The NHS is being urged to weigh patient outcomes rather than the sticker price of medical products, after the case for value-based procurement won support from peers across parties in the House of Lords.
The calls came during a debate on the Health Bill, in which peers considered an amendment tabled by Labour peer Lord Hunt of Kings Heath and backed by crossbench peer Baroness Finlay of Llandaff. The amendment would require ministers to report annually to Parliament on progress in adopting value-based procurement across the NHS and social care in England.
What the approach involves
Value-based procurement takes account of patient outcomes, clinical benefits and the wider costs of care instead of judging a purchase on its initial price alone. According to the debate, the approach is already being introduced across the health service following national guidance published in June.
Lord Hunt, a former health minister who has long advocated the policy, said procurement exists to secure value for money for the health service but "can do much more". The aim, he said, is 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 health and hygiene company Essity, in which continence products matched to patients' individual needs produced a 48% reduction in leaks and an 8% fall in product use.
Peers warn of false economies
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 taken up more widely across the NHS and social care. She argued that buying cheaper equipment could prove a false economy where it led to complications or further treatment, with the resulting costs often landing on different NHS budgets. Specialist cardiac pacemakers, she said, illustrated how more expensive devices can help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
"It is the clinicians who know that the cheapest is not necessarily the best," she said, adding that clinicians understand the outcomes associated with particular devices and that this knowledge needs to be embedded in the tendering process.
Conservative peer Lord Lansley, a former health secretary, 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" but cautioned that financial pressure could still push NHS buyers towards immediate savings over better long-term outcomes.
Minister sets out implementation
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. The intention, she said, is 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
Despite the broad support, the debate exposed concern about whether current purchasing practice is consistent with 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 warned that such items are 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, leaving open how the NHS will balance 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 "great support" for value-based procurement across political parties and "a real desire to see it rolled-out with momentum across the NHS in England".