The NHS is facing renewed pressure to weigh patient outcomes alongside purchase price when buying medical products, after the value-based procurement approach won cross-party support in the House of Lords.
The backing came during a debate on the Health Bill, in which peers considered an amendment tabled by Labour peer Lord Hunt of Kings Heath and supported by crossbench peer Baroness Finlay of Llandaff. The amendment would oblige ministers to report annually to Parliament on progress in adopting value-based procurement across the NHS and social care in England.
Rather than judging purchases on the initial price alone, the approach takes account of patient outcomes, clinical benefits and the wider costs of care. It is already being introduced across the health service following national guidance published in June.
A pilot in continence care
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement should secure value for money for the health service but could achieve more. The aim, he said, was to move away from always choosing the lowest price and towards quality that improves patient outcomes.
He cited a pilot run by South Tyneside and Sunderland NHS Foundation Trust with Essity, a global health and hygiene company, in which continence products matched to patients' individual needs produced a 48% reduction in leaks and an 8% fall in product use.
Cheapest 'not necessarily the best'
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 the approach to be adopted more widely across the NHS and social care. She argued that cheaper equipment could prove a false economy where 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 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.
The proposals also drew support from Conservative peer Lord Lansley, a former health secretary, 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 called the national guidance a genuine step forward but cautioned that financial pressures could still encourage NHS buyers to favour immediate savings over better long-term outcomes.
Minister confirms 'comply or explain'
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.
Questions over the Core List
Despite the broad support, the debate exposed disagreement over whether existing NHS 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 said 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 reconcile greater standardisation with its stated 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 clear cross-party support for value-based procurement and a genuine desire to see it rolled out with momentum across the NHS in England.