The NHS is being urged to look beyond the purchase price of medical products and consider whether higher upfront spending could improve patient care and cut costs over time, after the argument drew cross-party support in the House of Lords.
The debate took place during consideration of the Health Bill, where peers examined an amendment tabled by Labour's Lord Hunt of Kings Heath and backed 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.
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 article, the approach is already being introduced across the health service following national guidance published in June.
Pilot results cited
Lord Hunt, a former health minister and long-standing advocate of the policy, welcomed the progress made. Procurement existed to secure value for money for the health service, he said, but it could do much more: 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 patients were given continence products suited to their individual needs. The trust recorded a 48% reduction in leaks and an 8% fall in product use.
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. Buying cheaper equipment could prove a false economy, she argued, 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 devices whose higher cost can help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
Clinicians, she said, know that the cheapest option is not necessarily the best, and their understanding of outcomes for particular devices needed to be embedded in the tendering process.
Cross-party concern over price thresholds
Conservative peer Lord Lansley, a former health secretary, 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.
Replying to the debate, health minister Baroness Merron restated 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. The intention, she said, 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.
Core List questions remain
The debate also exposed concerns about whether existing purchasing practice matches 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. Such items were highly personal products rather than standard commodities, he said, and he 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, leaving open the question of how the NHS will reconcile 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 support for value-based procurement across the political parties and a real desire to see it rolled out with momentum across the NHS in England.