The NHS is being urged to look beyond the purchase price of medical products and consider whether spending more upfront could improve patient care and save money in the long run, after the value-based procurement approach won cross-party backing in the House of Lords.
The support came during a recent 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 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 weighs patient outcomes, clinical benefits and the wider costs of care rather than the initial purchase price alone. The approach is already being introduced across the health service following the publication of national guidance in June.
Pilot evidence cited
Lord Hunt, a former health minister and long-standing advocate of the policy, said procurement existed to secure value for money for the health service but could do much more. He argued for moving away from always choosing the lowest price 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.
Clinicians 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, potentially avoiding costly intensive care treatment. A professor of palliative medicine, she said clinicians know the cheapest option is not necessarily the best and understand the outcomes associated with particular devices, adding that this must be embedded in the tendering process.
Political support and caution
Former Health Secretary Lord Lansley, a Conservative peer, 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 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 purchase 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 concerns
The debate also 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, leaving questions over how the NHS would balance greater standardisation with its 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 support across political parties for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.