The NHS is facing calls to look beyond the upfront price of medical products and weigh whether paying more initially could improve patient care and reduce costs over time, after the value-based procurement approach won cross-party support in the House of Lords.
The support emerged during a recent debate on the Health Bill, where peers considered an amendment tabled by Labour's Lord Hunt of Kings Heath and backed 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 assesses patient outcomes, clinical benefits and the wider costs of care rather than simply the initial purchase price. The approach is already being introduced across the health service following national guidance published in June.
Pilot points to measurable gains
Lord Hunt, a former health minister and longstanding advocate of the policy, said procurement existed to secure value for money but could achieve more. He argued the aim was to move 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, run with health and hygiene company Essity, in which continence products matched to patients' individual needs produced a 48% reduction in leaks and an 8% fall in product use.
Baroness Finlay, a professor of palliative medicine, echoed that support and praised the work of the Department of Health and Social Care's Medical Technology and Innovation Directorate, calling for the approach to be adopted more widely across the NHS and social care.
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 pointed to specialist cardiac pacemakers as an example of how more expensive devices could help prevent serious infections in vulnerable patients, potentially avoiding costly intensive care.
Baroness Finlay said clinicians know the cheapest option is not necessarily the best, and that their knowledge of outcomes for particular devices needs to be embedded in the tendering process.
Political and ministerial support
The proposals also drew support from former Health Secretary Lord Lansley, a Conservative peer, who warned that rigid pricing thresholds could stop more expensive products 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 push NHS buyers towards immediate savings over better long-term outcomes.
Responding to the debate, 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 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.
Standardisation concerns remain
Despite the broad support, the debate exposed concerns about whether current NHS purchasing practice is consistent with the policy. Lord Hunt questioned NHS Supply Chain's recent decision to identify 79 additional product categories for possible 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 tailoring products 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 cross-party support for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.