The NHS is being urged to weigh patient outcomes and the wider cost of care, not just the upfront price of medical products, after value-based procurement gained cross-party support in the House of Lords.
During a recent debate on the Health Bill, peers examined an amendment tabled by Labour peer Lord Hunt of Kings Heath and backed by crossbench peer Baroness Finlay of Llandaff. It 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 broader costs of care rather than focusing only on the initial purchase price. The approach is already being introduced across the health service following national guidance published in June.
Pilot points to patient-level benefits
Lord Hunt, a former health minister and long-standing supporter of the policy, said procurement should secure value for money but could achieve more. He argued that purchasing should move away from an automatic focus on the lowest price and toward quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, run with health and hygiene company Essity. Supplying continence products matched to patients’ individual needs led to a 48% reduction in leaks and an 8% fall in product use, according to the account given in the debate.
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 could be a false economy if it caused complications or further treatment, with the resulting costs often falling on separate NHS budgets.
She pointed to specialist cardiac pacemakers as an example of how more expensive devices could help prevent serious infections in vulnerable patients and potentially avoid costly intensive care. Clinicians, she said, understand that the cheapest option is not always the best and know the outcomes associated with particular devices; that knowledge should be built into tendering.
Political support and pricing concerns
Conservative peer Lord Lansley, a former health secretary, also supported the proposals but warned that rigid pricing thresholds could stop 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, while cautioning that financial pressure could still lead NHS buyers to prefer immediate savings over better long-term outcomes.
Health minister Baroness Merron restated 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 aim 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
The debate also exposed concerns about whether existing purchasing practice fits 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 said such items were highly personal products rather than standard commodities and criticised the absence 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. That left open how the NHS would reconcile greater standardisation with its stated 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 broad support for value-based procurement across political parties and a real desire to see it rolled out with momentum across the NHS in England.