The NHS is facing calls to look beyond the upfront price of medical products and consider whether spending 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 backing emerged during a recent 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.
What the approach changes
Value-based procurement takes account of patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone. According to the debate, the approach is already being introduced across the health service following the publication of national guidance in June.
Lord Hunt, a former health minister and longstanding advocate of the policy, said procurement existed to secure value for money for the health service but could do more. He argued the aim was to 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, run with health and hygiene company Essity, in which continence products suited to patients' individual needs led to a 48% reduction in leaks and an 8% fall in product use.
Clinical judgement and false economies
Baroness Finlay 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 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 and potentially avoid costly intensive care treatment.
A professor of palliative medicine, she said clinicians knew that the cheapest option was not necessarily the best and understood the outcomes for particular devices, adding that this needed to be embedded in the tendering process.
The proposals also attracted support from former Health Secretary Lord Lansley, a Conservative peer, 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.
Government response and standardisation concerns
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 purchased 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.
The debate also exposed concerns about whether existing NHS purchasing practices were 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 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 real desire to see it rolled out with momentum across the NHS in England.