Peers have called on the NHS to weigh patient outcomes and the wider cost of care, not just the purchase price of medical products, after value-based procurement won support from across the political parties in the House of Lords.
The subject came up during the recent debate on the Health Bill, when peers considered an amendment tabled by Labour's Lord Hunt of Kings Heath and backed by crossbench peer Baroness Finlay of Llandaff. Under the amendment, ministers would have to report to Parliament each year on progress in adopting value-based procurement across the NHS and social care in England. The approach, which takes account of patient outcomes, clinical benefits and the wider costs of care rather than the initial price tag, is already being introduced following national guidance published in June.
Pilot cited as evidence
Lord Hunt, a former health minister who has long advocated the policy, said procurement existed to secure value for money for the health service but could achieve more. The aim, he argued, was to move away from always choosing the lowest price and towards quality that improves patient outcomes.
He pointed to a pilot run by South Tyneside and Sunderland NHS Foundation Trust with Essity, a global health and hygiene company, in which continence products were matched to patients' individual needs. According to Lord Hunt, the pilot produced a 48% reduction in leaks and an 8% fall in product use.
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 extended more widely across the NHS and social care. She argued that cheaper equipment could prove a false economy where 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 more expensive devices that can help prevent serious infections in vulnerable patients and potentially avoid costly intensive care.
Clinicians, she said, are the people who know that the cheapest option is not necessarily the best and who understand the outcomes associated with particular devices, and that knowledge needs to be embedded in the tendering process.
Support and caution from other peers
Former health secretary Lord Lansley, a Conservative peer, also supported the proposals, warning that rigid pricing thresholds could stop 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 push NHS buyers towards immediate savings rather than better long-term outcomes.
Government commitment
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, 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.
Questions over the Core List
Despite the broad support, the debate exposed concerns about whether current NHS 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 said such items were highly personal products rather than standard commodities, and criticised the absence of prior consultation with the relevant trade associations.
Baroness Merron acknowledged that products need to be tailored to individual patients but did not directly address the proposed expansion of the Core List, 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.