Cross-party support has emerged in the House of Lords for a wider shift in NHS procurement away from choosing medical products on price alone and towards assessing patient outcomes, clinical benefits and the longer-term costs of care.
The issue was raised during a debate on the Health Bill, where 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 in adopting value-based procurement across the NHS and social care in England.
Guidance already in place
Value-based procurement is already being introduced across the health service after national guidance was published in June. Under the approach, purchasing decisions are meant to take account of outcomes and the wider cost of care rather than only the initial purchase price.
Lord Hunt, a former health minister and longstanding advocate of the policy, said procurement existed to secure value for money but could achieve more. He argued that purchasing should move away from always selecting the lowest price and towards quality that improves patient outcomes.
He cited a pilot at South Tyneside and Sunderland NHS Foundation Trust, run with health and hygiene company Essity, in which continence products were matched to patients’ individual needs. According to his account, the pilot led to a 48% reduction in leaks and an 8% fall in product use.
Clinicians and tendering
Baroness Finlay, a professor of palliative medicine, backed the amendment and praised the work of the Department of Health and Social Care’s Medical Technology and Innovation Directorate. She 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. Specialist cardiac pacemakers, she said, illustrated how more expensive devices could 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 tendering.
Political support and ministerial response
Conservative peer Lord Lansley, a former health secretary, also supported the proposals and 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. She confirmed that NHS Supply Chain had adopted a “comply or explain” approach for future purchasing frameworks and said the intention 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.
Questions over standardisation
Despite the broad support, the debate 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. That left open how the NHS would 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 clear cross-party support for value-based procurement and a real desire to see it rolled out with momentum across the NHS in England.