness Finlay, a professor of palliative medicine, also backed the approach and praised the work of the Department of Health and Social Care’s Medical Technology and Innovation Directorate. She argued that buying cheaper equipment could prove a false economy if it led to complications or further treatment, with the resulting costs often falling on different NHS budgets.
She cited specialist cardiac pacemakers as an example of how more expensive devices could help prevent serious infections in vulnerable patients, potentially avoiding costly intensive care treatment. 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 tendering.
Political support and caution
The proposals also drew support from former Health Secretary and Conservative peer Lord Lansley, who warned 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.
Responding to the debate, health minister Baroness Merron reaffirmed the Government’s commitment to value-based procurement. She confirmed that NHS Supply Chain had adopted a “comply or explain” approach for future purchasing frameworks and said the intention was for value-based procurement to become routine when NHS teams bought 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 questions remain
Despite the broad support, the debate exposed concerns about whether existing NHS purchasing practices are 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 questions over how the NHS would balance greater standardisation with its commitment to clinically led, patient-centred procurement.
Health policy lobbyist Chris Whitehouse, whose agency Whitehouse Communications worked on the amendment with Essity, said there was now strong support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.