The NHS is under pressure to consider patient outcomes and long-term costs, not just the purchase price of medical products, after value-based procurement drew 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 in 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 focusing only on the initial 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 longtime advocate of the policy, said procurement had to deliver value for money but could do more. He argued for moving away from always choosing the lowest price and towards quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, conducted with health and hygiene company Essity. Providing continence products suited to patients’ individual needs led to a 48% reduction in leaks and an 8% fall in product use, he said.
Baroness Finlay, a professor of palliative medicine, echoed that support and praised the Department of Health and Social Care’s Medical Technology and Innovation Directorate. She called for wider adoption across the NHS and social care.
Finlay argued that cheaper equipment could be 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 more expensive devices that could help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
She said clinicians know the cheapest option is not necessarily the best and understand the outcomes associated with particular devices. That knowledge needed to be embedded in the tendering process, she added.
Political support and caution
Conservative peer Lord Lansley, a former health secretary, also supported the proposals. He 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.
Merron said the intention was for value-based procurement to become routine when NHS teams buy 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. Questions remain over 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 strong support for value-based procurement across political parties. He added that there was a real desire to see it rolled out with momentum across the NHS in England.